A 52-year-old office worker smokes more than a pack of cigarettes a day and frequently drinks alcohol. One day, he noticed an ulcer in his mouth but brushed it off, applying ointment and enduring the pain. However, after three weeks, it still hadn’t healed, and swallowing became difficult. He was later diagnosed with tongue cancer.
Yes, cancer can develop on the tongue. Although tongue cancer is a medically recognized condition, it remains unfamiliar to many. It is a type of oral cancer, which refers to malignant tumors that can occur on the tongue, inner cheeks, gums, palate, lips, or jawbone.
46% of New Tongue Cancer Cases Occur in People Under 50 – Even Reported in Their 20s
According to the medical community, tongue cancer accounts for just 0.4% of all cancer cases, making it rare. However, it accounts for approximately 30% of all oral cancers. Notably, about 85% of tongue cancers are squamous cell carcinomas that appear on the surface of the tongue and are visible to the naked eye, making early diagnosis by a specialist crucial.
Cases have been increasing among younger people in recent years, including those in their 20s. According to the National Cancer Registry, in 2021, 8% of new tongue cancer patients—around 80 individuals—were in their 20s and 30s. In total, 46% of new patients were under the age of 50.
The causes vary. In addition to smoking and alcohol consumption, cases linked to human papillomavirus (HPV) have also been reported. Lifestyle habits—such as frequent consumption of burnt food, extremely spicy or salty dishes, and foods over 70°C—as well as poor oral hygiene, are all considered risk factors.
Professor Park Hee Kyung from Seoul National University Dental Hospital’s Department of Oral Medicine explained that oral graft-versus-host disease, which can occur after a bone marrow transplant, also increases the risk of oral cancer. She emphasized that any mucosal inflammation should be actively treated, and a biopsy should be performed to determine whether the lesion is malignant.
When detected early, tongue cancer can often be treated while preserving tongue function, and the cure rate is high. Early-stage tongue cancer boasts a cure rate of 80–90%, but if the tumor progresses before detection, the survival rate drops to below 20%.
Professor Kwon Ik Jae from Seoul National University Dental Hospital’s Department of Oral and Maxillofacial Surgery noted that early-stage tongue cancer can be difficult to distinguish from common mouth ulcers. However, while ulcers typically heal within two to three weeks with proper care, tongue cancer does not improve over time.
If an ulcer or lesion persists on the same area of the tongue for more than two weeks, oral cancer screening is recommended. In the early stages, tongue cancer may appear as a sore with red margins. As it progresses, symptoms may include pain, bad breath, bleeding, and altered sensation.
Tongue cancer is diagnosed through a biopsy, in which a suspicious tissue sample is taken and examined under a microscope. The procedure involves local anesthesia and a couple of stitches, usually taking less than 10 minutes. Regular eating and daily activities can resume shortly afterward.
Fast Metastasis Requires Prompt Treatment – Confirm via Biopsy
Because tongue cancer tends to spread quickly, early treatment is critical. Once confirmed through biopsy, imaging tests are used to assess how far the cancer has progressed and determine the cancer stage. Surgical removal is the standard treatment. Since the tongue is vital for function, appropriate reconstructive surgery typically follows.
If the cancer is advanced, expected to impair tongue function, or has already metastasized, chemotherapy or radiation therapy may be administered first. Post-treatment side effects may include dry mouth due to reduced saliva, cavities, and difficulty swallowing or eating.
To prevent tongue cancer, quitting smoking and drinking is essential. Smoking is known to more than double the risk of developing the condition. Ill-fitting or irritating dental prosthetics should be promptly replaced. Spicy and highly seasoned foods should be avoided, and burnt food should also be consumed with caution.
Professor Baek Seung Guk from Korea University Anam Hospital’s Department of Otolaryngology advised that if pain or ulcer symptoms on the tongue persist or if an unusual lump is felt in the neck, one should visit a hospital without delay. He also emphasized that individuals who smoke or drink frequently should be especially diligent about oral hygiene.
Professor Park Hee Kyung added that she often sees patients in the clinic with visible tumors large enough to be identified with the naked eye. She expressed regret that the cancer wasn’t caught earlier and stressed that even if there is no pain, suspicious areas should be examined by a specialist.