Joining this family is a bit like picking your parents. You can't; it doesn't work that way. So here I am, like it or not.

I just spent over an hour struggling to write some semblance of a new, comprehendable, signature in less than 500 characters. It's 493, so don't bother counting unless you are really bored!

Things have moved along. Yesterday, in Vancouver, I became radioactive for the F-FDG PET/CT scan. Later we met with the surgeon who plans a partial glossectomy and removal of some throat bits. I also signed up for a blue light procedure that is supposed to allow the surgeon to see the margins when cutting. Anybody had this?

Yes my dr pioneered it at Pmh he also teaches it to international fellows. It is meant to cutdown the chances of recurrence. Good luck!

Thanks Cheryl. My surgery will be in Vanc. With luck I won't need chem. or rads. I asked about whether I am HPV+ or not, but they got on another subject. I will keep asking. It was a very rushed day with the PET at 11:00 AM, then the surgeon's interview at 2:30PM. A couple funny things transpired. We had to walk about 2 blocks from the PET building to the surgeon's carrying the CD of the scan. The surgeon didn't open it. He told me straight out that I had cancer spots and he was going to operate. No real team consultation, only an oncologist who said she will be at the table to do the blue light thing. Our impression was that the PET/CT was for use later and my diagnosis and treatment were decided by Vanc. and Prince George based on my biopsy, MRI, and CT scans done previously. More info: it is SCC and the MO said I am T1N0M0 to T2N0M0 at this time.

Hi Carpe:
Welcome to the next forum in your journey.

I'm a little worried that you mention there was no "real team consultation" on your case. It sounds like the surgeon is calling all the shots and even the oncologist is only along for the ride in providing the blue light service.

Do you know if this is the usual method used at this hospital in Vanc where one discipline over-rules the others or am I mis-understanding what you wrote?

As for the surgeon not even opening your scan results, I think it possible that the surgeon might have reviewed your scan if he had some time to prepare. But, you bringing it with you gave him no prep time. If he was very busy that day maybe he couldn't take the time to review it in your presence. If that is the case I'm hoping he at least reviews it later to better inform his knowledge of your case. If he never reviews it, then I would really be worried.

Please understand I am not trying to scare you by writing this, there are just a couple of things about what has gone on that somehow don't sit well after reading it. Maybe you need to ask some more questions. Maybe I'm the one who is reading this all wrong. I hope others jump in here and give their thoughts. We have some very informed Canuck members whom I'm hoping will comment.

Take care Carpe, we will get through this forum soon enough and move on into Post Treatment. I am so looking forward to the return of taste in food. I would kill right now for a cheeseburger and fries that I could actually taste.

Tony

The ENT will get a copy of PET report usually that day or the next, in my experiences, and if the hospital is associated with the place of the diagnostic scan, they can look at it in their system. I brought scans in myself from other hospitals, doctors, being I switched locations several times, some who looked at the scan briefly, in my presence, stating he will look further, and another that went to another area, not the exam room, to look at it where it may be set up for that purpose, but it takes time, experience, training to look at them unlike a CT which is more straight forward, and the diagnostic center has to write out the report with the findings, and their interpretation.

I had CT, MRI, FNAB, and a full body PET/CT was still ordered. This is to show any other involvement to distant areas, chest, locations outside the area previously scanned, and each are good for highlighting certain areas, and the PET can detect tumors as small as 5mm. I had one that was 3x7mm, which may not be detected by CT or MRI, which usually detects above 1cm.

I heard of the blue fluorescence, staining, being used during surgery.

I recall your tumor being on the back of your tongue, but could see or reach it. Not sure if this is the oral tongue or base of tongue. HPV-16 is 90% of the time in the oropharynx, tonsil, base of tongue. With a biopsy they can always test for that, and usually doesn't change treatment plans, outside of clinical trials, but being they are doing surgery first, it doesn't sound like oropharynx cancer, which usually involves Chemoradiation, it sounds like the oral tongue.

Good luck with everything.

Here in Canada we actually have electronic medical records. There are three ways of getting results. One on paper - which eventually finds its way there. Two, via phone - the dr. can call in for a preliminary. Three electronically. You can bet your dr. knew the score before you walked in. (I had my first CT at 11am - my family dr. had the written results by two that same day). All he or she had to do was pick up the phone or check his computer. It is the ENT/surgical oncologist who will be doing the blue light procedure. Often here you will have a dr. who runs point on everything. And frankly if you have non HPV related tongue cancer the first line of treatment is your ENT/Surgical oncologist - who will perform the surgery. Once that is done and pathology is back, he or she will send you on to rads and chemo. They may not have sat down and discussed what is going on in front of you... but they do consult between each other. There is a standard type of treatment for this particular cancer (oral tongue) so it sounds like you are on track. Technically the CT is meant to show the dr where to cut (and if there are mets), however with the blue light - the ct is merely a guideline since they will be seeing the cancer in real time.
My dr operated on my husband's cousin 20 for an unusual thyroid cancer. He looked at the ct and based on it said he would be removing her thyroid and 70 lymphnodes in the neck. He went in two weeks later and ended up removing 160, 90 were positive for cancer. The blue light really does make a difference.

good luck!!!

Thanks to Tony, PaulB and Cheryld. Cheryl I agree that my PET/CT could have been electronically sent to the surgeon as we were walking out the door.

As for the next topic, Cheryl, you may have to help me here so I don't get banned. My 59 years of experience with our socialized Canadian system is that you get in line, wait, be glad for your spot in line, wait, see the doctor, wait, see the specialist, wait, then get treated. I sense from our American friends here that they can go to another doctor for a second opinion. I presume they have to pay to do that. Now I know nothing about the American system, but here, in BC at least, we never pay at a doctor's office. We have a "Care Card" which is issued by the provincial government, which owns the hospitals, ambulances, equipment, and pays the salaries of everyone: surgeons, nurses, MDs, lab and Xray techs, clerks, janitors, ambulance attendants, etc. Partly our taxes pay for this; many unionized workers have payroll deductions and/or matching plans, and selfemployed folks like me are directly billed every three months. Nothing is free here, the costs are just more opaque. One rarely, at least here in the bush, hears of someone going for a second opinion. Maybe we just don't have the disposable income. This could, of course, go way off topic to Americans being able to income tax deduct their mortgages, a bone of contention in Canada. Let's not open that can of worms.

So I suppose that there might have been consultation among the two oncologists in Prince George and the surgeon and MO in Vancouver. The way our system is set up, these people can all be linked as if the whole province is one big hospital. Does this make sense?

PaulB, the PET/CT did not go below my waist.

In the spring I had a red sore spot on the top R/H edge of my tongue adjacent to my wisdom teeth (still have all four). There was also a white strip directly below that, on the underside. I also had a white spot above my vocal cords. The surgeon biopsied the red spot and the white spot.

In October the red spot and part of the white strip under my tongue were removed, sort of connecting the areas.

Now in November at PGCC they photographed a white spot on some flaps that I assume are above the vocal cords. If they are the vocal cords, then I am happy to only have one spot down my throat.

Now to further thicken the plot, VCC used some blue "vinegar" dye in my mouth and tell me that I have something developing on the front L/H underside of my tongue about an inch back from the tip.

There, I had to write this in hope of keeping track of all these things for me. Sorry if it's brain damage for you folks. Thanks for reading.

Hey there... I'm Canadian so yes I agree with what you've said re how our system works. Let me share a trick with you.. Push. You can most certainly ask for a second opinion, there are ways of jumping the system to move faster I've done it myself and done the same for my father in law,
If you want to see someone else then find the name of a dr. (Someone tops in their field - when my father in law was diagnosed in sept/Oct with esophageal cancer I told the referring dr I didn't want him treated locally. I found out the type of dr. he was going to be referred to and looked up the top thoracic cardiologist in Toronto. I asked my family dr. For a referral to her (she is affiliated with PMH here) I called her office gave them a heads up, and my dr sent the referral - she booked him in within a week and set him up for his ct the next day. Because of this he has gone through treatment and is two weeks out of rads already - they moved crazy fast because rather than being referred to the hospital /cancer center we were referred to a specific dr. (Minimal wait time - it's a bit like a back door) Plus I made a bit of a pain of myself by calling ahead to make sure they were organized getting him set up for things.
Make phone calls, ask to be put on waiting lists, and ask your dr. for a second opinion at a top hospital to a specific dr. (Most drs will refer only within their group of associates. If you request someone else specifically - this will get you to where you want to be - most people don't realize what you have access to.
I did the same thing with my dr. When I was diagnosed. Being proactive makes a big difference in your care. Also remember to be polite, instead if being demanding explain you're worried and just want to ... Get in as soon as possible - make sure you're making the right decision etc...
Most people simply do what their drs tell them without asking questions - knowledge is power. Hugs

Carpe, I agree with Cheryl. As a fellow Canuck, I did the same things. I saw initially a dentist, then a maxofacial surgeon, then 2 ENT's and did my research, ending up with the 2nd ENT "the guy" as my surgeon. Everyone I spoke to said he is the best, and he is. To his credit, the first ENT had also given me my surgeon's name, so I didn't run into the issue of referrals to colleagues. I think most doctors really do just want people to have the best care.

As Canadians, we have a reputation for being nice and accommodating, which is great for most things, but assuming you are in the best hands is not one of them. You may be, but put the time in to figure it out. Canadians spend more time shopping for winter tires than the right doctor, lol!

Cheryld and Tina 77 thanks for the suggestions. The hard drive on my desktop is growling badly this morning. I am responding on my iPhone and do not know if this will even work. I will post more from a new or repaired unit. This is barbaric!

It needs some TLC ... And maybe a hot water bottle (Canadian humor)

You are probably right. This is being typed on my new $$$$ computer which seems to have lost all our old data, including my wife's accounting files and email. The -20C (-4F)outside is warm compared to the reception this unit is getting. Her anger is keeping her warm.

I'm not impressed either as I type Dvorak, and this hunt and peck (qwerty) is as barbaric as using my phone. More later when normalcy returns. Stay warm.

Carpe - Deja vu is a sinister friend. No sooner did I send you a PM on ideas to recover data from your old tired computer, mine cratered too.

Fortunately, I had another hard drive complete with functional operating system that I could swap in.

Cheryld the new PC is running but lots of data needs converting, transferring etc., so I will be busy for the next while. It appears nothing is lost, just archived. Take care.

Love toying with new technology. ;o) tis awesome fun... and frustrating.

-20? You BC folks are such pansies....Come to Alberta, we'll show ya what cold really is.

Kevin is on the Arctic Slope right now...it's -40 there right now. Or at least it was yesterday. Crazy. I don't know how he does it. He went back to work in January 2012 in that kind of weather, 2 months after finishing tx. Crazy man, but I'm glad he's mine!!

HE IS CRAZY... Even when I feel great... -40 is NOT MY THING... in fact... I prefer +40.

tell him to keep warm. HUGS

Hello again folks. Had to work right up to Christmas Eve afternoon. We're still trying to get the new computer right. And our nice sunny -20C gave way to gloomy wet snow, rain, and temperatures around zero. A real mess.

Heard something interesting out on the road one day. One trucker asked another "Are you still living the dream, or looking for another one"? I said to myself, "Hell, I'm just dreaming to live"!

I hope everyone had a great Christmas. My present will be surgery in Vancouver on New year's Eve, of all days! They have been telling me it's early stage, and hope to remove all the ca by surgery. I know others on here have heard this before, but I'm buying it for now and staying optimistic.

If I really do get away with such minimal treatment, it will make me feel like a kid with a Bandaid on a scraped knee, compared to the suffering many of you have endured. I am unworthy.

Tomorrow we get ready to travel on Sunday. Everyone have a Happy New Year and I will check in next year!

Caripe Diem, many had surgery as their only treatment for early stage tongue cancer, and never looked back since, and wish the same for you. Good luck with surgery, of all dates, but may this bring in a better New Year for 2014. If you can stand that cold, you can do anything, not me Brrr.

Take care

Best wishes for a successful surgery. I will be waiting to see your post that all is ok.

Happy New Year!

Carpe Diem,

I'm glad you were diagnosed at an early stage.

I pray surgery is all you need, and for God's sake stay warm.
Patty Elle

Yes, we're all hoping you need only surgery. But, if that turns out not to be the case, you know where to come for all the support you will ever need. We're here for you.

take care, good luck

Tony

Just a note of encouragement to you. I had a squamous cell carcinoma removed from my tongue Friday, September 27th and was home the following Monday, eating by mouth, swallowing, & talking. I was told I needed the surgery the previous tuesday, so I did not have the time, really, to go online to read forums and get a lot of information. Sort of glad I didn't. No sign of any spreading into neck. My ENT surgeon wants to see me every 6 weeks for a while, have a CT scan every 3 months for a year, then once a year for 5 years.

My very best wishes to you.

Hi Carpe,

As my husband's advocate, I contacted everyone I knew worked in the medical field and was given this advice on the get go: When you call any doctor's office and you have the sense you are not able to get through beyond the administration simply say, 'I would like to have the doctor call me back on this issue'! Now I only used this in the critical planning phase because any lost information or tests that might not get pushed along delays your treatment. I also made a point to ask for a copy of my husbands records, that way there is no wasted time and I was also able to better understand his diagnostics by reading the results myself!

I get the feeling you are very pro-active!
I spent my first Christmas away from my family in Prince George in 1999 before moving to Vancouver for a few years. My little sister lives just in the outskirts of Vancouver.

You go Girl! Best to you, Sophie

First, Happy 2014 folks. I got the last computer problems fixed yesterday. Apparently Windows 8 doesn't like accepting "legacy equipment", i.e. old stuff like my Keytronic Dvorak keyboard.

Thanks Sophie T and all who have been so encouraging. My first name is Norman, 59, and I have never been a smoker.

I had my surgery at Vancouver General on Dec.31/2013. They put me on the 12th floor looking north over Granville Island, downtown, and the North Shore Mountains. There were some interesting fireworks displays throughout the night.

Anyway things certainly went well this time. The previous two biopsies were by scalpel and stitches. This was done by laser. He took a good 1" strip off my tongue (R/H underside) from about the midpoint, back to where it starts down my throat. He also took what he called a papilloma off the top of my vocal cords, a two-for-one deal! That evening for supper and New Year's Day morning for breakfast they served me the same thing: orange and apple juice, Jello, and tea. After breakfast they said I was OK to go. No Chemo or Rads are planned.

I am going to break this up into several posts. For those interested in my procedure, the oncologist who was originally supposed to use the blue light during the surgery was away, so no blue light. All my margins at the surgeon's visual limits. (Sign of cross, fingers and toes crossed, petting rabbit's foot....) As for my future, I will be seeing the MO in Prince George on Jan.15/2014, and my original biopsy surgeon (a colleague of my Vanc. surgeon) on Feb.20/2014.

Hanging over my head is the small spot picked up by the blue light on the R/F of my tongue at the Dec.2/2013 visit to Vancouver. For those interested, this tool is shown on this site in an area called Products/Products for Dentists/VELscope. I am going back and forth with these folks on the use of this technology. They want to use it cautiously, and sparingly, because they say it can yield false positives, gatekeeping as far as I'm concerned. This light shows up early problems not visible to the naked eye under normal light. If someone knows the cost of this device, a post will be welcome. My hope is that if the cost is not too prohibitive, they could become first line screening devices in hospitals where multiple doctors and dentists could have access to them. Of course, if the cost is quite reasonable then distribution could be even more widespread.

This post is for newbies. I could not have written it when I first introduced myself, because I had no experience. Having been at this for 8 months now I think there are some things that newbies need to know.

First, read the forum in order. This means the entire "New Posters Read This First", then the entire "Frequently Asked Questions", followed by as much of the "Introduce Yourself" as you feel you need.

Second, when you go to introduce yourself, here's a tip. If you are like me and thought you would write your intro in MS Word or some other w/p program, to paste in, then forget it. Save yourself the time and aggravation of having your work disappear. There is something in this forum's system that only allows us to type in the official box.

Third, remember that signature/profile/bio you have been encouraged to write? Do it sooner than later or you get an electronic spanking. Another tip, although you may have noticed that some of the veterans seem to have long bios, we newbies are limited to 500 characters. Not sure why.

After you have done these steps, the stuff in the other forum categories can be informative, encouraging, terrifying or depressing. If you have only just had an initial Rx and you are early, then focus on early stuff.

It's great to see your surgery went so well and that you have no other treatment to endure.

I mentioned the Velscope to my dentist as a possible tool to be used in future oral cancer screenings and she said she had read about the false positives issue already about it.

And though you haven't mentioned it yet, there is also another new product on the market. I don't know the name of it, but it's basically a soft brush that you whisk over any areas of interest and then send in for biopsy analysis, kind of a quick look tool. My dentist also had little confidence in this new tool, she basically called it a gimmick.

As for 500 character limits in our signatures, I think that applies to everyone, though I haven't counted characters yet on any of the old heads. I expect that is why they use so many 3 letter abbreviations, which I still don't know the meaning of and haven't made the effort to learn either. I want others to know me for more than just all the procedures I've endured.

Glad you're back.

Tony

OK, what's early stuff? Let's assume this is your first biopsy/surgery.

When done, you will NOT be a complete wreck, although someone else should take you home from the hospital. However, after about two days you will be more than capable of driving. So before you go in, make sure your vehicle is full of fuel. It's better not to be at the self-serve at 25 below in a howling wind. This goes for any other things that will need doing like making sure any bills that could come due are paid. Try to save your recovery time for recovery (and surfing this forum)! So use the laundromat, get some groceries ahead, and do as much as you can to avoid contact with people after the surgery.

Sorry socialites. We told EVERBODY to stay away over Christmas, and that we were visiting nobody, neither my wife, nor me. That goes double for snot nosed grandchildren and others such as handshakers. Those of you who like to kiss dogs on the nose and pull your lips back so the dog can lick your front teeth and gums, well you're on your own. If you are taking any sort of public transportation, buses, trains or aircraft (as I did, my Lear Jet was in the shop over Christmas...yup honest, and I have some land...), then acquire a couple medical masks to wear while travelling. I forgot to do this for the flight down and used a black scarf instead. This got me some serious attention from the airport hero-complex security pretenders. If you have a choice, get the style that has four attachment points and goes behind the ears. You do not want a cold or strep-throat during your recovery.

Although this may be obvious to most people, you should have clean teeth. For a day or two before surgery, get your teeth as clean as possible, brushing and flossing. The problem is that if they are going to work on your tongue, as in my case, your tongue will be swollen for most of the first two weeks to almost half again as large as normal. In my case, I still have my four wisdom teeth, so my tongue tries to sit over top the molars. Biting down on one's tongue is a very real possibility. Your best bet is to pull your tongue down, close your jaws carefully, and keep your mouth shut. You will catch on. OK, but how do I eat? Answer: carefully. More in another post. Returning to cleanliness, you will also not want to be manipulating your tongue much in the first day anyway. On surgery day have a paper pad and pen available to communicate with. Talking could be very painful, especially if you talk too much immediately post surgery, and then the anesthetists drugs wear off. If you are still on mostly liquids the second day you probably won't want to brush your teeth then either because of tongue pain. If you're absolutely determined to brush your teeth, I suggest an electric tooth brush as it moves your tongue less. I have always used regular Crest toothpaste. Even the traditional minty ones like Pepsodent bothered me, and I love the hottest, spiciest, foods on the planet. What some of these new whitening formulas might do on open wounds is for somebody else to report.

As soon as you can move your tongue a bit, hopefully even on the first day you might consider flushing your mouth with salt water to keep any infection at bay. One half teaspoon of table salt in a tall glass of warm water will work good, as often as every three hours. Gargle it, don't swallow it. Now if like me the damage is to most of the right underside of your tongue, then you will have to blast the salt water in there. I obtained a 2oz (60ml) syringe, made by the BD company in New Jersey, from my local pharmacy. It has nice long tip on it with about a 1/8" hole in the end. Now a popsicle stick or tongue depressor to shove your swollen tongue out of the way and your cleaning in style (preferable over the sink with your sleeves rolled up!) This will be very handy when you start trying to eat food. This surgery not like your worst trip to the dentist. It is even WORSE YET. I doubt many have left the dentist with a swollen, incapacitated tongue. You have no idea what your tongue does in your mouth until you have had oral surgery. While you're eating, your tongue brings food back into position to be chewed again. It goes up between your teeth and cheeks and pulls out stray bits. It also cleans out the area beneath itself. All this goes on pretty well subconsciously. After surgery you will find out that those "backwater" areas are too painful to use your tongue to clean out. This is where the syringe comes in. Another item to prepare ahead of time is good flashlight that can shine a focussed beam inside your mouth. Try several and make sure the batteries are good. For food planning then, stock up on the smoothest, non-grainy things you can think of.

Thanks Tony. I mentioned the VELscope to several people around here and it is creating interest. The northern part of BC, where I reside, has far higher rates of smoking than the south. We know the implications. Also, many of the younger generation have bought into the lung health benefits of smokeless/chew/dip tobacco, oh great. It would be interesting to see if your dentist worries about false positives when her oral parts start getting red, white, or painful.
N.

Carpe.... Instead of a 2oz syringe (which is given to automatically PEG tube users) try a waterpik on the lowest setting. This works the best at getting every tiny particle out from between teeth and also would work great with the saltwater rinsing.

Thanks Christine. I don't own a Water Pik, but have seen them over the years in stores. I can just imagine a tool with a pump forcing water through a small orifice would be ideal, and combined with curved plastic pipes getting stuff between the teeth should also be easier. Sounds like we are plugging the product doesn't it?!!

Greetings Newbies if you are following me. This time I want to mention food stuff. If you've been surfing around you likely have found the food list. For those with their first biopsy/surgery the calorie requirements are not so critical. Basically you want a near liquid diet to get over the first week or two. The hospital juice, Jello, and tea will get old fast.

To digress a bit, my "last supper" was on Monday night, Dec.30/2013 at the Raga up Broadway from the Holiday Inn where we stayed on a nice medical rate. I recommend them. Supper was Prawns Vindaloo with rice and lots of cold water. It was great, really sets your face on fire. They do have less zippy fare; it's a great place to eat. Anyway, my surgery was on Tuesday, New Year's Eve. Supper that night and breakfast Jan.1 morning was juice, Jello, and tea. Ugggghhhhh. I got discharged shortly thereafter and we went back to the Holiday Inn to regroup and prepare to stay a couple more days. I did not want to fly back immediately for two reasons. One was germs etc., but the other was aircraft cabin pressure. I find that if I can't swallow well, and with force, my ears do not pop properly. Who needs a painful flight just to save a few bucks? Next we went food shopping. (I'm not sure why, but on long posts this thing slows down making typing a chore. Need new post.)

Newbie Food continued. On either side of the Holiday Inn close by are a Shoppers Drug Mart and London Drugs. Grab some bottled water and either Ensure or Boost for meals. Just down the hill from the Broadway and Cambie Skytrain station is Whole Foods and across the street is a Save-On. At WF I got a small tub of mild guacamole, another of hummus, and to get adventurous, a tub of tapenade. The tapenade is small chopped olives of several varieties, and some oil and spices. These bits can and do get under the tongue and up in the cheeks, but it tastes so good! Across at S-O some Freybe fine Liver Suasage with Herbs, and a couple bottles of low sodium V-8 juice rounded out my first post hospital meal. I'm an omnivore and this liver sausage is about the only meat ground finely enough to get down in the first few days. Even then it's easier to eat washed down with the V-8 juice. There you go, meat, and veggies in a semi-liquid form. We came home two days later on the Friday. Now I am able to smash up hard boiled eggs, then add some guacamole, hummus, and olive oil. This should keep anyone powered up. Tonight I plan a baked cauliflower and broccoli recipe. You will survive, good luck.

Hello Carpe:
A page or two back on your thread we discussed the Velscope and other early diagnosis tools currently marketed and that were planned to be used in your surgery (ie blue light). This morning I was re-reading some of our websites literature at the link below.

http://oralcancerfoundation.org/HPV/ocf-hpv-opinions.htm

From what I read, unless I misunderstand, our own foundation doesn't place much faith in any of these technologies. Now, it seems to me this information is circa about 2010, so maybe changes have occured since time of writing.

Also, if memory serves, at the time all this stuff was written for publication on the website an exhaustive process was used with confirmation by multiple experts in the OC field to insure that everything said was very accurate.

I would love for Christine, Paul and Brian Hill to opine on this.

Tony

Greetings Tony. Although the powers that be may not have faith in the screening technology, someone is paying attention. On the OCF home page, right side, Cancer News, there are two screening related articles. The first is "Abstract B05" and the fifth is "LED Medical...." Dr. Poh, mentioned in the fifth article is one of the doctors who worked on me in Vancouver. Considering the stats on new Dx all over the world, let's hope these low tech, low cost, devices work.

Tissue auto fluorescence technologies have some value and as we learn to interpret what they reveal, (there is a bit of a learning curve) they are in some cases more useful than others. OCF was a funder of this technology long before there ever was a device on the market, when we recognized its potential. The work in those days as being done in cervical cancers, but I and our board saw the idea as useful in oral as well if it proved out. We funded research at MDACC, and later when devices appeared, I was a consultant to the manufacturer. Canada was the home of LED who made the first device - the VELscope, and it is also home to the BC Cancer Agency who has worked (Dr. Miriam Rosen) on the science for over a decade.

There have been wild marketing claims made by companies selling various devices these days about what it will and will not do. At the end of the day it can (not always) reveal dysplasia and cancerous cells that may be difficult to visualize with the naked eye. This is particularly useful in advanced cancers to determine/define surrounding tissues that while not yet malignant, but are dysplastic and on their way to it. Where it has not proven very useful is in HPV+ cancers, as they develop deep in the basal cells, and do not produce surface based lesions that the device can be used for (nor can they be seen by the naked eye). HPV in the tonsil very seldom ever produces a surface lesion or color change and it has metastasized through the normal lymph drainage passageways into the cervical nodes of the neck so fast, that in most cases a surface lesion never appears even in stage 4 disease.

So while it is highly useful, it is not the second coming, nor able to find everything, and it is highly non specific. It finds all tissues in which the fluorophores in the cells are non functional, indicating cellular damage, and more often that not this damage is NOT cancer. It can be benign things, even hyperkeratosis which is just the formation of a thickening of tissue from chronic low grade trauma. So this is where the "art " of interpretation of understanding what it is revealing comes into play. Everything that goes dark when you are using the light is NOT cancer, and most things are even just natural anatomical occurrences, such as any blood vessels that are close to the surface of the tissue, like under the tongue. The hemoglobin in the blood has the same reaction under the light as tissue abnormalities. Useful device/science yes, completely game changing device, no.

Brian thank you for putting the screening device matter in perspective. As possibly the luckiest guy on the site with OC, I want as much early detection as possible for everyone. They tell me that my OC was caught early, and the December 31, 2013 surgery is all I will need. It's tough to read the stories posted by folks diagnosed late. Worse yet are those whose cancers progress while they mistakenly relax with a benign diagnosis, because their samples weren't analyzed by labs properly experienced with this horrible disease.

You are right to express caution about wild marketing claims. The internet has allowed all the old scams new life with a greater audience. Separating the unscrupulous from the promising behooves us all.

When you consider Dr. Edmund Truelove's study using the Velscope, you realize what an important tool it is in the hands of a trained oral health professional.

I was able to catch his lecture at the 2012 Pacific NW Dental Convention and meet him and Dr. Dave Dean, who was one of the researchers in that study. What they found is that they could only visually identify medium, to high risk dysplasia less than 70% of the time.

This was a shocking figure to me, considering these were "the experts" in Oral Cancers. Now, every dental student working in the clinics at the University of WA uses a fluorescent screening device on new new patients.

I have too many stories of early detection successes that I've had the honor of being apart of to do anything but praise the technology, and expect the use of it on routine checkups.