Hello Everyone,
I just wound up on this site why trying to look for answers. I had a lump to the left of my upper front teeth on the gumline near the teeth. My dentist sent me to an oral surgeon who did an excisional biopsy. I figured everything was cool since I did not hear back from him for two weeks when I had a follow up. He than told me that I was diagnosed with Dysplasia and it needed to be treated or it would turn into Cancer. Obviously I freaked out because of the normal stuff. One night I watched my kids sleep and started to cry and I was really worrying about it. I got a copy of the biopsy and read it as I have some more surgery so they can remove the rest of the abnormal cell growth. The final diagnosis was Papillary Epitheial Proliferation with features of Dysplasia. The slightly worrisome part is that in the same area that they cut out, a smaller lump is there. I saw the dentist this Monday and they said it looks alot better so I guess I should stop worrying. I was just curious if anyone knows anything about dysplasia and what the timeline is for it to turn into Cancer? Thank you for your time.

Hello, I know you are upset by the biopsy results. Please relax, it is NOT cancer. You are very fortunate to have such good results! Dysplasia is the earliest form of pre-cancerous lesion recognizable in a biopsy by a pathologist. It does not mean you will be on a timeline to develop cancer. Everyone is different and while some will turn into cancer, others do not. Im sorry but I do not understand what Papillary Epitheial Proliferation means.

Hope I eased your mind a little.

Hello Christine,

Thank you very much for your post. It did help ease my mind and thank you for the explanation. I am sorry if I offended anyone I just did not really understand what was going on. I still kind of do not because I do not fit into the risk factors. I just was not expecting them. My Oral Surgeon says he wants to cut everything out but I am waiting for my insurance company to give me the go ahead. The waiting sucks. I am sorry for seeming unfortunate. I know I am fortunate for the results and I really do thank you for your reply. You are a really nice person for your kind words. Thank you very much.

My husband was another one with an initial diagnosis of dysplasia. His did turn malignant (and fortunately was caught at the very earliest stage possible), but that is the exception, NOT THE RULE. (See my signature for more info.)

Now that you have been told you have dysplasia, you need to remain vigilant. After my husband's leukoplakia was identified as dysplasia, I found this site and asked about the diagnosis. Here's what OCF founder Brian Hill replied (the emphasis is mine):
[quote=Brian Hill]Dysplasia are those cells which are no longer normal, but they are not really malignant yet -- an in-between state, so to speak. Dysplasias also do not always go completely over to the dark side, but they are a step in that direction -- and having them removed, or watched very regularly, is prudent. ... Keep an eye on things even after the removal from now until forever.[/quote]
In my husband's case, the excisional biopsy by a local ENT removed the whole thing (the initial biopsy, by an oral surgeon, took only a tiny part of it). When cancer was identified, he immediately was seen by an oral cancer specialist at Johns Hopkins, who determined that no further treatment was necessary but brought him back for regular checkups. He has now "graduated" to an annual check at Hopkins and gets a thorough oral cancer exam (complete with VELscope) every six months by his dentist.

You are lucky to have such a proactive dentist!

Groc, one thing you will learn from being here, a second opinion is necessary! Please dont just opt for surgery cuz this oral surgeon who is not a regular doctor of yours tells you to. Oral surgeons are exactly that....surgeons. Surgeons cut and once its gone, its gone. Please get another opinion before you do anything. Now that you know what it is and that you have it, if it would change at all you will be right on top of it. Please keep posting and get more responses from people who have been exactly where you are.

I whole heartedly agree with the advice to seek a second opinion. I would also suggest that you see an ENT (aka otolaryngologist), instead of another oral surgeon. ENTs are trained to treat oral cancer after the oral surgeon diagnoses it. Going directly to the ENT leaves out the expense of the middle-man, not to mention the delay. While the oral surgeon is messing around in your mouth making lots of money, cancer could be spreading through your body. Your insurance is much more likely to pay for treatment from an ENT. I know this through experience.

Good luck.

Hello Groc, and welcome to the OCF. Don't worry about offending anyone with your questions. We've all been through the "is it cancer?" and "what if it is" scenarios so everyone here understands your concern and wish you all the best. Your diagnosis is somewhat life altering as now you need to be vigilant but certainly not panicked. If it does turn into cancer, you will be right on top of it in it's early stages when treatments have a very high success rate. Keep us posted ok?

Thank you everyone for all the suggestions. I am going to get a second opinion. I was just going over my biopsy results and I do not think they have a true handle on what it could be so they are calling it Dysplasia, which is good. They could do one of those lets wait and see what it is is but they want to go in and remove all of it. I like the proactive approach. I have Kaiser so financially it is a better idea to go to one of their hospitals and see and ENT or Oral Surgeon. I will keep everyone posted. I think as long as I keep on this I will be okay. Thank you for all of your concern and advice. I really appreciate it.

I disagree with Slash. The oral surgeon did the most appropriate thing - he did a gold standard biopsy to determine what was going on and he got you a gold standard answer. The cells had become dysplasia. This can be the first step to malignancy. However, there are many different grades of dysplasia - low to high grade, with varying degrees of risk. To say that he is messing around your mouth to make money is a disservice to the guy, and to say this same comment given that he has done this by the book is just wrong.

Not all ENT's are the same there are 4 and 6 year ENT's. The vast majority of them are 4 year doctors who see the vast majority of strep throat and earaches in the US. The smaller group become head and neck surgeons. The first group don't know any more than an oral and maxillofacial surgeon, who is trained to do le Forte procedures in which they take your face and sinus chambers apart in 14 pieces and put you back together. I wouldn't dismiss their skills. Having said that, there are some that are just exodontists and extract teeth.

You are now at a point in which you need to have someone interpret the pathology report for you as to the extent of the dysplasia and it's grade. Of all dysplasia, only 25% becomes malignant left untreated. But in my book, something that has had some cellular transformation away from normal is something I want rid of, and to that end I am hyper conservative about watching things for any protracted period of time to see what it is going to do. I am not fond of the idea. And those of us that have danced with this thing before should not take a wait and watch attitude even with low grade dysplasia in my thinking. When low grade it is superficial, and can even be removed with a laser. I would get a consultation with someone that is affiliated with a cancer center so see that it is removed. Having said that, it is not uncommon for experienced oral surgeons to laser remove tissues like this or do so with a scalpel.

You have likely read lots on these boards. So you know this is not something to mess around with. But take solace in the fact that this isn't cancer. It is a step towards cancer, and a very early find which means a minimum of issues taking it off, and to the rest of your life. Keep us posted as to what you do and how it all turns out.

You don't say where you are in CA, but if you want to PM me I may be able to help you find the right person to deal with this, or give you the options open to you for its removal.

Hi Groc,

I am going to have to disagree with Brian. I have no disrespect for oral surgeons as a group, but they are not trained to treat cancer. Both oral surgeons and ENTs can diagnose oral cancer, but by working with an ENT to follow your dysplasia, you will already be in the proper treatment circle should (heaven forbid) cancer develop.

Brian is flat out wrong when he states that most ENTs have only 4 years of medical training. Quoting directly from the American Academy of Otolaryngology: �To qualify for certification by the American Board of Otolaryngology, an applicant must first complete college, medical school (usually four years), and at least five years of specialty training. Next, the physician must pass the American Board of Otolaryngology examination. In addition, some otolaryngologists pursue a one- or two- year fellowship for more extensive training in one of eight subspecialty areas.�

Good luck. I hope you stay cancer free.