I have recently noticed a lump in the right side of my tongue, approximately one inch back from the tip. I cannot get in to see the doctor for a few days and was curious if you could help me narrow it down. It does not hurt, nor does it protrude from my tongue. If I pinch my tongue, I can feel it in there. It is about the size of a pea, or possibly a fraction larger.

Shawn

One of the odd little facts about the tongue is that cancers arise far more frequently on the borders (sides) of the tongue than on the dorsum (top surface). The bottom surface of the tongue can also occasionally give rise to cancers, especially in folks who chew tobacco.

Small tongue cancers usually look like ulcers (small craters with "raw" centers), but they can also be nodular. (A nodule is a firm ball.) Since this lump is on the right side of your tongue, my first concern is that this might be an early tongue cancer. The only way to know for certain is to have the lump biopsied. Your doctor will inject a little bit of local anesthetic into the area of the lump and will then cut out all or part of the lump. This is not much fun, but neither is it as painful as it sounds.

The main risk factors for tongue cancer are tobacco use (smoking or chewing) and alcohol use. Tongue cancer tends to occur in older folks, but young people, even teenagers, have been diagnosed with tongue cancer. Survival of tongue cancer is critically dependent on early diagnosis and treatment -- so do not delay in seeing a doctor! Tongue cancers spread rapidly to the lymph nodes of the neck. Even for very small tongue cancers, the doctor must consider treating the neck (either surgically or by radiation therapy) to eradicate lymph nodes that may be cancerous.

Could this be something other than a cancer? Certainly. In particular, if you are a nonsmoker and nondrinker, chances are this is not a cancer. (But you should still have the lump evaluated quickly, since the few cancers that arise in nonsmokers/nondrinkers tend to be even more aggressive than usual!) There are numerous benign (noncancerous) tumors of the tongue, including tumors that arise from vascular, salivary or muscle tissue. Occasionally, infection may cause a tumor-like lump in the tongue.

So ... see a doctor QUICKLY. And if you do use tobacco or drink excessively, this little lump (even if it is not a cancer) should serve as a wake-up call for you to QUIT.