Tongue cancer: Malignancy of the tongue; squamous cell carcinoma of the tongue. Risk factors include smoking tobacco, smokeless tobacco, heavy alcohol intake, and dentures. Tongue cancer usually occurs after the age of 40, with men affected more than women.
Tongue cancer is divided into that on the anterior tongue and that at the base of the tongue. The anterior tongue is the front two-thirds while the base is the back third of the tongue. The anterior tongue is the site of two-thirds of all tongue cancers. Three-quarters of these tumors are small and can be effectively treated by surgery or radiation. The risk of metastasis is quite small but if metastases do occur, usually to the neck, they require prompt therapy. The prognosis (outlook) is generally good.
The base of the tongue is the site of only one-third of all tongue cancers but these tumors tend to be far more advanced and aggressive than those on the front of the tongue. Symptoms of tongue base tumors may be odynophagia (pain on swallowing food or fluid), otalgia (pain in the ear), or a mass in the neck. The mass is usually due to metastases that can be felt in three-quarters of cases at the time of the diagnosis. Treatment may involve a combination of methods (surgery, radiation, chemotherapy) and may need to be aggressive. The prognosis is more guarded than with anterior tongue tumors.