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#147541 - 03/28/12 10:21 PM new to the board
pleasant Offline
Member

Registered: 03/28/12
Posts: 14
Loc: MA
Hi, name is Brett.

For the past three months I have a little spot of what appears to be white swollen pappile near the midline and back of my tongue. that is, on the dorsal surface and near the back and center there is a kind of gash above the swollen pappile..it.. looks like a fissure about 1 cm long... and it itches... in fact the right side of my tongue has an itchy area right around it... sometimes the pappile bursts (it's really tiny) and there is a little hole.. and then it will do it all over again.

My PCP sent me to an ENT, but would not try antibiotics.


I am afraid I have sticked my tongue out, hyperextended it so much looking at the thing that it made IT sore.

The inflammed pappile spot is about 2mm in diameter and it seems to be a little sore.. especially if I pallpitate it.
I am going to an ENT tomorrow for an inspection and a biopsy of it.

I have looked at the rest of my tongue and all over.. and there is nothing else to see.. no white or red areas.. although like I said the right side of my tongue seems inflamed. There are no lymph nodes swollen.. but my tonsils sometimes swell if I stick out my tongue to far.

What can I expect for a biopsy?

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#147543 - 03/28/12 10:54 PM Re: new to the board [Re: pleasant]
EricS Offline
Patient Advocate (1000+ posts)

Registered: 01/03/09
Posts: 1844
Loc: Idaho
Welcome to OCF Brett!

Glad you found us, sorry you had to!

Biopsies of the inside of your mouth or on your tongue shouldn't be too bad really. They usually give you a local and take a few small samples to send to pathology, who then analyzes the samples under a microscope and determines if it's cancer or not. As they are the "only" way to confirm cancer, what you should expect are answers really.

Take each step as you have to and try not to let fear and worry overcome you. The survivors on these forums should give you hope that even "if" your biopsy comes back positive (and to be clear there are several other conditions that could be going on in your mouth, not necessarily cancer) it doesn't have to mean it's the end of the world.

As I say often, there is strength in numbers and that's why I always recommend plugging into these forums and the other patients, survivors and caregivers that can relate to what you are going through.

Best of luck, keep pluggin in and keep on keepin on!

Eric
_________________________
Young Frack, SCC T4N2M0, Cisplatin,35+ rads,ND, RT Mandiblectomy w fibular free flap, facial paralysis, "He who has a "why" to live can bear with almost any "how"." -Nietzche "WARNING" PG-13 due to Sarcasm & WAY too much attitude, interact at your own risk.

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#147547 - 03/29/12 02:12 AM Re: new to the board [Re: EricS]
ChristineB Offline
Administrator, Director of Patient Support Services
Patient Advocate (old timer, 2000 posts)

Registered: 06/23/07
Posts: 9129
Loc: PA
Brett, welcome to OCF! I hope you dont need to be here and that your sore turns out to be nothing serious!

As far as a biopsy goes, its usually a 3 visit thing. First time is the exam and they will give you 3 options. They will take your insurance info and get pre approved. The next visit is the biopsy and the third visit is the results. It usually takes a week for the results to come back. Most often you will need to go into the office to get the results in person.

The 3 ways to do a biopsy are as follows. Do it without anything to numb you, a local numbing agent or to be knocked out under anesthesia. Personally, I prefer just to let them take a tiny snip without anything. Then you dont have the numb mouth for hours or worse, have to get someone to drive you and sit with you while you sleep. Its really not that bad. You may be sore for maybe 2 or 3 days at the most. Of course all that depends on where your sore is and if the doc can easily get a tiny sample.

Try to keep yourself busy so you dont worry. I know its not easy to do but try reading a book, watching movies, or something else to keep your mind off the mouth problem.

Good luck!!!
_________________________
Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07, no caregiver
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 extended hospital stay, ICU & burn unit
PICC line w/ IV antibiotics 8 mo
10/4/10, 2/14/11 reconst surg
OC 3 times in 3 years
very happy to be alive smile

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#147552 - 03/29/12 04:16 AM Re: new to the board [Re: ChristineB]
Cheryld Offline
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)

Registered: 12/22/10
Posts: 5260
Loc: Toronto canada
Good luck on your biopsy! It shouldn't be too bad. Maybe a few days of pain... Minimal. Take care.
_________________________
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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#147557 - 03/29/12 10:56 AM Re: new to the board [Re: Cheryld]
Anne-Marie Offline
Patient Advocate (old timer, 2000 posts)

Registered: 11/03/06
Posts: 2671
Loc: TN
Hi Brett - I'm so glad you found this place. It's the best place to be for all the latest information and the compassionate and knowledgeable help from those who have been where you are. My son's biopsy was in a very swollen portion under his tongue. They just snipped a portion off with no numbing or anesthesia and results were a week later. It's good you are getting a biopsy which will tell you more clearly what's happening and can put you in control or what the next steps are. It could be just nothing but whatever it is, you will be better able to do something about it. Keep in touch here and let us know what's happening with you.
_________________________
Anne-Marie
CG to son, Paul (age 33, non-smoker) SCC Stage 2, Surgery 9/21/06, 1/6 tongue Rt.side removed, +48 lymph nodes neck. IMRTx28 completed 12/19/06. CT scan 7/8/10 Cancer-free! ("spot" on lung from scar tissue related to Pneumonia.)




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#147687 - 04/02/12 12:40 PM Re: new to the board [Re: Anne-Marie]
pleasant Offline
Member

Registered: 03/28/12
Posts: 14
Loc: MA
Hello again,

Thank you everyone for your welcome.

I had the biopsy done, it took about 5 minutes (punch biopsy)
That was 4 days ago.. it was a little hole on the top of my tongue near the center line.. about 3mm diameter, about 2 mm deep.

No sutures. It plugged up right away and it looked filled in.

But today I woke up and the plugg must have come out.. and now it hurts.

How long do punch biopsies without sutures take to heal?

I see the doctor in 13 days


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#147689 - 04/02/12 12:58 PM Re: new to the board [Re: pleasant]
pleasant Offline
Member

Registered: 03/28/12
Posts: 14
Loc: MA
I have a terribly good imagination, so it being painful from time to time on the fourth day makes me feel terrible, I see it as an ominous sign.

When the ENT saw the little dot, he looked through his magnifying thing and said "unremarkable" and then we did the biopsy, then on the way out he said I should not be concerned..that sometimes the tounge can do things like this..my PCP said the same thing and so did the dentist...

perhaps because it's right near the mid-line and top of my tongue
they do not seem concerned?


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#147691 - 04/02/12 01:08 PM Re: new to the board [Re: pleasant]
Cheryld Offline
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)

Registered: 12/22/10
Posts: 5260
Loc: Toronto canada
It sounds good! Usually a few days after surgery or a biopsy are the worst. Despite the fact hat our body clears the meds - it sometimes takes that long for the freezing to go away. Re location. Most of the tongue cancers (oral) tend to be under the tongue. Hopefully it won't take 13 more days to get the result. Bu I wouldn't worr too much. Take care!
_________________________
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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#147692 - 04/02/12 01:25 PM Re: new to the board [Re: Cheryld]
pleasant Offline
Member

Registered: 03/28/12
Posts: 14
Loc: MA
Hi Cherld,
I don't understand "freezing" to go away? and relocation?

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#147711 - 04/03/12 03:36 AM Re: new to the board [Re: pleasant]
Cheryld Offline
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)

Registered: 12/22/10
Posts: 5260
Loc: Toronto canada
Freezing - usually they freeze you locally During the biopsy - it wears off but sometimes the actual pain sensation is the worst a few days after... re: location - I meant - with regards to location - usually oral tongue cancer is under or on the side of the tongue.
_________________________
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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#147717 - 04/03/12 04:57 PM Re: new to the board [Re: pleasant]
braziliangirl82 Offline
Senior Member (100+ posts)

Registered: 01/26/12
Posts: 111
Loc: br
In 3 days I started eating again. In 10 days I were fine. In 20 days I was 100%.
_________________________
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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#147741 - 04/03/12 11:21 PM Re: new to the board [Re: braziliangirl82]
pleasant Offline
Member

Registered: 03/28/12
Posts: 14
Loc: MA
Okay,

I had this biopsy done last Thursday, it was a punch biopsy
The lesion was in the middle of my tounge almost near the back.
after the biopsy It was a little deep hole, proabably only 2mm.
He didn't tell me anything, like gargle or the like.
But he did throw me on Amxocillan 500mg 3 times a day.

So, that was TH, FR, SAT, SUN, MON, TUES

But I have this soreness around the area and redness..
and it kind of travels down the tounge
and some times it flares up.. and then settles back down.
I am pretty sure I am fighting an infection.

Perhaps he should have sutured it? Perhaps I didn't keep it clean enough?

At any rate I am seeing the GP tomorrow for a full physical, and I left a message at the ENT's office questioning this behavior.

I think I will go get some more hyrdrogen peroxide and a thermometer.

I have a bad feeling about this behavior.

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#147759 - 04/04/12 03:04 AM Re: new to the board [Re: pleasant]
Cheryld Offline
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)

Registered: 12/22/10
Posts: 5260
Loc: Toronto canada
Try not to worry until you get our results - it is possible you do have an infection, the mouth is one of the dirtiest places on your body. Try to keep the area clean. Take care...
_________________________
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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#147828 - 04/05/12 11:18 PM Re: new to the board [Re: Cheryld]
pleasant Offline
Member

Registered: 03/28/12
Posts: 14
Loc: MA
The biopsy was negative;

It said on the screen at my PCP:

Inflammation...no Malignancy detected

The woman from the ENT's office called me and told me that too,
and then she said sometimes the pathologist may send it out for a second opinion..

I see the ENT again in a week for a review.

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#147843 - 04/06/12 03:59 AM Re: new to the board [Re: pleasant]
Cheryld Offline
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)

Registered: 12/22/10
Posts: 5260
Loc: Toronto canada
Yeah!, keep a close eye on it... smile
_________________________
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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#147845 - 04/06/12 04:17 AM Re: new to the board [Re: Cheryld]
ChristineB Offline
Administrator, Director of Patient Support Services
Patient Advocate (old timer, 2000 posts)

Registered: 06/23/07
Posts: 9129
Loc: PA
Excellent news! Congrats!!!!
_________________________
Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07, no caregiver
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 extended hospital stay, ICU & burn unit
PICC line w/ IV antibiotics 8 mo
10/4/10, 2/14/11 reconst surg
OC 3 times in 3 years
very happy to be alive smile

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#147855 - 04/06/12 11:41 AM Re: new to the board [Re: ChristineB]
pleasant Offline
Member

Registered: 03/28/12
Posts: 14
Loc: MA
Thank you!

The biopsy left a little 3mm hole since it was a punch or scoop thing, so I am trying to see that heal up.

It's been covered, then bleed, then oozed and the inflammation weant down.

I am on the 8th day of that and just concerned if it won't heal correctly.

I think sticking my toune out to look at it, may actually be upsetting the healing process!



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#147858 - 04/06/12 02:13 PM Re: new to the board [Re: pleasant]
BuffaloFan Offline
Contributing Member (25+ posts)

Registered: 04/05/12
Posts: 30
Loc: Rochester NY USA
Originally Posted By: pleasant


I think sticking my tongue out to look at it, may actually be upsetting the healing process!




Recommend not sticking it out unless a herd of wild pink elephants come walking through your living room. grin

Good luck
_________________________
squamous cell carcinomas Stage 2, 1/26/2012. Surgery 2/15/2012 - Finished Chemo 5/18/2012 Finishing Radiation 5/29/2012
So make every minute count-Jump up, jump in and seize the day-And let's make sure that in every single possible way -Today is gonna to be a great day

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#147882 - 04/07/12 01:27 AM Re: new to the board [Re: BuffaloFan]
Kerri Offline
"Above & Beyond" Member (500+ posts)

Registered: 08/08/11
Posts: 592
Loc: MA
Hi, Brett!

I'm just catching your thread now, but I am so happy to hear that your biopsy was negative!

My experience with my initial biopsy was that he had to excise a piece of tongue(about the size of a chick pea) under local anesthetic and boy did it hurt like hell! So, my experience was quite different than some posting in this thread.

As far as a punch biopsy goes, they may not have stitched it due to the location. My ENT/surgical oncologist said that "the tongue is very forgiving" in that it fills in well and will kind of "remold" itself to the confines of your oral cavity. My guess is that you are indeed irritating it by sticking it out so far and so often. That would make a normal tongue sore, unless you're Gene Simmons! So, I would say give it a rest. You may want to avoid acidic foods until it heals and any textures that are difficult for you to manipulate with the tongue. If you're still concerned about infection or keeping the biopsy site clean, you can ask your ENT for chlorohexidine oral rinse, which will help cleanse the wound. You shouldn't use it long-term, though, because it stains your teeth.

All said and done, the best part is that you don't have oral cancer! I'm glad you came to us for support! Best of luck to you!

smile Kerri
_________________________
37 y/o fem at Dx (23 wks preg @ dx on 3/16/11)
SCC L oral tongue (no risk factors)
L partial gloss/MND 3/28/11 @ 25 wks preg
T1-2N0M0; no rads/chemo
Tonsillectomy on 8/6/12 +SCC L tonsil T2-3N1M0 (HPV-)
Treated with 35 rads/7 carbo & taxol (Rx ended 10/31/12), but many hospitalizations d/t complications from rx.
Various scans since rx ended are NED!
Part of genetic study for rare cancers @ MGH.
42 years old now...I wasn't sure I would make it! Hoping for 40 more!

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#147904 - 04/07/12 01:30 PM Re: new to the board [Re: Kerri]
pleasant Offline
Member

Registered: 03/28/12
Posts: 14
Loc: MA
Hi, Thank you for your replies..

seems like at 8 days it should be all healed up. but it keeps getting slightly inflamed and re-opening. perhaps thats what happens with second intention (no stiches).

perhaps I am expecting too much..

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#147905 - 04/07/12 01:38 PM Re: new to the board [Re: pleasant]
ChristineB Offline
Administrator, Director of Patient Support Services
Patient Advocate (old timer, 2000 posts)

Registered: 06/23/07
Posts: 9129
Loc: PA
Try rinsing your mouth at least 5 times per day with a mixture of...

16 oz warm water
2 tsp baking soda
2 tsp salt

This helps with healing mouth sores so it should help you too. Also get some protein powder or up your protein intake for about a week. Protein will help you to heal faster. Between those two things, you should heal alot faster.

Good luck!!!
_________________________
Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07, no caregiver
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 extended hospital stay, ICU & burn unit
PICC line w/ IV antibiotics 8 mo
10/4/10, 2/14/11 reconst surg
OC 3 times in 3 years
very happy to be alive smile

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#147906 - 04/07/12 01:41 PM Re: new to the board [Re: pleasant]
pleasant Offline
Member

Registered: 03/28/12
Posts: 14
Loc: MA
See this was like a little white spot about 2 mm on the dorsum of the tounge near the midline.. and in the area there was inflammation.. like a red raised area near it.

The biopsy said "inflammation"

I wonder how long people can have problems like this that are not malignancies?

In retrospect, I think I may have eaten a large mouth full of almonds back in November and I remember I bit down and my tongue and it hurt in this area.

But then again a year previous to that, I seem to remember a period of time where certain foods would bother the area.

I guess I am just concerned, because difficulty in healing is troublesome.. unless this specific area of the tounge is less amiable to healing.

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#147908 - 04/07/12 03:32 PM Re: new to the board [Re: pleasant]
Kerri Offline
"Above & Beyond" Member (500+ posts)

Registered: 08/08/11
Posts: 592
Loc: MA
I would say just make sure a close eye is kept on it by you and an ENT. Be persistent and your own advocate! Just enjoy the fact that you are fine right now!
_________________________
37 y/o fem at Dx (23 wks preg @ dx on 3/16/11)
SCC L oral tongue (no risk factors)
L partial gloss/MND 3/28/11 @ 25 wks preg
T1-2N0M0; no rads/chemo
Tonsillectomy on 8/6/12 +SCC L tonsil T2-3N1M0 (HPV-)
Treated with 35 rads/7 carbo & taxol (Rx ended 10/31/12), but many hospitalizations d/t complications from rx.
Various scans since rx ended are NED!
Part of genetic study for rare cancers @ MGH.
42 years old now...I wasn't sure I would make it! Hoping for 40 more!

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#148039 - 04/09/12 10:42 PM Re: new to the board [Re: Cheryld]
pleasant Offline
Member

Registered: 03/28/12
Posts: 14
Loc: MA
Hello,

11th day.. I go back and see the ENT on Thursday morning.

I have to say that this area seems to be healing but slowly.. but it's taking longer then I expected.. The biopsy that he did was with some kind of cup forceps or something and he let it heal by second intention, no sutures.

It keeps having periods of light inflammation, to itchiness and then slight dull pain very low in intensity under it... with no reffered pain. The tounge swelling has gone down, but not completley.

How long would these things take to heal? they said about two weeks.. but perhaps it sometimes longer?

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#148124 - 04/11/12 11:11 PM Re: new to the board [Re: pleasant]
pleasant Offline
Member

Registered: 03/28/12
Posts: 14
Loc: MA
Hello,

I think the area is healed, but is slow to coming around from eliciting minor pain and swelling. I don't know.. it seems sometimes to feel like it used to.. and then it goes back to a needly inflmmation kind of sore..

Just to see the other day, I ate an orange (this was 2 days ago)
just to see if it was an open wound... and it didn't hurt at all like a canker sore does.

I am really kind of worried about this sore spot.. it seems that perhaps I recall it being sore at other times.. like almost 7 months ago..

What kind of questions should I ask the ENT tomorrow?
He's obviously going to take a look at it.. what should I ask him?. The biopsy said negative... "Are you SURE?"
it's right near the center of my tounge.. perhaps it's right over cartilage?

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#148129 - 04/12/12 02:21 AM Re: new to the board [Re: pleasant]
Cheryld Offline
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)

Registered: 12/22/10
Posts: 5260
Loc: Toronto canada
Explain to the dr how worried you are and ask to see him or her frequently until it's healed. And after hat because it should be monitored. Good luck!
_________________________
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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#148314 - 04/15/12 02:44 PM Re: new to the board [Re: Cheryld]
pleasant Offline
Member

Registered: 03/28/12
Posts: 14
Loc: MA
Hello Again, I did.

He said come back in 2 months and that the biopsy report said acanthosis with mild atypia. parakeratosis with acute inflammation in surface epilithium.. no evidence of malignancy.
And he felt that it was fine, but we would look again in 2 months.

The doctor said leave the area alone and try to keep the little fissure clean. For some reason the area has a fissure there, that looks out of place. (this is the dorsal of the tounge, near the midline)

so being the kind of guy I am, I called up and tried to talk to the pathologist. I got another one and just asked what some of the words meant. When I read him the diagnosis.. he said it was an inflammation response.

So, I'll see the ENT in 2 months. I don't know what else to do.


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#148345 - 04/16/12 01:17 AM Re: new to the board [Re: pleasant]
Cheryld Offline
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)

Registered: 12/22/10
Posts: 5260
Loc: Toronto canada
Sounds good! Just keep a close eye on it! Take care!
_________________________
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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