Tongue cancer

What is tongue cancer?

Tongue cancer is a rare type of head and neck cancer.

The tongue has two parts, and cancer can develop in either of them:

The front part is the part you can see. Cancer that develops in this part of the tongue is called mouth cancer.
The back part is the base of the tongue, which is very close to the throat. Cancer that develops in this part of the tongue is called oropharyngeal cancer.

Symptoms of tongue cancer

If you are worried about tongue cancer, we have more information about the signs and symptoms.

Causes of tongue cancer

Doctors do not know the exact causes of tongue cancer. But there are risk factors that can increase your chance of developing it.

The main risk factors for head and neck cancer are:

smoking or chewing tobacco
drinking large amounts of alcohol.

Your risk of developing tongue cancer is higher if you do both.

Having one or more risk factors does not mean you will get tongue cancer. Also, having no risk factors does not mean you will not develop tongue cancer.

We have more information about the causes and risk factors of head and neck cancers.

Diagnosis of tongue cancer

You usually start by seeing your GP or your dentist. They will examine your tongue and mouth closely. They will refer you to a specialist doctor if:

they think that your symptoms could be caused by cancer
they are not sure what the problem is.

The specialist doctor will ask about your symptoms and general health. They will examine your tongue and feel for any lumps in your neck. These may be caused by swollen lymph nodes, but can be caused by other medical conditions.

You may have some of the following tests:

Nasendoscopy

A nasendoscopy is used to look at the inside of your nose and throat.
Biopsy

The doctor collects samples (biopsies) of cells or tissue from the area that looks abnormal. A doctor who specialises in analysing cells (called a pathologist) looks at the sample under a microscope for cancer cells.

Waiting for test results can be a difficult time, we have more information that can help.

Further tests for tongue cancer

If tongue cancer is diagnosed, your doctor may want to do some further tests to find out more about the cancer. These tests may include:

CT scan

A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of your body.
MRI scan

An MRI scan uses magnetism to build up a detailed picture of areas of your body.
Ultrasound scan of the neck

An ultrasound scan of the neck uses soundwaves to produce a picture of your neck and lymph nodes on a computer screen.
PET scan

A PET scan uses low-dose radiation to check the activity of cells in different parts of the body

Staging and grading of tongue cancer

The results of your tests helps your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging.

A doctor decides the grade of the cancer by how the cancer cells look under the microscope. This gives an idea of how quickly the cancer might grow or spread.

Knowing the stage and grade helps your doctors plan the best treatment for you.

Treatment for tongue cancer

A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).

Your cancer doctor or specialist nurse will explain the different treatments and their side effects. They will also talk to you about the things you should consider when making treatment decisions.

Treatment for tongue cancer may include:

Surgery

Surgery may be used to remove part of the tongue or lymph nodes in the neck.
Radiotherapy

Radiotherapy uses high-energy rays to destroy the cancer cells. It can be used on its own, but is often given in combination with chemotherapy. This is called chemoradiation.
Chemotherapy

Chemotherapy uses anti-cancer drugs to destroy cancer cells.
Chemoradiation

Chemoradiation is when you have chemotherapy and radiotherapy together. Chemotherapy can make the cancer cells more sensitive to radiotherapy treatment.
Targeted therapies

Targeted therapy drugs work by targeting something in or around the cancer cell that is helping it grow and survive.

We have more information about:

how different treatments are used to treat tongue cancer
what will happen before your treatment and how to prepare.

You may have some treatments as part of a clinical trial.

After tongue cancer treatment

You have regular follow-up appointments after treatment. These may continue for several years. You may also have regular follow-up appointments with a speech and language therapist (SLT), dietitian, restorative dentist and dental hygienist.

If you have any problems or notice new symptoms between appointments, let your doctor know as soon as possible.

Sex life and fertility

Head and neck cancer and its treatment can sometimes affect your sex life and fertility.

If you are worried about this, it is important to talk with your doctor before you start treatment.

We have more information about:

Late effects

Some side effects that develop during treatment can take months to improve or may become permanent. Other side effects can develop years after treatment has finished.

These side effects are known as long term or late effects. We have more information about long-term and late effects of head and neck cancer treatment.

Well-being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes to the way you live such as eating well and keeping active can improve your health and well-being and help your body recover.

It can be difficult to eat well after treatment for head and neck cancer, but your dietitian can help you.

Your feelings

For some people, it takes several months to recover from treatment. It can be hard to cope if treatment has changed your appearance, voice or how you eat and drink. It is common to feel overwhelmed by different feelings.

There are national support groups that you may find helpful:

The Mouth Cancer Foundation

The Mouth Cancer Foundation gives information and support to people affected by head and neck cancers.
Changing Faces

Changing Faces offers advice and information to anyone who is affected by a change in their appearance.

Macmillan is also here to support you. If you would like to talk, you can:

Call the Macmillan Support Line on 0808 808 00 00.
Chat to our specialists online.
Visit our Online Community to talk to people who have been affected by head and neck cancer, share your experience, and ask an expert your questions.

About our information

References

Below is a sample of the sources used in our tongue cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

British Association of Head and Neck Oncologists. Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines. 2016. Available from: https://www.bahno.org.uk/_userfiles/pages/files/ukheadandcancerguidelines2016.pdf (accessed September 2018).

Reviewers

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Chris Alcock, Consultant Clinical Oncologist.

Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.