Young Woman Confronts Tongue Cancer and Transforms Life Outlook

Every year, more than 700 cases of mouth, head, and neck cancers are diagnosed in Ireland. Traditionally, these cancers predominantly affect men and older adults, particularly those with risk factors such as smoking and excessive alcohol consumption. However, recent data from the Marie Keating Foundation indicates a concerning rise in cases among younger, non-smoking individuals, especially women. One such case is that of Orlaith Maher, a 24-year-old from Tipperary, who received a diagnosis of tongue cancer in January 2025.

Maher first noticed an issue with her tongue in October of the previous year. “When I moved my tongue from side to side, it hurt a bit on the left side,” she recalled. Despite not seeing anything unusual in the mirror, a small lump was palpable. A few weeks later, a small white patch appeared, accompanied by pain in her left ear and a feeling of fluid buildup. Concerned, she brought these symptoms to her dentist’s attention during a scheduled appointment in November. The dentist performed an oral screening and subsequently referred her to an oral and maxillofacial surgeon at the South Infirmary in Cork.

After undergoing an examination, Maher was scheduled for a biopsy. “I received a letter about three weeks later for a review appointment,” she explained. During this appointment, her doctor delivered the life-altering news: she had squamous cell carcinoma of the tongue, the most prevalent form of oral cancer, accounting for approximately 90% of all oral cancer cases.

Although the diagnosis was shocking, Maher appreciated the straightforward manner in which her doctor communicated the details. “He told me it was cancer, and then outlined what needed to happen next. Honestly, that was all I wanted to know — what is going to happen now?”

Cancer of the tongue is considered rare, and the level of support required varies depending on the treatment plan. Fionnuala Creighton, a cancer nurse with the Irish Cancer Society, noted that typical treatments include surgery, chemotherapy, radiotherapy, or a combination of these methods alongside targeted cancer drugs. Given Maher’s background as a speech therapist, she was acutely aware of the potential impact on her profession and her ability to communicate. “I was scared in terms of what my speech would sound like afterwards,” she admitted.

To determine the extent of the tumour and whether the cancer had spread to her lymph nodes, Maher underwent an MRI, CT scan, and X-ray. The MRI revealed a tumour measuring 2 cm long and 8 mm wide. “They explained I would need what they called a ‘free flap’ because they would be removing part of my tongue and would need to reconstruct it,” she said. Her surgeon informed her that a section of skin from her wrist would be used for the reconstruction.

Despite the daunting prospect of surgery, Maher maintained a positive outlook throughout the process. “I think being positive got me through it,” she stated. “I had such good support from my family and friends. The cancer was caught early, and I had excellent care from the medical team.” She focused on each step rather than the long-term implications, which helped her manage the emotional weight of her diagnosis.

In February, Maher underwent surgery to remove the tumour along with a 1 cm margin of surrounding tissue, which was confirmed to be cancer-free. Unfortunately, the cancer had spread to two lymph nodes in her neck, necessitating radiation therapy. She completed 30 rounds of radiation over six weeks, a challenging period marked by significant side effects. “The radiation caused ulcers all over my mouth, which stung when I ate. My diet suffered, and eventually, I was put on a liquid diet,” Maher explained. Just two days after finishing radiation, she was hospitalized with a lung infection, staying for four nights.

Recovery became a team effort involving a physiotherapist, occupational therapist, speech therapist, and dietitian. Treatments targeting the tongue can lead to complications with eating, drinking, and speech. Creighton noted that some patients may need ongoing support, including psychological assistance, to cope with the permanent changes that can result from both the cancer and its treatment.

By September, Maher had returned to work, gradually working to restore her life to what it was before her diagnosis. An active individual, she continued running up to just before starting radiation. “I’m back playing football now and I’m running again and exercising normally,” she reported. “My speech is normal. My eating and drinking are fully back to normal, except I can’t really eat spicy foods anymore, and I do suffer a bit with dry mouth.”

Maher received her first post-radiation scan in September, which revealed no signs of cancer. Reflecting on her journey, she stated, “I would say my outlook on life has changed. Before, I used to just go to work, Monday to Friday, and on the weekend play football and meet my friends the odd time. Now I want to do fun things and spend more time with my family. Life is short, and it should be about spending time with the important people, because you never know what might happen.”