The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

Tongue Cancer

A common oral cavity malignancy with distinct anterior (mobile) and posterior (base) tongue subsites.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Tongue Cancer?

Tongue cancer is a malignancy of the tongue, almost always squamous cell carcinoma. It is anatomically and clinically divided into two distinct entities: oral tongue cancer (anterior two-thirds, mobile portion) and base of tongue cancer (posterior third, oropharyngeal). These differ significantly in epidemiology, etiology, and treatment.

Oral tongue cancer typically affects the lateral border and is strongly associated with tobacco and alcohol use. It is increasingly seen in young non-smokers, particularly women, suggesting unidentified risk factors. Base of tongue cancer is part of the oropharynx and is increasingly HPV-related (particularly HPV-16), with rising incidence in middle-aged men.

Tongue cancer often presents with a non-healing ulcer, mass, or pain on the tongue. Diagnosis is by biopsy with imaging for staging. Treatment depends on subsite, stage, and HPV status. Oral tongue cancer is typically treated with surgery and reconstruction, while base of tongue cancer often receives chemoradiation as primary treatment, especially for HPV-positive disease.

Symptoms

Persistent tongue ulcer or sore not healing (over 2-3 weeks)
Lump, mass, or thickening of the tongue
Red or white patches (erythroplakia/leukoplakia)
Pain in tongue, often referred to ear (otalgia)
Difficulty moving the tongue (advanced disease)
Difficulty swallowing or chewing
Speech changes or slurring
Numbness of the tongue or jaw
Bleeding from tongue lesion
Bad breath (halitosis) with advanced disease
Painless neck lump (cervical metastasis)
Weight loss with progressive disease
Trismus (jaw stiffness) with deep invasion

Risk Factors

Tobacco use (cigarettes, cigars, pipes, chewing tobacco, snuff)
Alcohol consumption (synergistic with tobacco)
HPV infection (especially HPV-16, base of tongue)
Betel nut and areca nut chewing (high prevalence in South Asia)
Poor oral hygiene
Chronic mechanical irritation (sharp teeth, ill-fitting dentures)
Premalignant lesions: erythroplakia, leukoplakia, oral submucous fibrosis
Age over 50 (declining for HPV-related disease)
Male sex (3-4 fold higher)
Immunosuppression
Lichen planus, Plummer-Vinson syndrome
Fanconi anemia, dyskeratosis congenita
Previous head and neck cancer (field cancerization)
Genetic factors (rising in young women without traditional risk factors)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Tongue ulcer not healing within 2-3 weeks
  • Persistent tongue pain or ear pain
  • Lump or thickening on the tongue
  • Red or white patches on the tongue
  • Difficulty moving the tongue
  • Speech or swallowing changes
  • Numbness of tongue or mouth
  • Painless neck lump
  • Bleeding from tongue lesion
  • Smoker, drinker, or HPV-positive individual with any tongue changes

Treatment Methods

01
Smoking and alcohol cessation (essential)
02
Dental evaluation and oral hygiene optimization
03
Multidisciplinary head and neck tumor board review
04
Biopsy with HPV/p16 testing for base of tongue lesions
05
Imaging: MRI tongue, CT neck, PET-CT for staging
06
Oral tongue cancer: primary surgical resection (partial glossectomy, hemiglossectomy)
07
Reconstruction: primary closure, local flap, or free flap (radial forearm, anterolateral thigh)
08
Elective neck dissection: tumors with depth over 4 mm
09
Sentinel lymph node biopsy: alternative in select early cases
10
Adjuvant radiation: positive margins, perineural invasion, advanced T or N
11
Adjuvant chemoradiation: extracapsular extension or positive margins
12
Base of tongue cancer (HPV-positive): definitive concurrent chemoradiation
13
Transoral robotic surgery (TORS): selected base of tongue cases
14
Induction chemotherapy: select advanced cases
15
Immunotherapy (pembrolizumab, nivolumab): recurrent/metastatic disease
16
Targeted therapy (cetuximab): alternative to cisplatin
17
Speech and swallowing therapy: pre and post treatment
18
Long-term surveillance for recurrence and second primaries
19
Dental and prosthetic rehabilitation

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Onkoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Anaemia

Dahiliye (İç Hastalıkları)

Anaemia is a low haemoglobin level that reduces oxygen delivery, causing fatigue, pallor, and shortness of breath. It is not a disease itself but a sign of many underlying conditions. Most cases are correctable with appropriate diagnosis and treatment.

Iron Deficiency Anaemia

Dahiliye (İç Hastalıkları)

Iron deficiency anaemia develops when dietary intake, absorption, or losses create an iron shortfall, most often affecting women and children. Identifying the underlying cause is the core of management, alongside iron replacement.

Vitamin B12 Deficiency

Dahiliye (İç Hastalıkları)

Vitamin B12 deficiency can cause megaloblastic anaemia, neurological symptoms, and cognitive impairment. Early treatment with intramuscular or oral B12 largely prevents irreversible complications.

Hypertension (High Blood Pressure) Management

Dahiliye (İç Hastalıkları)

Hypertension is often called the silent killer because it progresses symptom-free for years and can damage the heart, brain, kidneys, and eyes. Regular monitoring, lifestyle change, and evidence-based drug therapy dramatically reduce cardiovascular risk.

Chronic Kidney Disease

Dahiliye (İç Hastalıkları)

Chronic kidney disease is one of the most common complications of chronic conditions such as diabetes and hypertension, and can be silent in its early stages.

Hepatitis B (HBV)

Dahiliye (İç Hastalıkları)

Hepatitis B is a DNA virus infection causing acute and chronic hepatitis with risk of cirrhosis and hepatocellular carcinoma; diagnosis integrates HBsAg, HBeAg, anti-HBc, and HBV DNA with management based on disease phase using nucleos(t)ide analogues (entecavir, tenofovir) and universal infant vaccination.

Hepatitis C (HCV)

Dahiliye (İç Hastalıkları)

Hepatitis C is an RNA virus causing chronic hepatitis that may progress to cirrhosis and hepatocellular carcinoma; modern direct-acting antiviral (DAA) pangenotypic regimens (sofosbuvir/velpatasvir, glecaprevir/pibrentasvir) achieve sustained virologic response over 95% in 8–12 weeks with universal adult screening and cure for nearly all patients.

Fatty Liver Disease

Dahiliye (İç Hastalıkları)

Non-alcoholic fatty liver disease (NAFLD) is closely related to obesity and metabolic syndrome and is largely reversible with early treatment.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.