What should you know about melanoma tongue cancer?

A dark, changing or bleeding area may be noticed, but colour alone cannot confirm the diagnosis. A clinician examines the mouth and may arrange a biopsy so a pathologist can identify the cells involved.

The tongue contains several types of tissue, so a suspicious mark, ulcer or lump can have causes other than melanoma. The diagnosis depends on examining a sample under a microscope. The report may describe the tumour's depth, edges and other features that help the cancer team plan care. Examination of nearby areas and imaging may be used to understand whether disease is confined to the tongue or involves lymph nodes or other sites.

Treatment is individualised. Surgery may remove the tumour with a margin of surrounding tissue; reconstruction can be discussed when removal affects speech or swallowing. Radiotherapy may be considered when local control requires additional treatment or when surgery is not suitable.

Arrange an appointment with a dentist, oral medicine clinician or doctor for a tongue lesion that persists, changes, becomes painful, or bleeds. Bring a list of medicines and describe when the change began. If a biopsy confirms melanoma, ask for review by a head and neck oncology team. The plan may include biopsy review, scans, surgery, radiotherapy or other specialist treatments based on the findings.

Do not scrape, burn or repeatedly irritate the area while waiting. Softer foods and gentle mouth care may reduce discomfort, but they do not replace assessment.

Seek prompt medical care for a tongue area that is enlarging, repeatedly bleeding, or associated with a persistent ulcer, new numbness, a neck lump, or difficulty chewing, speaking or swallowing. Seek urgent help if swelling causes trouble breathing or if bleeding does not settle with gentle pressure. These signs do not prove melanoma, but they warrant timely examination.

Ask where the lesion is located, whether a biopsy is needed, what the pathology report shows, and whether nearby lymph nodes need assessment. You can also ask how proposed surgery might affect speech or swallowing, when radiotherapy would be considered, and what symptoms should trigger an earlier review.