Tongue cancer is a rare type of oral cancer that occurs when cells on your tongue grow and divide uncontrollably. It develops due to genetic mutations in the cells of the tongue, often triggered by lifestyle factors and environmental exposures.
While tongue cancer is more common in older adults, young people can also develop the disease. It is also a fact that tobacco use, such as cigarette smoking, is one of the leading risk factors for oral cancers like tongue cancer, according to the World Health Organization (WHO). However, one must understand that the causes of and risk factors for tongue cancer can go beyond tobacco use. Here's what an expert wants you to know.
Also Read: Tongue Cancer: Symptoms, Causes, Treatment
Tobacco Use And Tongue Cancer Risk
A 2024 study published in the Lancet Oncology suggested that one in three cases of oral cancer globally are due to smokeless tobacco, meaning types of tobacco products that are not burnt or smoked, including chewable tobacco, snuff, snus, or dissolvable tobacco.
When it comes to tongue cancer, all forms of tobacco, including cigarettes, cigars, pipes, chewing tobacco, and smokeless tobacco, increase the risk of developing tongue cancer.
In an interaction with the OnlyMyHealth team, Dr Sachin Marda, Senior Consultant Oncologist and Robotic Surgeon (Cancer Specialist), Yashoda Hospitals, Hyderabad, explains, "Chewing tobacco often causes leukoplakia, which are white patches that develop inside the mouth or throat. Tobacco also causes erythroplakia, a red, raised patch developed inside the mouth."
Both leukoplakia and erythroplakia are signs of dysplasia, which is a pre-cancerous condition. If left untreated, they can progress and become cancerous.
Causes Of Tongue Cancer That Go Beyond Tobacco Use
Besides tobacco, the following are the other causes of tongue cancer:
- Excessive consumption of alcohol
- Smoking
- Poor oral hygiene
- Sharp teeth and ill-fitting dentures
- Poor quality of diet that is low in fruits and vegetables.
- Family history of tongue cancer
- A weakened immune system
Can HPV Infection Increase Tongue Cancer Risk?
According to the US Centers for Disease Control and Prevention (CDC), Human Papillomavirus (HPV) can infect the mouth and throat. "It usually takes years after being infected with HPV for cancers to develop in the oropharynx (back of the throat, including the base of the tongue and tonsils). This is called oropharyngeal cancer. HPV is thought to cause 60-70% of oropharyngeal cancers in the United States," the health body shares.
Hence, HPV is also linked to a large portion of tongue cancers, particularly those affecting the base of the tongue.
Dr Marda describes HPV as a common virus that's transmitted through sexual contact. "HPV16, which is the main culprit in most cervical cancers, also causes HPV-related head and neck cancers."
"As soon as HPV infects cells through oral sexual contact, it starts changing the physiology of the cells. If the immune system is not strong enough to fight the infection, it can lead to tumours. These usually develop in the throat, near the tonsils, at the back of the roof of the mouth, or at the base of the tongue," he adds.
Also Read: Oral Cancer Doesn't Always Happen Due To Smoking, Expert Warns! Here Are Other Causes
Early Signs Of Tongue Cancer
Some of the early signs of tongue cancer you should watch out for include:
- Persistent Sores: A sore or ulcer on the tongue that does not heal within two weeks is a primary symptom. Unlike common ulcers, these sores are often painless in the early stages.
- White or red patch inside the mouth
- Pain, tenderness, or discomfort in the tongue that persists and recurs, especially during eating or speaking, is a symptom.
- A lump or thickened area on the tongue that does not resolve may be a sign of cancer.
- Difficulty in moving the tongue affecting speech, swallowing, or other functions
- Bleeding from the tongue without any known cause is another symptom to watch for.
- Neck swelling or neck lymph node enlargement
Role Of Early Detection
According to Dr Mahathi, tongue cancer is more common in people aged 40 and older. "Men are more likely to develop tongue cancer than women. This is because of higher consumption of alcohol and tobacco among men compared to women," he explains.
In addition to assessing your risk factors, it is also crucial to go for regular screening to facilitate early detection of tongue cancer.
Dr Mahathi says, "Early detection of tongue cancer can increase survival rates by 80–87%. However, survival quickly declines, often to less than 40%, if the illness spreads to the lymph nodes or other organs. Therefore, it is definitely life-saving to recognise the condition early through regular oral examinations and to pay attention to warning signs such as recurrent mouth sores or lumps on the tongue."