In 2004, I had an ulcer on the left side of my tongue. It was red and painful, especially when I ate spicy food. At my regularly scheuduled dentist appointment, I showed my dentist the spot. He assured me it was nothing and told me to watch it. It didn’t go away. At my next dentist appointment, I pointed out the ulcer to my dentist again. He referred me to an oral surgeon.
At my first appointment with the oral surgeon, he assured me it was probably nothing. I wasn’t a smoker or heavy drinker. And I was only 33 years old. He suggested an in-office biopsy just to be certain. I went back on another day and with local anesthetic, he took a small sample of the area to send to pathology. A couple of weeks later, I got a call to report the biopsy showed “dysplasia” or abnormal cells. The biopsy area healed and I didn’t think much about it.
A year or so later, I noticed a similar ulcer in the same area of my tongue. I showed my dentist and I made an appointment with my oral surgeon. We scheduled another in-office biopsy, this time under light sedation, which was much less uncomfortable. Again, the incision healed by the time the pathology report, again noted “dysplasia”.
In 2007, I was pregnant with my 4th son and the red, painful ulcer spot was back. I went to my dentist. I went to my oral surgeon. I was referred to an Ear, Nose and Throat specialist. He recommended a laser procedure under general anesthesia once I was farther along in my pregnancy. I wanted to wait until after he was born (due late August), but by April, the area was causing me constant pain and my doctor and I thought it was time to do the procedure. His plan was to simply laser the area to remove it without biopsy. In the operating room, he decided to take a sample to send to pathology.
The day after Mothers Day 2007, we found out the biopsy indicated Squamous Cell Carcinoma. My ENT immediately started the process for me to be seen by a Head and Neck cancer specialist at MD Anderson Cancer Hospital in Houston, Texas. We were there a few weeks later where, after a whirlwind of tests and appointments, I had a partial glossectomy (removal of 2.6 mm x 2.6 mm x .5cm of the left side of my tongue). The depth of invasion was just under the margins that would have required a neck dissection to check for cancer in my neck lymph nodes. My 4th son was born August 3, 2007.
For the next 2 years, I had checkups and CT scans at MD Anderson every few months. I remained clear of any signs of cancer. The same area of my tongue began showing signs of irritation again in 2011. Another surgical biopsy was scheduled with my local ENT. The pathology once again indicated “dysplasia”.
I was having regular checkups with my ENT after the 2011 biopsy. Again, in early 2012, the same area of my tongue looked suspicious and another surgical biopsy was done. The initial results were again “dysplasia”, but I requested my pathology slides be reviewed by MD Anderson. Those results showed some cancerous cells were present. We made trips to MD Anderson for checkups and a needle biopsy of an enlarged lymph node (negative for cancerous cells) was done there in August of 2012. I was also seeing my ENT regularly.
We began watching a spot in the same area of my tongue in late 2013 and at a checkup with my ENT, we again decided another surgical biopsy was necessary. In February 2014, after examination by my doctor in at MD Anderson, I had another partial glossectomy (removal of 2.5cm x 1.4cm x .3cm of the left side of my tongue). I also had another needle biopsy of an enlarged lymph node (negative for cancerous cells) during this visit. The pathology results from this surgery showed “moderate to severe dysplasia”, but no cancer was found. The incision has healed almost completely. There is some numbness, but I have no speech, swallowing or eating issues so far as a result of the many (7 in all) procedures I have had on my tongue.
I will continue to have checkups with my local ENT and with my doctor at MD Anderson regularly. There will probably be more biopsies in the future, but with contstant monitoring, the hope is that the abnormal cells, if any, will not have the opportunity to progress into cancer.
Ask your dentist for an oral cancer screening at your next checkup.