Squamous cell carcinoma (SCC) is a common form of skin cancer that can affect the tongue. At stage 1, it is highly treatable. There may be a visible sore on the tongue, but not always.

SCC is the most common type of tongue cancer and the second most common type of skin cancer overall. It is unusual for this condition to be life threatening, especially if a doctor detects it early.

Continue reading this article to learn about stage 1 SCC of the tongue, including diagnosis, treatments, and how the condition may develop.

SCC is a type of skin cancer. It usually occurs in areas of the skin frequently exposed to UV light, such as the face, lips, or hands. However, it can also develop in other places, including the tongue.

Tongue SCC occurs when cells become cancerous and start dividing and growing atypically. Some of the factors that can contribute to this include:

What does stage 1 tongue SCC look like?

Stage 1 SCC of the tongue may or may not be visible, depending on the location of the cancer.

If visible, it may look like a pink or red sore at the side of the tongue that does not heal and may bleed easily. If the cancer is more developed, it may look like a gray, pink, or red lump, similar to an ulcer.

However, if the cancer is closer to the base of the tongue, a person may not be able to see it. Instead, they may experience pain, changes in their voice, or difficulty swallowing.

Is SCC aggressive?

SCC is not typically aggressive. It usually grows slowly, allowing more time for a doctor to discover and treat the cancer before it grows deeper into the surrounding tissue or spreads elsewhere.

However, in cases where a person has a compromised immune system, SCC can grow more quickly. This may be due to certain medications, such as immunosuppressants, or health conditions that affect immune activity.

Without treatment, SCC of the tongue can grow deep into the surrounding tissue, causing damage and spreading to other parts of the body.

Yes, stage 1 SCC of the tongue is curable. Those who receive early diagnosis and treatment have a relatively high rate of survival.

According to the American Cancer Society, localized tongue cancer has a 5-year survival rate of 84%. This means that 84% of people with early tongue cancer survive for at least 5 years in comparison with people of the same age without tongue cancer.

However, this statistic includes all types of tongue cancer, not just SCC. A person’s individual outlook will depend on factors such as their age, their overall health, how aggressive the cancer is, and whether the cancer is HPV positive, among others.

Sometimes, a dentist finds evidence of oral cancer during an examination. In this case, they may refer a person for tests.

When diagnosing SCC of the tongue, a doctor will complete a clinical examination. They will visually examine the tongue and may ask questions about a person’s symptoms, medical history, and lifestyle.

To confirm if a lesion is a cancer, a doctor may perform the following:

  • a biopsy, which involves taking a small sample of tissue and sending it to a laboratory for analysis
  • a laryngoscopy, which allows them to see inside the throat
  • certain scans, such as:

These tests allow medical professionals to make a diagnosis. If cancer is present, the tests also help doctors assess its size, depth, and spread to determine its stage.

Surgery is the main treatment for stage 1 SCC of the tongue.

A doctor can often treat early stage SCC with surgery alone. In some cases, they may also recommend radiation therapy.


To treat tongue cancer via surgery, a surgeon will usually perform a partial glossectomy. This removes a tumor from the tongue. Where possible, they will also remove a margin of tissue of at least 1 centimeter (cm) around the growth and may remove lymph nodes in the neck.

With the tumor gone, surgeons may then close the tongue. They may use a skin graft to do this. Sometimes, they may perform procedures to reconstruct the tongue and any other affected areas to ensure a person can still talk, chew, and swallow as usual.

Radiation therapy

Radiation therapy directs a beam of radiation at a tumor or surrounding tissues. This destroys cancer cells.

Doctors will usually only treat more advanced SCC with radiation therapy. However, they may also use it to treat cases of early stage tongue cancer if a person is not a candidate for surgery or has certain health conditions.

A doctor may also use radiation therapy after a glossectomy to reduce the risk of the cancer returning.

Doctors most often use the TNM staging system to assess how advanced cancer is. This stands for:

  • tumor size and spread
  • nodes, which refers to the lymph nodes
  • metastasis, which is when cancer spreads and attaches itself to other parts of the body

By assessing these factors, doctors can assign cancer a number from 0–4 to denote the stage. Stage 1 is the second stage and one of the earliest.

Below are the definitions for each stage:

  • Stage 0: The cancer is only in the top layer of cells that line the tongue and has not grown deeper into the tissue. It has not spread anywhere else in the body.
  • Stage 1: The cancer is no larger than 2 cm in diameter and has not begun to grow into the surrounding tissues or spread anywhere else in the body.
  • Stage 2: The cancer is 2–4 cm in diameter. It has not begun to grow into the surrounding tissues or spread anywhere else in the body.
  • Stage 3: The cancer is any size and may be growing into the base of the tongue or other nearby tissues. It may or may not have spread to one lymph node on the same side of the neck as the original tumor but is not growing further away in the body.
  • Stage 4A: The cancer is any size and has begun to grow into surrounding structures, such as the deep tissue of the tongue. It may be in one or more lymph nodes but has not grown outside of them, and the nodes are no bigger than 6 cm. The cancer has not spread to distant parts of the body.
  • Stage 4B: The cancer is any size and is growing into nearby structures and tissues. It may be in one or both lymph nodes and may have grown outside the lymph nodes. The cancer has not spread to any distant parts of the body.
  • Stage 4C: The cancer is any size and is growing into nearby tissues and structures. It may or may not have spread to the lymph nodes. It has spread to distant parts of the body.

Stage 1 squamous cell carcinoma (SCC) of the tongue is an early stage skin cancer. If visible, it may manifest as an open sore, rough patch, or lump. This type of cancer is often slow-growing. In some cases, it can be more aggressive.

With early diagnosis and treatment, tongue cancer has a high 5-year relative survival rate. Treatment may involve surgery, and in some cases, radiation therapy.

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