Posted By: Tyson Lingual Tonsil Biopsy - 12-05-2011 07:43 AM
Hello folks, and thanks for the many posts from others that I've found extremely helpful and comforting over the last few days. I'm not entirely sure whether or not I am a cancer patient yet, but I had a "slap in the face" kind of visit to the ENT the other day.

For the sake of providing some background I'm currently 30 and I admit to not always having made the best decisions when it comes to oral cancer risk factors. I drank a decent amount in college and I smoked cigarettes for a couple of years. I kicked the smoking habit a year or so after I finished school but I traded it for a chewing tobacco habit which I sort of started and stopped a few times over the next couple years before kicking that one as well. I've also battled acid reflux on a few occasions. I never worried much about most of those vices because serious consequences seemed like such a long shot at my age, and I was sworn (by my wife) to give them up once we had children.

My thinking on consequences has since changed drastically. About 6 weeks ago I got a pretty severe sore throat but didn't think much of it. I used to get sore throats about every 6 months until I had my tonsils out about 3 years ago, generally once I went on Amoxicillin they would clear up. This time I realized after a week or so that the feverish feeling had gone away and I was left with a pain on the right side of my throat and occasional pain in my right ear. After another week I became worried and scheduled an appointment with a local ENT who I found on one of the local "best doctor" lists.

At my first appointment the doctor checked me out and used the scope to look up my nose and down my throat (Transnasal Endoscomy?). He said that he could see a little bit of residual effect from stomach acid, and he also noticed a lesion on the lower right base of my tongue which he said could potentially be Lingual Tonsillitis. He put me on Omeprazole twice a day and a 5 day course of Azithromycin and told me to check back in a couple weeks and see if I was still having pain.

Initially I thought that things seemed to feel better, but after two weeks I still felt a lot of pain at times. My voice felt raspy when I talked sometimes, like I needed to drink hot tea or suck on a cough drop to be able to talk normally. I had pain in the right side of my throat above my Adam's Apple, and occasional throbbing in my right ear. At times it felt just slightly difficult to swallow. I also had a few other random sensations like light pain in the back of my neck and upper chest and headaches that I wasn't sure were related but seemed just a little odd.

I went back to the ENT last Thursday and he looked down my throat again and he asked me if a few areas on the right side of my low tongue were sensitive to the touch of the scope (they weren't, mostly my nose was just hating life). The doctor then told me that he wanted me to go in for a CT Scan and that he wanted to biopsy the lesion on my lower tongue as soon as possible. He said that cancer was still a very low percentage chance at my age but he wanted to be on the safe side.

I got the CT Scan that same day and I brought the images back to the ENT. The Radiologist report won't come in until early next week, but upon glancing at the images the ENT said that they pretty much confirmed what he was seeing with the scope but not much more: a little bit of asymmetry and a swollen area on the right side of the throat, but nothing that he was terribly worried over.

I'm set to have surgery to biopsy the area on Tuesday and I'm definitely a little bit anxious. Mostly I'm wondering a few things: How painful is the biopsy and recovery (not too worried, just mostly trying to figure out if I'll be back at work the next day or should plan on taking time off)? How long does it typically take to get the results? Will the doctor have any additional info/suspicions right after the surgery when he has the chance to get a better look at the area? Do the symptoms described above ring true for anyone who either has oral cancer or who went thru a similar biopsy and didn't end up having cancer?

It's easy to go crazy about these kind of things, I have a 2 month old baby and for some reason I've been fearing the worst all weekend. Reading some stories from other folks in similar situations has helped me to be less nervous if I were diagnosed with cancer, so I really appreciate everyone here and thanks in advance for any feedback.
Posted By: Anne-Marie Re: Lingual Tonsil Biopsy - 12-05-2011 08:59 AM
Hi Tyson - You sure have come to the right place for the best and latest information. Glad you found us! It's good you are having the biopsy Tuesday (tomorrow) so you don't have long to wait. And it's not cancer until a biopsy says it is. When my son had his biopsy, it was very quick and not really a big deal. It did not interfere with his normal activities. It's been a while but I think his biopsy results took about a week. I'm sure you will be hearing from others with some more recent experience that more closely resembles yours. Try to keep busy until your appointment time so that your mind doesn't go crazy thinking about all the "what ifs". You could check the main page of this site where it says "Diagnosis" which has a section on different types of biopsies and it will help you think about (and write down) questions you might have for the doctor or for anyone here. Let us know what happens.
Posted By: Cheryld Re: Lingual Tonsil Biopsy - 12-05-2011 01:04 PM
Hi there - try not to worry too much, as Anne Marie says its not cancer til the biopsy says it is.ni think you could probably go back to work right after it on Tuesday - often you're frozen a bit so you should be fine, and you should be okay once it wears off, my tumor was in my oral tobgue area - it was sensitive - but no more painful than my initial tumor - and of course food irritated it. Results are a week maybe a bit more depending on your hospital but your ct results should be lost immediate - you might be able to get them today -though it may not tell you much more than our already know! good luck! Hope you. Don't need to join our group! Take care
Posted By: Gary Re: Lingual Tonsil Biopsy - 12-06-2011 11:04 PM
Surgical biopsy? I guess, but my tonsil (tumor) was biopsied by snipping a piece out. They numbed the throat - it was no big deal. If they are giving you a tonsillectomy, that's a fairly unpleasant procedure for an adult. They will give you pain meds I am sure.

They are supposed to numb your nose and throat with a numbing spray (I like the banana flavored stuff) when they use the nasolarygnoscope. It's no big deal either, I occasionally request it even.

Be sure that the biopsy sample is tested for HPV as well. In the long shot that you do have cancer, it is more likely that, at your age, that would be more of a causative agent than use of tobacco products. Why didn't you quit 2 years ago? Wasn't that the agreement with your wife? Maybe tobacco isn't the causative agent now but it could very well be in the near future.

GERD is more known to be a causative agent of esophageal cancer. You definitely want to get a handle on that as well.

There are conditions, other than cancer, that can be causing your symptoms. You are wise to rule out cancer.
Posted By: Maria Re: Lingual Tonsil Biopsy - 12-06-2011 11:23 PM
It will depend on the procedure. The had to put my husband under for the biopsy. Snippets were sent to the lab as the biopsy proceeded - no cancer on the surface, he had to go a bit deeper to find it. We had the cancer diagnosis immediately (a year ago today, exactly), the HPV determination was four days later when those lab results were in. Our doctor (bless his heart) got those results to us as soon as he had time to send them.

For his procedure, the followup was no heavy lifting for two weeks. He had a pretty good sore throat for a week or so, but was able to work.
Posted By: ChristineB Re: Lingual Tonsil Biopsy - 12-07-2011 03:12 AM
Tyson, welcome to OCF. Glad you have found this forum to help you with your concerns. Hope your biopsy turns out to be nothing serious. If it would be then you have found a great resource for help.

A biopsy can be done 4 ways. First a fine needle biopsy is the easiest one but it isnt as black and white as a regular biopsy. A needle takes a tiny sample of your cells. Then you can have some cells scraped or cut to be sent to the lab. You can be put to sleep for the biopsy or have it done with a local numbing shot. The final way is to just have the doc take a couple teeny tiny snips while you are awake. Ive had biopsies done asleep, with a local and awake with nothing. I prefer to just get it over with by letting the doc just do it and be on my way.

Depending on how much tissue and the location will determine how sore yo will be. It could be 2 to 4 days til you feel better. Its really not that bad. Results generally take about a week to come back. Try to stay busy so you will be focusing on other things and not worry so much. If it turns out to be cancer then it will be treated and you can move on with your life.

Best wishes!

Posted By: Tyson Re: Lingual Tonsil Biopsy - 12-07-2011 06:03 AM
Thanks so much for the responses all, I really appreciate the kind reception and the info.

I had the biopsy today under general anesthesia so I'm on Oxycodone (just taking half dose since it makes me nauseous, will probably switch to just Tylenol tomorrow) and Cephalexin at the moment. The doctor told me after the procedure that he found some calcification in the right lower tongue that he removed and cauterized along with other snippets. I wasn't in a great state to ask questions because I was pretty loopy, but he wants to see me in a week to see where I'm at and discuss whatever results come back from the lab. From my feeble attempt at some research afterwards I'm not clear on whether it was a tonsilolith or something else.

@Gary: I will definitely ask about HPV, thanks for bringing that up. My deal with my wife has always been that I would quit tobacco once we had kids (and that was just 2 months ago). It's never been very hard for me to quit but it is generally hard not to start back up again at some point down the line. I do feel like this experience has given me enough of a reality check that I have stronger motivation not to jump back in this time around, and I'm doing some research on successful quitting strategies to try to improve the odds.

@Maria/Christine: I think the main reason that the doctor decided to put me under general anesthesia is because he was keeping the option of lingual tonsillectomy open, but once he got in and took a look he didn't feel that it was necessary. My throat is scratchy and it's a bit hard to eat or talk loudly, but I'm not in a terrible amount of pain or anything and I expect I'll be back to work Thursday or Friday.

Again thanks, and I'll post again after my appointment next week.
Posted By: Maria Re: Lingual Tonsil Biopsy - 12-07-2011 04:49 PM
Glad to hear from you, Tyson. Try to have some quality time with the kids to take your mind off things, and maybe take your wife to a movie (I like her as she is being so good about encouraging you to get off tobacco!). Best wishes and fingers crossed for your family.
Posted By: Gary Re: Lingual Tonsil Biopsy - 12-07-2011 09:43 PM
Hi Tyson,
At least the biopsy is over! I had a bit of anxiety over mine as well. Now all you have is the anxiety of waiting for the path report. I honestly don't know how people get through this without anti-anxiety meds :-()

I had tonsillitis so often as a kid they could never find a window to remove them - then they tried to kill me in my mid 50's ;-)

Evidently you are not alone with lingual tonsil issues. See:

http://ehealthforum.com/health/topic26254.html#b

Quitting tobacco and other irritants certainly can't hurt.

Posted By: Tyson Re: Lingual Tonsil Biopsy - 12-12-2011 01:17 AM
Got some great news, the lab results came back and they didn't show anything other than inflammation!

I'm supposed to go back to see the ENT later this week so hopefully I can still get some of my more questions answered in person. It sounds like the doctor is pretty confident that irritation from the calcified area was causing the inflammation and painful symptoms but I'm still not clear on whether that resulted from something external getting caught in the lingual tonsil or what. I haven't experienced the very painful symptoms that I had before surgery at all this week so it seems like he was probably correct about the source of the problem.

Once again I'm super grateful for the comments and encouragement on the forum here. All the best to all you folks, and I hope you have an amazing holiday season!
Posted By: Maria Re: Lingual Tonsil Biopsy - 12-12-2011 03:03 AM
A very happy holiday season to you and your family, Tyson!
Posted By: Cheryld Re: Lingual Tonsil Biopsy - 12-12-2011 05:52 AM
Awesome!
Posted By: julieann Re: Lingual Tonsil Biopsy - 12-12-2011 06:02 AM
Hi Tyson:
Your kind of posts are the ones we love to read - congratulations on a good report. Now you can enjoy the holidays.
julieann
Posted By: Gary Re: Lingual Tonsil Biopsy - 12-13-2011 12:26 PM
That's great news Tyson.

Stay away from those tobacco products!
Posted By: Tyson Re: Lingual Tonsil Biopsy - 12-21-2011 09:28 PM
So unfortunately I've had some more throat discomfort since the operation. It's odd, I haven't really had the same sensations on the right side of my throat, but about 4-5 days after the operation I started getting similar symptoms (less severe) primarily on the left side. It's really odd, the discomfort kind of comes and goes but at times it can be pretty bothersome. In some ways it has me concerned that something was missed during biopsy, although the more rational side of me says that it's likely something else.

I'm headed out of town for the holidays, but I've got a visit back to the ENT set for early Jan. Hope you all have a great Christmas and a happy New Year!
Posted By: Tyson Re: Lingual Tonsil Biopsy - 01-09-2012 06:54 AM
Probably my last post unless anything major changes, but I wanted to provide a quick update. I visited my ENT late last week, he asked some questions about how I've been doing, took a quick look and sent me on my way telling me not to be worried. It was the first time I had seen him face to face since the biopsy so he gave me a bit more context. He said that while taking samples he noticed something hard in the lower right lingual tonsil area that he hypothesized was something foreign that got stuck and the tissue around became irritated and/or calcified, which he removed.

My primary symptoms are gone, I don't have the severe pain in my right throat and ear like I had initially. The only thing that worries me a bit is that I still get an odd achy sensation at times in my throat, in the area just behind my jaw and under my ear, and in my ear (on both sides at different times). It's not very painful but it's just annoying/odd enough to make me a bit concerned.

At any rate I guess the fact that the CT and biopsy both looked normal should remove my fears of cancer or any kind of tumor, I just get kind of nervous that I'm still not crystal clear on the root cause. The fact that several people post in these threads that the doctor had to go "deep" to find a tumor makes me just a tiny bit nervous that something is being missed.

At any rate I guess there's not much to do at the moment other than wait and make sure the symptoms don't get worse, and not to worry too much about something that doesn't seem very major. Again I really appreciate the support and information from everyone here and I hope 2012 is treating you well so far!
Posted By: Cheryld Re: Lingual Tonsil Biopsy - 01-09-2012 04:09 PM
That's great do keep an eye on thing but go out and live your life!! smile
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