What causes ulcers on the tongue

Tongue cancer (tongue cancer): symptoms and prognosis

One in four cases of oral cancer is tongue cancer.
© iStock.com/Wavebreakmedia

Tongue cancer is one of the forms of cancer of the mouth, jaw and face. In about every fourth oral cavity cancer, the tongue is particularly affected. A growth of malignant (malignant) cells forms on the edge or on the underside of the tongue, which divide in an uncontrolled manner - this leads to tongue carcinoma. This can happen if an error occurs during normal cell division and the cells degenerate.

In nine out of ten cases of tongue cancer, these are so-called squamous epithelial cells, i.e. cells from the surface of the tongue. Anyone who smokes, drinks a lot of alcohol and / or has injuries to their tongue increases their risk of tongue cancer.

Tongue cancer pictures to recognize

Typical changes on the tongue are usually a symptom of tongue cancer. Tongue cancer is particularly common on the side of the tongue; Changes here can indicate tongue cancer.

Tongue Cancer: Recognizing Symptoms and Avoiding Risk Factors

More men than women develop tongue cancer

About three quarters of those affected are men, and most of them are over 60 years old. In principle, tongue cancer can also occur at a young age. It usually begins with a small, non-healing wound, a "lump" or a whitish stain on the tongue. In the further course, the tongue carcinoma grows further and leads to pain, swallowing disorders and other complications. Early diagnosis and therapy is particularly important in this form of oral cancer.

Tongue Cancer Symptoms: These signs are possible

It often takes a few months for tongue cancer to develop the first noticeable symptoms. At first only a hardened area on the tongue is usually noticeable, later the tongue cancer is accompanied by other symptoms.

A tumor on the tongue can look very different in the early stages: in some people it appears as a small wound that simply won't heal, in others as a hardened "lump" or whitish patch on the mucous membrane. What tongue cancer looks like and what symptoms it causes depends, among other things, on the exact place where it develops. Most cancers develop on the edge or underside of the tongue; rarely the tip of the tongue can also be affected.

First symptoms of tongue cancer

If a tumor on the tongue does not initially cause discomfort to most of those affected, the tumor grows more and more over time. Then tongue cancer can cause the following symptoms:

  • "Lump feeling" in the area of ​​the tongue
  • Tongue pain
  • Difficulty swallowing
  • Speech impairment (slurred speech)
  • increased salivation

Whether and how much the tongue is restricted in its mobility depends entirely on the exact location and size of the growth. Another typical symptom of tongue cancer is a whitish-yellow coating that cannot be wiped off. However, this does not show up in all those affected.

Tongue Cancer: Causes, Triggers, and Risk Factors

Tongue cancer is one of the types of cancer for which various risk factors are known. Among other things, alcohol and tobacco consumption are high on the list of causes.

It is not clear in all forms of cancer which mechanisms cause the cells to degenerate. However, with tongue cancer there are a number of typical causes that most patients have in their history. This includes:

  • Smoke
  • heavy consumption of alcohol
  • poor oral hygiene
  • repeated mechanical irritation

Alcohol and tobacco consumption are considered risk factors

Among other things, badly fitting teeth or a broken tooth can irritate and injure certain areas on the tongue again and again. Such wounds often no longer heal properly and are predestined sites for tongue cancer. Other causes such as tobacco smoke and alcohol are generally considered risk factors for all forms of cancer of the mouth and throat. Filterless cigarettes and high-proof alcoholic beverages such as schnapps are particularly harmful.

For various types of cancer - not just tongue cancer - viral infections are also being discussed as possible causes, for example with human papillomaviruses (HPV). Finally, there are cases when the trigger is completely unclear. The risk of tongue cancer generally increases with age.


This is how a doctor's tongue cancer diagnosis works

Tongue cancer can be diagnosed by a dentist, dermatologist, orthodontist, or general practitioner. Usually, however, it cannot be determined at first glance whether it is a malignant tumor.

In order to correctly classify a growth on the tongue, the doctor first asks a few questions about the medical history (anamnesis). For example, he asks what symptoms it is causing and when you first noticed the tumor. It is also important whether and how much you smoke and drink alcohol, whether you have previous illnesses and what medication you are currently taking. This information forms the basis on which the doctor ultimately makes the diagnosis of tongue cancer.

The doctor then carefully examines the tongue and oral cavity. The doctor carefully feels the growth and the surrounding area with his fingers to determine which areas are hard to the touch and whether the indurations are flexible. If necessary, he also feels for the lymph nodes on the neck, as this is where daughter tumors (metastases) quickly form in the case of tongue cancer.

Tongue cancer diagnosis by CT or MRI

In order to determine how big the suspected tongue cancer actually is, various imaging methods can be used for the diagnosis. Computed tomography (CT) or magnetic resonance tomography (MRT) provide the most precise images.

Ultimately, however, only a tissue sample (biopsy) can confirm the diagnosis of tongue cancer. These removed cells are examined in the laboratory for changes that are typical of cancer. In most cases, this step will help you determine whether it is tongue cancer.

Therapy: treatment measures for tongue cancer

As soon as the diagnosis of tongue cancer has been made, the doctor will plan the treatment with you. Treatment in a specialized center often makes sense, as the doctors there have a lot of experience with tumors of the tongue and oral cavity.

Usually the only treatment option is surgery. The surgeon removes the degenerate tissue of the tongue and all daughter tumors. The sooner this happens, the better the chances of recovery.

Surgery can only be avoided in the rarest of cases for tongue cancer. The smaller the tumor, the gentler the operation - which is why it is important for tongue cancer to be treated as early as possible. Otherwise, larger parts of the tongue may have to be removed (glossectomy). If it is suspected that the cancer has already developed daughter tumors (metastases), doctors may also need to remove one or more lymph nodes from the neck.

Combination therapy for oral cancer

Often the doctors treating tongue cancer combine surgery with radiation therapy. After an operation there is always a residual risk that not all malignant cells have been removed. The rays can be used to fight any remaining tumor cells so that they do not multiply again and lead to a relapse (relapse).

In some cases of tongue cancer, surgery is not possible or the tumor cannot be completely removed. Then radio-chemotherapy can be used, i.e. a combination of radiation and chemotherapy.

Course and prognosis in tongue cancer patients

In tongue cancer, the course depends on various factors. Depending on where the tumor is and how early it is treated, the prognosis can vary considerably.

If a doctor detects the malignant growth early and initiates treatment, tongue cancer usually goes well. It is important that all cancer cells are removed and that those affected switch off certain risk factors, for example no longer smoking, drinking alcohol and ensuring thorough oral hygiene. In general, tumors on the edge of the tongue have a slightly more favorable prognosis than those under the tongue.

Untreated tongue cancer: risk of complications

However, if the tongue cancer is left untreated for a long time, it can lead to serious complications. The tumor continues to grow and not infrequently spreads to the floor of the mouth. At an advanced stage, tongue cancer prevents those affected from swallowing and eating so that they become emaciated and dry out (dehydrated).

It is also a malignant tumor that can form daughter tumors (metastases). Early therapy or - even better - preventive measures are all the more important so that tongue cancer does not occur in the first place.

Prevent tongue cancer with smoking cessation and moderate alcohol consumption

Although cancer is not one hundred percent preventable, there are a few steps you can take to greatly reduce your risk of tongue cancer.

You can prevent tongue cancer by following these steps largely prevent:

  • Refrain from tobacco consumption - in addition to cigarettes, this also applies to cigars, pipes, e-cigarettes and all other forms of smoking.

  • Drink up alcohol only in moderation. Above all, avoid hard liquors such as schnapps and other spirits.

  • Maintain thorough oral hygiene: brush your teeth thoroughly twice a day. Dental floss, interdental brushes and mouthwashes can be a useful addition to dental care.

  • If you have problems with your teeth, such as a broken tooth or a bulging denture, be sure to find yours as soon as possible dentist on. Also go for a check-up at least once a year.

  • Ask your doctor or dentist for advice as soon as you have a "knob" or another noticeable changes on the tongue or the lining of the mouth. In the rarest of cases it is actually tongue cancer. However, if you want to prevent a severe course, you are on the safe side.

The most common types of cancer in Germany