Tongue Cancer

Diagnosis

Tongue cancer is often first identified by a doctor, dentist, or other healthcare professional during a routine checkup. Several tests and procedures may be used to diagnose tongue cancer, depending on your medical history and symptoms.

Testing may include:

• Examining the mouth and throat: A physical exam checks for lumps on the tongue and swollen lymph nodes in the neck
• Endoscopy: A thin tube with a light and camera is inserted through the nose to look for signs of cancer in the mouth and throat, and to check if it has spread
• Biopsy: A sample of tissue is removed from the tongue using a thin needle or by cutting out a small section. The sample is analyzed in a lab to determine if cancer cells are present and may be tested for HPV
• Imaging tests: X-rays, CT, MRI, or PET scans can show the size, location, and potential spread of the cancer. Sometimes a barium swallow X-ray or ultrasound is used to examine the throat and lymph nodes

Treatment

Treatment for tongue cancer usually involves surgery followed by radiation, chemotherapy, or both. The treatment plan is based on the cancer’s location, growth rate, spread, test results, as well as your age and overall health.

Surgery options include:

• Glossectomy: Removal of part or all of the tongue along with a margin of healthy tissue. Physical therapy can help with speaking and swallowing after surgery
• Transoral or robotic surgery: Special tools or robotic arms allow access to hard-to-reach areas of the tongue and throat
• Neck dissection: Removal of lymph nodes in the neck if cancer has spread, or as a precautionary measure
• Sentinel node biopsy: Removal of lymph nodes most likely to contain cancer to determine if further treatment is needed
• Reconstructive surgery: Uses healthy tissue or bone from other parts of the body to restore the tongue, face, or jaw after surgery

Other treatments may include:

• Radiation therapy: High-energy beams such as X-rays or protons kill cancer cells, often used after surgery or along with chemotherapy
• Chemotherapy: Medicines that kill cancer cells, used before or after surgery or with radiation to improve effectiveness
• Targeted therapy: Drugs that block specific chemicals in cancer cells, used for cancer that recurs or spreads
• Immunotherapy: Medicines that help the immune system find and destroy cancer cells, often used when other treatments have not worked
• Clinical trials: Studies of new treatments that may offer access to emerging therapies

Advanced tongue cancer treatments can affect speaking and eating. Working with a rehabilitation team can help manage these changes and improve quality of life.