We Asked a Doctor If Having Lymphoma Increases the Risk of Tongue Cancer

Dave Coulier, of the famous series “Full House”, has just revealed that he has been diagnosed with oropharyngeal tongue cancer linked to HPV. His news comes just over a year after he was diagnosed with stage 3 non-Hodgkin’s lymphoma. We asked our chief medical officer, Sohaib Imtiaz, MD, if there was a chance the two cancers were related.

Q: Dave Coulier was diagnosed with lymphoma last year and now has tongue cancer. Is there a link between the two?

Imtiaz: I’m not part of Coulier’s care team, so I can’t speak about his specific case, but second primary cancers like this can occur in patients with lymphoma or types of blood cancer that affect the lymphatic system.

At the outset, it should be noted that lymphoma does not directly cause head and neck cancers.

As my colleague Amit Garg, MD, a California-based oncologist and hematologist, told me: “There is no evidence that lymphoma causes head and neck cancers. The most common risk factors for head and neck cancer include smoking, excessive alcohol consumption, HPV infection, and immunosuppression.”

However, research has shown that lymphoma patients are at significantly increased risk of developing a second primary cancer (new, unrelated cancers that develop in people who have already had cancer), including head and neck cancers, such as tongue cancer. These patients have a risk three times higher than the general population.

This elevated risk is well documented and particularly notable for survivors of non-Hodgkin lymphoma and Hodgkin lymphoma.

In general, the relationship between lymphoma and subsequent tongue cancer depends on many different factors.

Immunosuppression, whether due to the underlying disease or its treatment (chemotherapy, radiotherapy), plays a major role, as does exposure to shared risk factors such as viral infections (Epstein-Barr virus, HPV).

Treatment-related effects, particularly after hematopoietic stem cell transplantation (sometimes used to treat lymphoma), further increase susceptibility to solid tumors of the oral cavity.

The bottom line: There is no evidence of a direct biological link between lymphoma and tongue cancer, but patients with lymphoma, like Coulier, face a higher risk of a second primary cancer due to immune system suppression, overlapping risk factors and the effects of treatment options.