Tongue cancer: what is it?

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Tongue cancer is most commonly caused by squamous cell carcinoma, cancer of the surface tissue of the tongue. Squamous cell carcinoma is one of the most common cancers and can affect many different organs. Tongue cancer is a form of oral cancer, caused by tobacco use in about 75% of cases. It can affect the oral tongue, the portion that may protrude from the mouth, or the base of the tongue, the back third of the body of the tongue.

Tongue cancer and other oral cancers are most often caused by smoking or other tobacco use, but alcohol abuse can also contribute to the disease, especially when combined with tobacco use. Alcohol-based mouthwashes can also be problematic, even when no alcohol is consumed. In Asia, chewing betel nut and areca is a significant risk factor for tongue cancer. The sexually transmitted disease Human Papilloma Virus (HPV) is another risk factor.

Oral tongue cancer is typically diagnosed before tongue base cancer, as the oral tongue is more visible. It most often presents as a lesion or ulcer on the side of the tongue. It is often small and grayish pink to red in color. The tumor typically bleeds easily when touched or bitten. It can cause problems with speaking, swallowing and chewing.

Tongue base cancer usually presents as pain, difficulty swallowing, a feeling of fullness in the throat, or changes in the voice. It is often more advanced than oral tongue cancer when first noticed, as early signs easily go unnoticed. In any suspected type of tongue cancer, a biopsy of the lesion can determine whether it is cancerous.

If the tumor is small enough, it can be surgically removed. Often, in cases of oral tongue cancer, surgery can be completed without adverse effects on speech or swallowing. Radiation is another option for treating tongue cancer. Surgical treatment is preferred if possible because it is less expensive and less time consuming and is often as effective as radiation therapy. Because there is a limit to the amount of radiation the human body can absorb, surgical treatment leaves open the option of radiation therapy should it become necessary in the future.

Cancer of the base of the tongue is often treated with radiation, while oral tongue cancer is usually treated with surgery if possible. Even if speech or the ability to swallow is impaired, eradicating a potentially fatal disease is worth it. Chemotherapy can also be used for tongue cancer, although it is rarely the only treatment. It can be used for palliative rather than curative therapy, or in combination with other treatments.

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