What is cancer of the tongue?

Cancer of the tongue is a malignant tumor that begins as a small lump, a firm white patch, or an ulcer. If untreated, the tumor may spread throughout the mouth and to the rest of the body. As a tumor grows, it becomes more life-threatening. Benign (noncancerous) tumors can also grow anywhere in your mouth.

How does it occur?

Tongue cancer is one of the more common and serious types of mouth cancer. Although the exact cause is unknown, it most often occurs among pipe, cigar, and cigarette smokers and people who use smokeless tobacco. It also occurs in people who consume large amounts of alcohol and among denture wearers. It is rare in people under age 40, particularly women. It is most common in men over age 60.

What are the symptoms?

Tongue cancer begins as a small lump or thick white patch. Over time this lump turns into an ulcer that has a firm, raised rim and a delicate center that bleeds easily.

If the tumor is not treated, it can spread to the gums, lower jaw, lymph nodes, neck, and floor of the mouth, eroding healthy tissues in these areas. The tongue becomes rigid and immobile if the tumor grows large enough. Eventually, the tumor may block the throat, making swallowing and breathing difficult.

If the disease remains untreated, you may also experience:

• stiff and rigid tongue muscles

• pain (in later stages)

• bad breath

• difficulty with saliva

• difficulty in eating, speaking, or swallowing.

How is it diagnosed?

Your doctor will examine your tongue and mouth and ask about the history of the growth on your tongue, especially if you have had it more than 10 days. Your doctor may also recommend a tongue biopsy, in which a small tissue sample is removed from the affected area of your tongue under local anesthesia. The tissue sample will be analyzed to see if it is malignant (cancerous).

What is the treatment?

The doctor, usually an oncologist (cancer specialist), will determine the treatment for tongue cancer based on the stage (spread) of the disease when it is diagnosed. Your doctor may recommend that you have one or more of the following treatments:

• radiation

• anticancer drugs (chemotherapy)

• surgery to remove the malignant tumor.

Plastic surgery and speech therapy are often part of your therapy, particularly if it is necessary to remove any portion of your tongue, lymph glands, or jaw to remove all of the cancer. (Plastic surgery is often necessary to restore function and appearance.)

How long will the effects last?

The effects of tongue cancer will vary depending on the stage at which the growth is detected, effectiveness of the treatment recommended by your doctor, and your overall health.

If tongue cancer is diagnosed at an early stage, about 80% of people can be cured completely.

When tongue cancer is diagnosed after it spreads into the lymphatic system, the cancer is more harmful. Ask your doctor about the effectiveness of treatment for this advanced stage of the disease.

How can I take care of myself?

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

Follow these guidelines:

• Have a routine annual or semi-annual dental exam, especially if you smoke. Often dentists are the first to find signs of cancer of the tongue.

• Call your doctor if you notice any unusual lump, sore, or discolored area on your tongue that doesn't heal in 10 to 20 days, becomes worse, or spreads rapidly.

• Be sure that dentures fit properly and that edges of teeth are smooth so that they do not irritate your mouth or tongue.

• Avoid using tobacco in any form.

• Avoid heavy use of alcoholic beverages.

• Complete the full course of surgery, radiation, and/or chemotherapy treatments your doctor orders.

• 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, call or write:

• AMC Cancer Information
  Phone: 1-800-525-3777

• American Cancer Society, Inc.
  1599 Clifton Road, NE
  Atlanta, Georgia 30329-4251
  Phone: 1-800-ACS-2345

What can be done to 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 by:

• completing the full course of surgical, radiation, and/or chemotherapy treatments ordered by your doctor

• avoiding the use of tobacco in any form

• avoiding heavy use of alcoholic beverages

• seeing your doctor immediately if you notice a return of any previous symptoms, such as a lump or ulcer on your tongue that doesn't heal, but worsens and spreads

• maintaining good oral hygiene, taking good care of your teeth and gums, and having regular dental checkups, particularly if you wear dentures

• eating well-balanced meals, exercising regularly, and maintaining good general health practices.