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Doctor consulting with patient about tongue cancer

One of several types of oral cavity (mouth) cancer, tongue cancer is fairly rare, accounting for less than 1% of all new cancer cases diagnosed annually. Oral cavity cancer is a type of head and neck cancer that can refer to cancers that start in or around the mouth—on the gums, lips, floor or roof of the mouth and other places besides the tongue. Additional types of head and neck cancers include those that begin in the larynx, throat, nasal cavity and salivary glands.

As with other malignancies, tongue cancer occurs when cells divide in an abnormal and uncontrolled way. If untreated, the abnormal cells can form a tumor and eventually spread to other parts of the body.

Different types of tongue cancer

When categorized by location, there are two tongue cancer types:

  • Oral tongue cancer, which refers to cancer in the front two-thirds of the tongue
  • Oropharyngeal tongue cancer, which forms at the base of the tongue in the back portion of the mouth and may extend into the throat

Whether tongue cancer occurs in the front or the back of the mouth, the malignancy usually starts in the thin, flat squamous cells that line the surface of the tongue. For this reason, squamous cell carcinoma is the most common type of tongue cancer, accounting for about 90% of all cases. There have been a few documented cases of lymphoma and sarcoma that developed in the tongue, but these types of tongue cancer are considered extremely rare.

Even though both oral and oropharyngeal cancers are likely to be squamous cell carcinomas, cancer specialists will want to identify where in the mouth the abnormal cells began forming. This is because the most effective treatment can differ according to where the cancer began.

Tongue cancer causes

Exactly what causes tongue cancer? Researchers don’t know for sure, but tongue cancer has been statistically linked with smoking and other tobacco use, alcoholism, cirrhosis of the liver and syphilis. Poor oral hygiene and ill-fitting dentures may also contribute to the development of tongue cancer, and some people may be genetically predisposed to it. Additionally, human papillomavirus (HPV) infection has been linked to the oropharyngeal type of tongue cancer.

Most patients who are diagnosed with some type of tongue cancer are 55 or older, and the disease is most common in men age 60 and older. However, HPV-related oropharyngeal tongue cancer is on the rise in younger people.

Early signs of tongue cancer

Many of the early warning signs of tongue cancer can also be symptoms of other conditions. However, it’s a good idea to consult with your dentist or primary care physician if you have:

  • Red or white patches on your tongue
  • Sores, lumps or mouth ulcers that don’t heal
  • A painful, swollen or bleeding tongue that doesn’t get better
  • A sore throat when swallowing
  • Difficulty moving your tongue or jaw
  • A feeling that something is stuck in your throat
  • Persistent hoarseness
  • Ear pain

People who smoke or drink excessively are at a higher risk for tongue cancer and should be especially vigilant about having their symptoms evaluated by a medical professional.

Stages of tongue cancer

Both types of tongue cancer—oral and oropharyngeal—are typically diagnosed through a biopsy. If cancer is confirmed, physicians will classify it according to how much cancer is present and whether it has spread (metastasized) to other parts of the body. One common staging system uses the letter “T” and a number from 1 to 4 to indicate how advanced the tongue cancer is. For example, a patient with a T1 cancer has the smallest grade of tumor, while someone with a T4 tumor has the highest grade.

Another way that physicians categorize tongue cancer is by grading it as low, moderate or high, indicating how aggressively the cancer is growing and the probability that it will metastasize. The location, stage and other factors unique to an individual’s cancer will help determine the most appropriate treatment.

Head and neck cancer specialists at Moffitt Cancer Center

Tongue cancer is among the many types of head and neck cancers we screen for and treat at Moffitt. Our Head and Neck Cancer Program encompasses a team of highly skilled surgeons, medical oncologists, radiation oncologists, endocrinologists, pathologists, radiologists and others who specialize in treating head and neck cancers. When cancer is diagnosed, these experts work together with each patient to develop an individualized treatment plan that incorporates the most appropriate options from a wide array of therapeutic services, which may include clinical trials as well as novel chemotherapy and targeted radiation therapy.

What’s more, in addition to cancer treatment, our patients can receive effective pain management and rehabilitative services from our highly regarded specialists at Moffitt. This means they don’t have to deal with the stress of seeking these invaluable services from another provider. Instead, they can count on receiving a coordinated, comprehensive approach to treatment and recovery that will give them the edge they need in their battle against cancer.

In fact, when you turn to Moffitt because you or one of your loved ones is concerned about cancer symptoms or a cancer diagnosis, we’ll support you with top-notch, compassionate care from the moment you reach out to us. We’re providing every new patient rapid access to a cancer expert. A referral is not required to schedule an appointment.

For more information about our approach to tongue cancer diagnosis and treatment, contact Moffitt Cancer Center today by calling 1-888-663-3488 or filling out our online new patient registration form.


National Cancer Institute: Tongue Cancer Facts Oral and Oropharyngeal Cancer
ASCO Answers: Head and Neck (PDF)
American Cancer Society: Risk Factors for Oral Cavity and Oropharyngeal Cancers