OVERVIEW

What is tongue cancer?

Tongue cancer is the most common type of oral cancer, predominantly affecting individuals aged 40–60, with a higher incidence in males than females.

The most frequent site of occurrence is the middle one-third of the tongue's lateral border. Early symptoms may include nodules, erosions, or rapidly progressing ulcers with everted edges. It can invade nearby muscles and even the mandible. Patients may experience persistent pain that gradually worsens, sometimes radiating to the ear. In advanced stages, tongue movement becomes restricted, leading to drooling and difficulty swallowing.

Treatment involves surgical resection or radiotherapy of the primary lesion, along with neck lymph node dissection to address potential metastasis.

Is tongue cancer common?

In recent years, the incidence of tongue cancer has risen, making it the most prevalent oral cancer. However, oral cancers overall remain relatively rare and are not classified as common tumors.

SYMPTOMS

What are the symptoms and manifestations of tongue cancer?

Tongue cancer may present with the following manifestations:

• A rapidly growing mass on the tongue, sometimes accompanied by pain or bleeding.

• It may appear as a mucosal ulcer on the surface—initially presenting as a sore on the tongue that does not heal and gradually enlarges.

• Some cases of tongue cancer develop from leukoplakia. Patients with oral leukoplakia should be alert to possible malignancy if the white patches become rough or painful.

• When the tumor grows large enough to affect the tongue muscles, symptoms such as drooling, difficulty swallowing, or speech impairment may occur. If nerves are involved, the tongue may feel numb.

CAUSES

What are the causes of tongue cancer?

Factors currently associated with oral cancer include: smoking, betel nut chewing, alcohol consumption, and nutrition (such as deficiencies in vitamin A, vitamin C, and other nutrients, which have been linked to oral cancer).

Is tongue cancer hereditary?

It is not genetically related.

Is tongue cancer common in children and young adults?

There has been a trend of increasing incidence among younger individuals in recent years.

Who is most commonly affected by tongue cancer?

Most cases occur in individuals over 45 years old, with a higher incidence in males than females. Those with unhealthy habits such as smoking, drinking, or betel nut chewing, as well as people with residual tooth roots or crowns that chronically irritate the oral mucosa and cause ulcers, have an increased risk of developing tongue cancer.

DIAGNOSIS

What tests are needed for tongue cancer?

An enhanced MRI of the tongue can be performed. The most reliable test is a tissue biopsy, which involves removing a small piece of tissue for histopathological examination.

Which diseases is tongue cancer easily confused with?

It needs to be differentiated from oral ulcers and benign oral tumors.

TREATMENT

Which department should I visit for tongue cancer?

Dentistry, Head and Neck Surgery, Otolaryngology, Oncology.

How is tongue cancer treated?

Early-stage cases can be treated with surgical resection, involving partial or extensive removal of the tongue. However, tongue cancer tends to metastasize early, so early neck lymph node dissection may be considered based on the situation.

If the tumor is large and more than half of the tongue is removed, tongue reconstruction may be performed simultaneously to preserve tongue function, using tissue from another part of the body to replace part of the tongue.

Some tongue cancers are sensitive to radiotherapy, which can be administered preoperatively to shrink the tumor before surgical removal. Postoperative adjuvant radiotherapy may also be considered based on surgical outcomes.

Chemotherapy is another common treatment but is not the primary approach. For distant metastases (e.g., in the lungs, bones, or heart), chemotherapy may help alleviate symptoms.

What are the potential risks of tongue cancer treatment?

Post-surgery, patients may experience facial deformities, speech impairment, or swallowing dysfunction. Reconstructive surgery can aid recovery, and active rehabilitation training may help restore speech and swallowing functions.

Do tongue cancer patients need follow-up examinations? How often?

Yes.

Most recurrences occur within the first two years after surgery. Generally, follow-ups are recommended every 1–3 months in the first year, every 2–4 months in the second year, every 4–6 months from years 3 to 5, and every 6–12 months after 5 years. Each examination should include physical checks and ultrasounds of the affected area and neck. If suspicious findings arise, CT, MRI, or even a biopsy may be required.

What is the prognosis for tongue cancer?

• Early-stage tongue cancer has a lower malignancy level, can often be completely removed surgically, and has a 5-year survival rate of >50% if lymph nodes are unaffected. Tongue function is usually partially preserved, maintaining a relatively good quality of life, though recurrence is possible.

• Late-stage tongue cancer has a significantly lower survival rate. Larger tumors requiring extensive resection may impair tongue function and increase metastasis risk. Distant organ metastasis further worsens survival outcomes.

• Patients with systemic diseases or advanced age tend to have poorer prognoses.

How likely is tongue cancer to recur?

About 12% of oral cancer patients experience recurrence after treatment.

Genetic predisposition and radiotherapy increase recurrence risk. Continued smoking and alcohol use post-diagnosis can more than double the risk of developing another oral cancer compared to the general population.

What is the likelihood of tongue cancer causing death?

Due to delayed diagnosis, approximately 25% of oral cancer cases ultimately lead to death.

DIET & LIFESTYLE

What should tongue cancer patients pay attention to in daily life and diet?

• Quit smoking and limit alcohol consumption after treatment;
• Avoid chewing betel nut;
• Maintain a balanced and nutritious diet;
• Promptly address and treat any residual roots or damaged crowns in the oral cavity;
• Adhere to regular follow-up examinations.

PREVENTION

How to Prevent Tongue Cancer?

Preventive measures include:

• Quit smoking and drinking, avoid chewing betel nut;

• Maintain a balanced diet and nutrition;

• Avoid excessively hot foods and drinks to prevent irritation of the oral mucosa and tongue;

• Avoid harmful oral stimuli: promptly remove sharp edges of dentures to prevent repeated irritation from ill-fitting dentures;

• Maintain oral hygiene, and extract residual roots or crowns as soon as possible;

• Schedule regular oral examinations to detect cancerous or non-cancerous growths early.