Tongue Cancer

What is cancer of the tongue?

Cancer of the tongue is a growth of abnormal cells on the tongue. If untreated, the tumor may spread throughout the tongue to the floor of the mouth, the gum (jaws), and the throat. As a tumor grows, it becomes more life threatening by spreading (metastasizing) to lymph nodes in the neck and later to the rest of the body.

The general term for this type of cancer is cancer of the oral cavity.

How does it occur?

Tongue cancer is one of the more common and serious types of oral cancer. It mainly occurs in people who smoke cigarettes, pipes, or cigars or use smokeless tobacco. People who drink large amounts of alcohol and use tobacco are especially at risk.

Tongue cancer is rare in people under age 40. It is also rare in people who do not use tobacco and alcohol. It happens most often after age 60.

What are the symptoms?

The tumor starts as a small lump, a thick white patch, or a sore (ulcer) on the tongue. It may or may not be painful or tender. Over time this lump turns into an ulcer with a firm, raised rim and a center that bleeds easily.

The tongue becomes rigid and hard to move if the tumor gets big enough to affect the muscle of the tongue. Eventually, the tumor may make it hard for you to swallow or talk.

If the disease is not treated, you may also have:

• pain
• bad breath
• drooling
• trouble eating
• trouble breathing
• trouble talking

How is it diagnosed?

Your healthcare provider will examine your tongue and mouth and ask about the history of the growth on your tongue, especially if you have had it longer than 10 days. You may have a tongue biopsy. For a biopsy, your tongue is numbed with an anesthetic and then a small tissue sample is removed from your tongue. The sample is tested to see if it is malignant (cancerous).

What is the treatment?

Your healthcare provider, usually a surgeon specializing in cancer treatment, will determine your treatment based on the spread of the cancer when it is diagnosed. Treatment is most successful during the early stages of the disease. Your healthcare provider, ear/nose/throat surgeon, and cancer specialist will determine the treatment based on the following factors:

• the stage (size and extent) of the tumor
• the location of the tumor.

Possible treatments are radiation therapy, surgery, and chemotherapy. They may be used alone or in combination:

• Radiation therapy to shrink the tumor. Radiation therapy may be the only treatment, or it may be combined with surgery and chemotherapy.
• Surgery to remove the tumor. Plastic surgery may also be desirable or necessary if tissue from another part of your body is needed to replace a part of the throat.
• Chemotherapy with or without radiation treatments and with or without surgery if the tumor is large and has spread. Chemotherapy is the use of anticancer drugs to destroy cancer cells and help stop them from spreading.

If tongue cancer is found at an early stage, these treatments may cure it. In advanced cases, treatment may stop the growth for a while and ease the symptoms.

Your treatment team will discuss the treatment plan with you and your family. Ask your healthcare provider to write down for you the stage of your cancer and the planned treatment. Having more than 1 method of treatment may help save your ability to swallow and speak as normally as possible.

Speech therapy is often part of the treatment, particularly if parts of your tongue, lymph glands, or jaw need to be removed to remove all of the cancer.

How long will the effects last?

The effects of tongue cancer depend on the stage at which the growth is found, the treatment, and your health.

• When tongue cancer is found and treated early, about 80% of people can be cured.
• When tongue cancer is found after it has spread into the lymphatic system, the cancer is more harmful. Ask your healthcare provider about the effectiveness of treatment for this advanced stage of the disease.

How can I take care of myself?

Talk to your provider about any concerns you have regarding the course of your illness and treatments. Ask about side effects you may have from radiation, surgery, or chemotherapy. You may want to make a list of questions at home and take it with you when you visit your provider. Ask a family member or friend to go with you who can listen, too. If you don't understand a word or concept, ask your provider to explain it. Take notes if you need to.

Follow these guidelines:

• If radiation therapy is part of your care, see the dentist recommended by your provider for special care before treatment starts.
• Be sure that dentures fit properly and that the edges of teeth are smooth so that they do not irritate your mouth or tongue.
• Do not use any type of tobacco.
• Avoid use of alcohol.
• Be sure you understand the treatments your healthcare provider orders. Ask questions and talk about your concerns with your provider.
• Keep all follow-up appointments with your provider.
• Take good care of your teeth and gums and have regular dental checkups, particularly if you have had radiation treatment.
• If possible, join a cancer support group during your illness and recovery.
• Maintain a hopeful and positive outlook throughout your treatment and recovery.

For more information, contact:

• American Cancer Society, Inc.
  Phone: 1-800-ACS-2345 (1-800-227-2345)
  Web site: http://www.cancer.org
• AMC Cancer Research Center and Foundation
  Phone: 1-800-525-3777
  Web site: http://www.amc.org
• Cancer Information Service
  Phone: 1-800-4-CANCER (800-422-6237)
  Web site: http://www.cancer.gov/aboutnci/cis

How can I help prevent cancer of the tongue from spreading or recurring?

You may be able to reduce the risk of recurrence or spread of tongue cancer if you:

• Complete the full course of surgical, radiation, and chemotherapy treatments ordered by your healthcare provider.
• Do not use any type of tobacco.
• Avoid heavy use of alcohol.
• See your provider right away if you notice a return of any previous symptoms, such as a lump or ulcer on your tongue that does not heal.
• Eat healthy and exercise regularly.