Tongue cancer is a type of cancer that begins in the cells of the tongue. Understanding its appearance is an important part of recognizing potential issues, as early detection can influence outcomes. This article describes what tongue cancer can look like and how it is diagnosed. This information is a guide and does not replace professional medical consultation.
Visual Characteristics of Tongue Cancer
The appearance of tongue cancer can vary, but it often begins with subtle changes to the tongue’s surface. A common sign is the development of a white or grayish patch, known as leukoplakia, that cannot be scraped off. Similarly, a red patch, called erythroplakia, which may be flat or slightly raised and can bleed if scraped, is another potential indicator. Some lesions have both red and white areas, referred to as erythroleukoplakia.
These patches represent abnormal cell growth and may be precancerous or cancerous. In the initial stages, these areas are often flat and may not cause any pain, which can lead to them being overlooked. As the condition progresses, a more defined lump or nodule might form on the tongue, feeling thick or hard to the touch.
Another primary visual sign is an ulcer or sore that does not heal within a couple of weeks. Unlike a typical canker sore, a cancerous ulcer is persistent and may appear as a red or grayish crater-like area. It might bleed easily when touched or bitten. The presence of any sore, patch, or lump that persists is a reason to seek a medical evaluation.
As a tumor grows larger, it can affect the nerves, causing numbness or a tingling sensation in the tongue or other parts of the mouth. You might also notice a thickening of the tissue in one area. If bleeding occurs without any obvious injury, such as biting your tongue, it could be a sign of an underlying lesion.
Location and Appearance on the Tongue
The tongue is divided into two main parts, and the location of a tumor affects its appearance and symptoms. The oral tongue is the front two-thirds that you can move and see easily. Cancers that develop here are discovered earlier because they manifest as visible signs like a persistent sore or lump, often located on the side of the tongue.
In contrast, the base of the tongue is the back third, which is part of the throat, or oropharynx. Cancers in this location are much harder to see without specialized medical instruments. Consequently, the initial signs are not visual but are related to the cancer’s effect on surrounding structures. A persistent sore throat, a feeling of a lump in the throat, or difficulty swallowing are common early symptoms.
Pain that seems to radiate to the ear, known as referred pain, can also be a symptom of cancer at the base of the tongue. The first noticeable sign is often a lump in the neck, which indicates that the cancer has spread to the lymph nodes. Voice changes or hoarseness may also occur if the tumor grows large enough to affect the larynx.
Conditions That Can Resemble Tongue Cancer
Several benign, or non-cancerous, conditions can cause sores or patches on the tongue that might be mistaken for cancer. Canker sores, also called aphthous ulcers, are a common example. These sores are painful, have a white or yellowish center with a red border, and heal on their own within one to two weeks. Their distinct pain and short duration help differentiate them from persistent, often painless cancerous lesions.
Oral thrush, a fungal infection caused by an overgrowth of Candida yeast, presents as creamy white patches on the tongue and inside the mouth. A primary difference is that these patches can be wiped or scraped away, revealing a red, inflamed surface underneath that might bleed slightly. Oral thrush is more common in individuals with weakened immune systems, those who wear dentures, or as a side effect of certain medications like inhaled steroids.
Geographic tongue is a harmless inflammatory condition that creates a map-like pattern of smooth, red patches with slightly elevated white borders on the tongue’s surface. This pattern can change in location, size, and shape over days or weeks. While it can cause mild discomfort or sensitivity, it is not associated with cancer.
Traumatic ulcers are another common issue, caused by an injury like accidentally biting the tongue or irritation from rough teeth or dental appliances. These ulcers are painful and are located at the site of the trauma. Once the source of irritation is removed, they heal within a short period. The clear cause and healing process distinguish them from cancerous sores.
The Diagnostic Process
When a suspicious spot or lesion on the tongue is identified, a healthcare professional will begin the diagnostic process with a thorough examination. This involves a visual inspection of the entire mouth, including the tongue, gums, and cheeks, and a physical palpation of the neck to check for swollen lymph nodes. They may use a small mirror and light to get a better view of the back of the mouth and throat.
To get a more detailed look at suspicious tissue, a professional might use special tools. A fluorescent light can help reveal abnormal tissue that isn’t visible to the naked eye. An endoscope, which is a thin, flexible tube with a camera, may be used to examine the base of the tongue and throat area more closely.
If these initial examinations raise concerns, the definitive step to confirm or rule out tongue cancer is a biopsy. A biopsy involves removing a small piece of the suspicious tissue, which is then sent to a laboratory for analysis. A pathologist examines the cells under a microscope to determine if they are cancerous.
If cancer is confirmed, further imaging tests such as CT scans or MRIs may be ordered. These tests determine the size and extent of the tumor and see if it has spread to other areas, which helps in planning treatment.