Tongue Cancer: Causes, Symptoms, and Treatment Options
Tongue cancer is a type of cancer that usually begins in the cells lining the surface of the tongue and may spread over time. It is one of the most common types of oral cancers and is strongly linked to smoking, alcohol consumption, and chronic irritation.
When diagnosed early, the treatment success rate is high!
Causes of Tongue Cancer
Tongue cancer can be influenced by both environmental and genetic factors.
Smoking and Alcohol Use:
- Smokers have a 25 times higher risk of head and neck cancers compared to non-smokers.
- The risk increases significantly when smoking and alcohol are combined.
Viral Infections:
- Infections such as Human Papillomavirus (HPV) and HIV may increase the risk of oral cancers.
Dietary Habits:
- Excessive consumption of salty, smoked, and processed foods may increase susceptibility to cancer.
- Deficiencies in vitamins A, C, and E can weaken the immune system and contribute to cancer risk.
Genetic Predisposition:
- Individuals with a family history of head and neck cancer are at higher risk.
Poor Oral Hygiene and Chronic Irritation:
- Ill-fitting dentures, sharp broken teeth, and chronic tongue biting can increase cancer risk.
Tongue cancer is more commonly seen in men and individuals over the age of 60.
Symptoms of Tongue Cancer
Tongue cancer may not cause symptoms in the early stages. However, the following signs may appear as the disease progresses:
- Persistent sores or ulcers in the tongue and mouth that do not heal
- Bleeding or hard areas on the tongue
- Pain or difficulty while chewing or swallowing
- Bad breath
- Numbness in the tongue or mouth
- Unexplained weight loss
- Lump in the neck (enlarged lymph nodes)
- Speech difficulties and changes in voice
If you notice a sore or lump in your mouth that lasts longer than two weeks, consult an ENT specialist!
Diagnosis of Tongue Cancer
Clinical examination and imaging methods are used in the diagnosis of tongue cancer:
Biopsy:
- A tissue sample is taken from the suspicious area on the tongue and examined pathologically.
Imaging Techniques:
- Ultrasound (USG): Used to evaluate lymph nodes in the neck.
- CT and MRI: Determine tumor size, spread, and involvement of nearby tissues.
- PET Scan: Used to detect whether the cancer has spread to other parts of the body.
When diagnosed at an early stage, tongue cancer can have a treatment success rate of up to 70%.
Treatment Options for Tongue Cancer
Surgery is the most effective treatment for tongue cancer. However, additional treatments may be required depending on the stage and spread of the disease.
Surgical Treatment (Tumor Removal)
- The cancerous tissue must be completely removed with clear margins.
- Depending on the tumor’s spread, part or all of the tongue may be removed (partial or total glossectomy).
- If cancer has spread to the neck, lymph nodes may also be removed (neck dissection).
Surgery alone may be sufficient for patients diagnosed in early stages!
Radiotherapy (Radiation Therapy)
- Used in moderate and advanced stages to shrink tumors and eliminate remaining cancer cells.
- Also used after surgery to reduce the risk of recurrence.
- With intensity-modulated radiation therapy (IMRT), healthy tissues are protected while targeting the tumor area.
Chemotherapy (Drug Therapy)
- Used in advanced stages to destroy cancer cells and control metastases.
- May be used alone or in combination with radiotherapy in patients not suitable for surgery.
In advanced cases, a combination of chemotherapy and radiotherapy is often applied.
Tongue Cancer Staging and Prognosis
Treatment success depends on the stage and spread of the disease:
- Stage 1: Tumor is limited to the surface of the tongue. High treatment success rate (70–80%).
- Stage 2–3: Tumor has grown or spread to lymph nodes. Surgery + radiotherapy is recommended.
- Stage 4: Advanced stage with distant metastasis. Treated with chemotherapy and radiotherapy.
In early-diagnosed patients, the 5-year survival rate is around 70%!
Rehabilitation After Tongue Cancer
Post-operative rehabilitation is essential to improve quality of life.
Nutritional and Dietary Support:
- Soft and liquid foods are recommended due to potential swallowing difficulties.
- Special nutrition plans ensure patients receive adequate calories.
Speech Therapy:
- Applied for patients who had partial or full removal of the tongue to regain speech ability.
Physical and Occupational Rehabilitation:
- Physiotherapy can help restore jaw and neck movements.
Conclusion and Recommendations
If tongue cancer is diagnosed early, the treatment success rate is very high!
Avoid Risk Factors:
- Quit smoking and alcohol use!
- Maintain proper oral hygiene!
- Eat a healthy and balanced diet!
Be Alert for Early Diagnosis:
- Consult an ENT doctor if you notice a non-healing sore or swelling in the mouth!
- Have regular dental checkups!
Consulting a specialized ENT doctor is very important for the diagnosis and treatment of tongue cancer.
Prof. Dr. Elif Aksoy
ENT Specialist – Head and Neck Cancer Surgery
