Dr. Amit Chakraborty

Dr. Amit Chakraborty

Head & Neck Cancer Specialist
 MS, MCh – Surgical Oncology

Blogs | 05- October-2023

Tongue Cancer Stages And Treatment

Tongue Cancer Stages And Treatment<br />

Tongue cancer, a lesser-known yet equally impactful form of oral cancer, can have life-altering consequences if not detected and treated promptly. With numerous factors at play, it is crucial to understand the different stages of tongue cancer, its causes, and the available treatment options. 

In this comprehensive guide, we will shed light on the various aspects of this disease, from its early symptoms to the factors affecting prognosis. Our goal is to empower you with the knowledge to make informed decisions about your health and seek appropriate care when needed. 

Whether you are concerned about your risk of developing tongue cancer or looking for resources to support a loved one facing this challenge, this article is valuable in navigating this complex topic.

Defining Tongue Cancer and Explaining its Development

Tongue cancer is a type of oral cancer that originates in the cells of the tongue. It can occur in two distinct areas: the front two-thirds of the tongue, known as the oral tongue, and the back one-third, referred to as the base of the tongue. 

Most cases of tongue cancer begin in the squamous cells, the thin, flat cells that make up the tongue’s surface.

Tongue cancer develops when genetic mutations in healthy cells cause them to grow and multiply uncontrollably, forming a tumor. These cancerous cells can invade nearby tissues, spread to the lymph nodes, and eventually metastasize to other body parts.

The most common types of tongue cancer are squamous cell carcinoma, verrucous carcinoma, and mucoepidermoid carcinoma. Each type has its unique characteristics in terms of prognosis and treatment options. 

The exact cause of these genetic mutations remains unclear. Still, several risk factors, such as tobacco and alcohol use, human papillomavirus (HPV) infection, and a weakened immune system, have been linked to the development of tongue cancer.

Diagnosis of Tongue Cancer

It is essential to diagnose tongue cancer early. Delayed diagnosis can lead to a more aggressive form of the disease, which is much harder to treat and may result in poorer outcomes. 

Early signs and symptoms of tongue cancer often include a sore or swelling that does not heal, pain or tenderness when chewing or swallowing, red patches on the tongue, and difficulty moving the tongue.

Your tongue cancer doctor in Mumbai may recommend a biopsy to confirm the diagnosis if these signs or symptoms are present. Once diagnosed, staging helps determine the extent of the spread of cancer cells within the tongue and beyond it. 

The stages range from 0 to IV. Stage IV indicates the extensive spread of cancer cells throughout the body. 

Stages of Tongue Cancer and Their Determination

The stages of tongue cancer are determined based on the tumour size, lymph node involvement, and the presence of metastasis, commonly referred to as the TNM staging system:

  1. Tumor (T): Describes the size and extent of the primary tumour.
  2. Node (N): Indicates whether the cancer has spread to nearby lymph nodes.
  3. Metastasis (M): Denotes if cancer has metastasized to distant body parts.

Based on the TNM classification, tongue cancer is assigned one of the following stages:

  • Stage 0: Abnormal cells are present but have not yet become invasive cancer.
  • Stage I: The tumour is small (2 cm or smaller) and has not spread to lymph nodes or distant sites.
  • Stage II: The tumour is between 2 cm and 4 cm and has not spread to lymph nodes or distant sites.
  • Stage III: The tumour is either larger than 4 cm or has spread to one lymph node on the same side of the neck but not to distant sites.
  • Stage IV: The cancer is more advanced, with larger tumours, significant lymph node involvement, or distant metastasis.

Different Treatments for Tongue Cancer and How They Work

The treatment for tongue cancer depends on the patient’s stage, location, and overall health. Some common treatment options include:

Surgery: Surgical tumour removal is often the first-line treatment for early-stage tongue cancer. This may involve removing a small portion of the tongue (partial glossectomy) or a more extensive procedure (total glossectomy) for larger tumours. Lymph nodes in the neck may also be removed if there is evidence of cancer spread.

Radiation therapy: High-energy beams, such as X-rays or protons, kill cancer cells. Radiation therapy can be used alone or in combination with surgery, depending on the stage and location of the tumour.

Chemotherapy: Drugs kill cancer cells or stop them from dividing. Chemotherapy may be administered before surgery to shrink the tumour or eliminate any remaining cancer cells after surgery. It can also be combined with radiation therapy for more advanced cases.

Targeted therapy: These drugs specifically target the abnormalities in cancer cells that enable their growth and survival. Targeted therapies are often combined with chemotherapy or radiation therapy for advanced tongue cancer.

Immunotherapy: This treatment stimulates the body’s immune system to recognize and attack cancer cells. Immunotherapy is generally reserved for advanced tongue cancer that has not responded to other treatments.

The choice of treatment depends on various factors, including the stage and location of the cancer, the patient’s overall health, and potential side effects. 

A multidisciplinary team of cancer doctors, such as medical oncologists & surgical oncologists, will work together to determine the most appropriate treatment plan for each patient.

Also, Read- Is Removal of The Tongue Necessary For Tongue Cancer

Prognosis & Outlook for People With Tongue Cancer:

The outlook for people with tongue cancer varies depending on several factors, including the stage at diagnosis, the type of treatment received, and the patient’s overall health.

In general, early detection and treatment lead to a more favourable prognosis. According to the American Cancer Society, the 5-year relative survival rate for oral cavity and pharynx cancers (which include tongue cancer) is:

  • 84% for localized cancer (cancer that has not spread beyond the primary site)
  • 66% for regional cancer (cancer that has spread to nearby lymph nodes or tissues)
  • 39% for distant cancer (cancer that has metastasized to other parts of the body)

It is important to note that these statistics are only general estimates and may not accurately predict an individual’s prognosis.

Factors affecting prognosis:

  • Stage of cancer: The stage of tongue cancer at the time of diagnosis is one of the most critical factors affecting prognosis. Early-stage cancers, which are small and localized, generally have a better prognosis than advanced-stage cancers with larger tumours, lymph node involvement, or distant metastasis.

  • Type of treatment: The effectiveness of the chosen treatment plan can also impact the prognosis. A well-tailored treatment approach, often involving a combination of surgery, radiation therapy, chemotherapy, targeted therapy, or immunotherapy, can increase the chances of success and improve the overall outlook.

  • Patient’s overall health: A person’s general health plays a significant role in their ability to tolerate treatments and recover from them. Patients with a strong immune system and no major underlying health issues are more likely to respond better to treatment and have a more favourable prognosis.

  • Tumour characteristics: Certain molecular and genetic characteristics of the tumour can influence prognosis. For instance, tongue cancers associated with human papillomavirus (HPV) infection tend to have a better prognosis than those unrelated to HPV.

  • Age: Younger patients generally have a better prognosis than older patients, as they often have better overall health and can better tolerate aggressive treatments.

While these factors contribute to the overall outlook for people with tongue cancer, it is essential to remember that each patient’s situation is unique.

An individual’s prognosis should be discussed with their oncologist, who can provide personalized information based on their specific case and treatment plan.


Tongue cancer, a form of oral cancer, develops when genetic mutations cause cells in the tongue to grow uncontrollably. Early detection and treatment are crucial for a favorable prognosis. 

The stage of cancer, type of treatment, and the patient’s overall health significantly impact the outlook. Understanding the symptoms, risk factors, and available treatments is vital for informed decision-making and seeking appropriate care. 

By staying vigilant about one’s oral health and following recommended screening guidelines, individuals can actively contribute to better outcomes in their fight against tongue cancer.