Hello everyone,
Need help on understanding the patho report from many of you experts.
She had surgery 1 wk ago today. SCC on right side of tongue. 70 yrs old. Went Monday to ENT dr. he removed the BOLT( gauze) that was holding the skin grafted to her tongue.
She's still having a lot of mucus in her mouth and pain. Did anyone have this problem. The dr. said it will get better. For next 2 wks he just wants her on pureed foods. He said no chewing at all. She's still having trouble getting food down.
Coughs some. I think her tongue is still swollen and sore. Anyone have this trouble? Cathy, Lisa or Jerry? Any suggestions of foods that are easy to get down?
Anyhow patho states the margins are clear. Which makes me very happy. T1 tumor. (does this mean stage 1 )?
Under diagnosis right hemi tongue- states ulcerated moderately well differentiated keratinizing squamous carcinoma.
also under diagnosis labeled a-f.
Each margin labeled with a letter. Medial, posterior,lateral, deep and anterior margin.
Under anterior deep margin say chronic sialadenitis-no evidence of malignancy.
Under tongue deep margin-skeletal muscle negative for malignancy.
All the rest of margins say no tumor found, no evidence of malignancy.
Jerry was wondering if you could help me understand some of this info?
I'm not sure of all the layers of the tongue. But to cut into the skeletal muscle does this mean that the tumor was deep?
When we took my mom for her follow up they did not have patho report. My father picked it up next day but did not speak to dr. about it.
She has another follow up next week.
Will find out then when she will be having radiation.
Maybe I am trying to read to much into this patho report.
Thank you all for listening and I hope everyone is doing ok. Take care. Michelle

Michelle,

I didn't have a graft, but I did have plenty of swelling and soreness for several weeks while my tongue healed. (I still remember the day after the surgery when they moved me from the ICU to a private room, and the nurse's aide showed up a few minutes later with a cafeteria tray containing a well-done steak -- even in my heavily medicated state, I had to laugh out loud!) When I couldn't handle solid food, the list of things that seemed easier to swallow included: broth (warm, not hot), ice cream, applesauce, pudding, instant breakfast, smoothies from the blender, yogurt, scrambled eggs, and many different flavors of baby food.

I'm not sure I can shed a great deal of light on the specifics of the pathology report -- her doctor should explain it to her and be able to put it into the context of her overall treatment plan.

Cathy

Hi Michelle,

I, too didn't have a graft so I can't really address that issue. You will more than likely hear from many who did.

I'll try to answer as many of your questions as I can.

T1 does mean Stage I.

Sialedentitis is a bacterial infection of a salivary gland and it appears that your mom had a chronic or long term infection. (no malignancy).

I'm sorry but I don't know what the skeletal muscle of the tongue is. Never heard of this.

Hope this was of some help. Keep asking.

Jerry

I am so glad that we have a dentist on the board regularly. Thanks for being here doc. I agree with Jerry that this is a term that I have never heard when reffering to the tongue. Even outside the area of the tongue this is vague and out of the ordinary terminology. Clearly most major muscles have insertion points where they attach to the osseous structure of the body. In reference to the mouth and not to the tongue we have a variety of muscles that are often involved in advanced oral cancers, and even outside the oral environment in the neck muscles with skeletal attachments often are implicated. But his use of this phraseology is obsure at best.

Michelle,

My mom did have a skin graph taken from the front part of her upper leg (nasty scar that she has has multiple cortison injections from her regular dr) It did not heal very nicely and the graph did not really take that well. Her breathe was really bad for a couple weeks but once it healed she was fine. It will take a few weeks before the graph attaches but when it does the healing takes place rather rapidly. I have been thinking about you and if there are any questions that you have please email me.

Take care,
Dani

Michelle,

My personal favorite was Campbells Tomato Soup. My husband would make it with about half to 2/3 of the can of water. It really soothed the savage beast my tongue turned into. Not sure if it was the sodium in the soup, the tomato or the fact that my husband found something that really did the trick for me and made a presentation every time he brought it to me. Jello pudding cups, popsicles, little individual servings of Blue Bell ice cream, sherbet... he had a never ending supply of cold smooth things that really helped.

Best to your mom,
Lisa

The mucus problem will increasing get much worse as radiation and chemotherapy begin. There are many elixers out there but nothing really works well. Tussin expectorant 4 times daily seems to work best.
When does that problem end?
I still have major problems with mucositus....
Darrell

THANK YOU ALL FOR YOUR RESPONSES. All the information is very helpful.
We will find out more next week when my mother goes back to see the dr. about the patho report.

Cathy I can't believe that they tried to feed you a steak.
Dani I would love to hear your mom's story.
Sorry that she had to go through 2 operations.
What type of cancer did she have? And where did she have it?
Did she have a partial or hemiglossectomy?
Did she have chemo or radiation?
Sorry for all the questions.

Darrell Hi how are you doing. Sorry about your reoccurance. Is in the same area?
Did you have routine pet or CT scans? And is this when they found it or were you having symptoms?
My mom had it back in 1986 and 1988. Then 2003 had another surgery for high grade dysplasia.
Today I pulled out her patho report from her last surgery in 2003. It said High-grade dysplasia/carcinoma in-situ-arising in backround of mild to moderated squamous dysplasia.
I was wondering if she should of had radiation then in 2003 for the carcinoma in-situ.
I remember the dr. saying it wasn't cancer then.
Anyhow now she has it again. This will be her first time for the radiation.
I think she is having a lot of mucus in her mouth right now from the surgery. Her tongue is still healing and has the graft.
It's been 2 weeks today and she still is taking her pain medicine. Tylenol with codiene. She said it's getting better each day.
She's 70 and it takes your body longer to heal when you are older.
Thanks to all the rest of you for your response.

I just take one day at a time. Try to look at the positive side. It appears that it has not spread anywhere else, and they got clean margins.
Now we just have to get through the radiation.


Take care everyone. Michelle