People often associate cancer with older adults, but in reality, most cancers tend to develop in middle-aged individuals who have long been exposed to carcinogens through lifestyle habits such as smoking and drinking alcohol. However, tongue cancer is increasingly being diagnosed in younger patients, including those under 30. Delayed diagnosis and treatment are common as they are often mistaken for oral ulcers.
To mark World Head and Neck Cancer Day, which falls this Sunday, we explored tongue cancer with insights from Professor Han Seung Hoon of the Otolaryngology Department at Hallym University Dongtan Sacred Heart Hospital.
A patient with tongue cancer / Photo courtesy of Hallym University Medical Center
The tongue, a highly flexible muscular organ, plays a crucial role in detecting food’s taste, temperature, and texture and assists in forming and swallowing it. It’s also one of the most common sites for the development of oral cancers. There has been a steady increase in the number of tongue cancer cases, which has shown a significant rise in head and neck cancers. According to the National Cancer Registration Project’s annual report, new head and neck cancer patients increased from 32,147 in 2017 to 41,460 in 2021—a 29% increase. Specifically, the number of tongue cancer cases rose from 748 in 2017 to 993 in 2021, marking a 33% increase. This is the most significant increase among the various organs affected by head and neck cancer, except for lip cancer, which has a relatively low number of cases.
Interestingly, the number of new tongue cancer patients is also rising among younger age groups. In 2021, 80 new tongue cancer patients in their 20s and 30s accounted for 8% of the total. Those in their 20s to 50s made up 46% of new cases, nearly half of all patients, with most under 60.
Early symptoms of tongue cancer include inflammatory ulcers that appear as round white necrotic lesions, thick white patches known as leukoplakia, and red spots.
More than half of tongue cancers develop on the sides of the tongue, and initially, they may not cause pain. However, once the tumor invades the nerves around the tongue, it can lead to severe pain.
These early symptoms resemble those of common oral mucositis, making differentiation difficult. Oral mucositis can occur due to factors like excessive stress, fatigue, physical trauma, infections from bacteria, irritating foods, or allergic reactions.
Han explained that oral mucositis typically heals naturally within 1 to 2 weeks. However, if symptoms persist for more than three weeks or worsen, it could be a sign of tongue cancer. Compared to oral mucositis, tongue cancer lesions are more extensive, and bleeding or pain may continue. He emphasized the importance of checking for firm lumps in the submandibular area or neck, which could indicate lymph node metastasis.
Once diagnosed with tongue cancer, imaging tests assess the extent of tissue invasion and possible metastasis. Treatment primarily involves surgically removing the tumor along with surrounding healthy tissue. Tongue cancer often metastasizes to the lymph nodes in the neck, necessitating surgery to remove these lymph nodes depending on the thickness of the lesion. In cases where more than half of the tongue needs to be removed, reconstructive surgery using skin and muscle from the wrist or thigh may be required. After surgery, patients may undergo additional treatments, such as radiation therapy or chemotherapy, depending on their health conditions.
Tongue cancer is challenging to treat, but early diagnosis and intervention can help preserve tongue function. Delayed treatment can lead to rapid metastasis, reducing the chances of a complete cure. Therefore, it’s crucial to monitor early symptoms and consult a specialist immediately if any concerning signs arise.
“To prevent tongue cancer, reducing smoking and drinking is paramount. Also, maintaining good oral hygiene by preventing cavities and gum disease is crucial,” Han added.
“I hope that World Head and Neck Cancer Day could raise awareness about tongue cancer and the importance of early diagnosis.”
Most Commented