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#158939 12-14-2012 04:58 AM
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Dear all

I was diagnosed with tip on tongue cancer, underneath and on the left hand side and had surgery on the 14th November. My surgeon took out a big chunk but found that the biopsy had got all of it and lots of healthy tissue was removed, however he wanted to be safe than sorry. I have not had a neck dissection as the tumour was so small (3mm by 4mm) he said it was protocol not to do the invasive neck surgery for such a small tumour.

I am really very grateful that it�s been caught early but I feel like the whole cancer thing has just hit me like a truck and it�s sinking in now, I�m having awful nightmares. It�s now just a month after surgery and I have a lisp that upsets me as I�m a Counsellor/Psychotherapist who was attending interviews for jobs up until this happened. I get so scared when I speak to strangers and can�t ever imagine being given a job speaking like this, especially as the jobs I�m qualified for involves advocacy, public speaking and campaigning.

I�m being referred to a speech therapist and a clinical psychologist by my amazing Macmillan nurse (UK special cancer nurse) so I really hope they can both help.

I really don�t want to fall into the victim trap when I�ve been so lucky and others aren�t but I feel so awful. Can anyone give me any hope for my lisp to improve due to a shorter tongue and less of a tongue down the left hand side, and also if any feeling will come back in my tongue? � the doc won�t say either way if the nerves will regenerate or my speech will ever be the same, humph!

Thank you, Kate


T1N0M0 Tip of tongue cancer
32 year old female from the UK
Diagnosed 31 Oct 2012
Surgery 14 Nov
Partial glossectomy
No neck dissection as tumour 3 by 4 mm
Ex smoker and drinker
Joined: Dec 2010
Posts: 5,260
Likes: 3
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Hi there and welcome - I had a similar tumor- it was larger than yours and initially after 2 cts and an MRI - determined to not have spread past the tongue - wrong!!!!! I could feel a node pop up prior to Surgery but it didn't matter as my dr told me he was removing 40 nodes from the get go. thankfully he did and caught it with only one node involved.

For this type of cancer (non HPV related) the usually remove them as a Precaution.

I don't want to scare you just make you aware of two things - your tumor was very small so chances are you're clear. But do keep a close eye on your neck just in case anything pop up. And if it does hightail it back to see him immediately. (if you are very young this is even more important as this cancer tends to be more aggressive in younger people.

Secondly your speech will improve once you've healed. I had half of my tongue removed on the left side and a new piece grafted from my wrist then they radiated it... And now - almost 2 years out you can barely tell - things will improve. Hugs and welcome


Cheryl : Irritation - 2004 BX: 6/2008 : Inflam. BX: 12/10, DX: 12/10 : SCC - LS tongue well dif. T2N1M0. 2/11 hemigloss + recon. : PND - 40 nodes - 39 clear. 3/11 - 5/11 IMRT 33 + cis x2, PEG 3/28/11 - 5/19/11 3 head, 2 chest scans - clear(fingers crossed) HPV-, No smoke, drink, or drugs, Vegan
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Welcome to OCF! Recovery can take months. At this point you still have some swelling so it will alter your speech. Try seeking out a speech pathologist. They can do wonders in helping you to get back to normal.

Best wishes!


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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Hello, thank you for that, you've given me some hope.
I guess there is still a little swelling at the front left hand side tip to go down yet. Its S�s and Th� that are rubbish right now.They do say the tongue can get stronger. I have been reffered to a speech therapist so fingers crossed that will help in the new year.

Last edited by Englishgirl32; 12-14-2012 09:22 AM.

T1N0M0 Tip of tongue cancer
32 year old female from the UK
Diagnosed 31 Oct 2012
Surgery 14 Nov
Partial glossectomy
No neck dissection as tumour 3 by 4 mm
Ex smoker and drinker
Joined: Dec 2012
Posts: 7
"OCF across the pond"
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Joined: Dec 2012
Posts: 7
Thanks for that. I'm being checked every month and will have all sorts of scans regularly. Don't worry I'll be the first one down there if my neck feels swollen. Fingers crossed hey.
I do trust they have done the right thing with the neck, I think they are doing it this way more and more now for small tumours with clear margins. I�m 32 so hoping that if there is a stray cell then my strong immune system will fight it off.


T1N0M0 Tip of tongue cancer
32 year old female from the UK
Diagnosed 31 Oct 2012
Surgery 14 Nov
Partial glossectomy
No neck dissection as tumour 3 by 4 mm
Ex smoker and drinker
Joined: Jan 2006
Posts: 756
Likes: 1
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Hi Kate and Welcome to OCF!

As many on the board would say, �glad you found us, but sorry you had to!�

I also had tongue cancer � right lateral side � and have had 4 surgeries to remove part of the tongue each time. After each surgery I did have problems with speech and still have some problems when I talk a lot or I�m tired, but for the most part my speech is pretty good. Definitely go for the speech therapy. I didn�t as my doctor didn�t recommend it, but I had been to a speech therapist as a child so I did some of the �tongue exercises� which seemed to help. You can start my just moving the tongue in circles, side to side, and try to curl it. I�m sure when you see the speech therapist they will provide better instructions for your particular situation.

I also did not have a neck dissection because my tumor was small, but did have radiation 8 months later (long story). I did have a recurrence a few years later (same location), and at that time some of the doctors recommended a neck dissection but again did not have one. During my �cancer journey� I consulted with 4 surgeons (ENTs) and 2 radiation oncologists at 4 different medical facilities. I did my research, asked a lot of questions, and used the resources on the OCF website and the OCF forum to help me decide.

My surgeries were done by 2 different ENTs and I continue to see both of them regularly. Thanks to the after effects of radiation I am having some dental issues, so I also see a prosthodontist and a periodontist, both with experience with oral cancer patients.

So you are doing the right thing by being checked frequently and I�ve found that I knew something was wrong even before my doctor did. Dealing with a cancer diagnosis is a big and affects you both physically and mentally. Seeing a clinical psychologist is a great idea.

I wish you the best!


Susan

SCC R-Lateral tongue, T1N0M0
Age 47 at Dx, non-smoker, casual drinker, HPV-
Surgery: June 2005
RT: Feb-Apr 2006
HBOT: 45 in 2008; 30 in 2013; 30 in 2022 -> Total 105!
Recurrence/Surgeries: Jan & Apr 2010
Biopsy 2/2011: Moderate dysplasia
Surgery 4/2011: Mild dysplasia
Dental issues: 2013-2022 (ORN)
Joined: Jan 2012
Posts: 112
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Hi English Girl, i'm a brazilian girl, almost the same age. My case is pretty like yours except i did not drink or smoke! I also had a small tumour. My doc which is awesome said that a neck dissection would be done if the depth of tumour was larger than 0.3 cm. Mine was 0.6. So depth is what matters not the size.

Other thing is the grade. Your tumour was well differentiated?

So, the good thing is that i had a neck dissection but none of them were positive.


December, 2011 - T1N0M0 SSC Oral Tongue sugery (Dec 07, 2011). Partial glossectomy, primary closure. Selective Neck dissection, all 57 nodes free. 29 at diagnosis, no risk factors at all. No smoking, drinking and HPV negative. Can you explain? I can't.
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Hello Susan
Thank you for the tongue exercises, I've already started on them so I can get a head start for when I see the speech therapist in the New Year. Another chap also said the tongue becomes more flexible and that he can stick his tongue out further than he could after surgery.
I'm sorry you have had to have four surgeries but very glad you avoided the neck dissection which I've heard can have awful complications. A lot of people in my life (family/friends etc) are putting the frighteners on me about not having had the neck dissection and it's really quite upsetting and makes me think of death every day. I have a great team at my hospital and it was a big group of experts that were all in agreement about not having the neck dissection. I should trust them as they do this every day and know my cancer unlike others. I guess you also had these fears but your doctors seem to have made the right decision.
Thank you for replying Sue.


T1N0M0 Tip of tongue cancer
32 year old female from the UK
Diagnosed 31 Oct 2012
Surgery 14 Nov
Partial glossectomy
No neck dissection as tumour 3 by 4 mm
Ex smoker and drinker
Joined: Dec 2012
Posts: 7
"OCF across the pond"
Member
OP Offline
"OCF across the pond"
Member

Joined: Dec 2012
Posts: 7
Hi Brazilian girl

Oh that�s a good question, I'm not sure if my tumour was well differentiated, I'm seeing my Dr again in January so I�ll ask him. I'm sure it was otherwise I guess he and his team would have done the neck dissection.
How is your speech? Has it got better over time? Was your tongue shorter after surgery? Is it feeling a bit more normal? Sorry about the questions haha.
I think that is why I'm lisping, or it could just be that it's only just over 4 weeks after the surgery.

Thanks for message by the way.
Kate


T1N0M0 Tip of tongue cancer
32 year old female from the UK
Diagnosed 31 Oct 2012
Surgery 14 Nov
Partial glossectomy
No neck dissection as tumour 3 by 4 mm
Ex smoker and drinker
Joined: Jan 2012
Posts: 112
Senior Member (100+ posts)
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Senior Member (100+ posts)

Joined: Jan 2012
Posts: 112
Hi Dear, well my speech is about 90% ok after one year. I still have some sequels in some letters. For example, the hardest word for me is VIDRO, which means GLASS. vidro is in portugues, and i must say that when i speak english people barely notice anything. i can say DROWNING perfectly but VIDRO goes out a bit stuck.

Well, one year ago I was removing that bothering NG tube. I tought i won't survive but i'm here. 2012 was harder for me because i delt with all this cancer paranoid and in the same year i lost my father to lung cancer. So you imagine how hard it was...

But everyhting adjusts itself.

What about your speech?


December, 2011 - T1N0M0 SSC Oral Tongue sugery (Dec 07, 2011). Partial glossectomy, primary closure. Selective Neck dissection, all 57 nodes free. 29 at diagnosis, no risk factors at all. No smoking, drinking and HPV negative. Can you explain? I can't.
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