Hello. I'm 33 years old with an appointment set for tomorrow to get a biopsy done on my upper right gums. Here's my story. Years ago, and I'm talking quite possibly 4 years ago I had a small white sore form on my upper gums on the right side. Honestly, I didn't think much of it, and that's mostly because it didn't hurt at all. Months passed and this sore didn't go away. Sometimes it would swell a bit, sometimes it would hurt but that was only after irritating it by eating or smoking more than a pack a day (I normally smoke about a pack a day). I've been a regular full time smoker since the age of 14. Even with this, I didn't think this might be the start or any type of warning signs of cancer. After months had passed and this sore was still persisting, I decided to go to my general dentist. What he told me, was that this sore was nothing to worry about and should clear up on it's own. Well here I am now, basically 4 years later, and that sore is still in it's same spot, still white. But now, I have another sore next to it which is red, and this one hurts more than the first one ever had. I quit smoking as of 2 days ago. Cold turkey. I'm too scared and not about to play with my life like that. What scared me, was looking up what these sores could be. I'm not sure of the duration of this second sore that has formed. I've had pain in that area for a while now. Sometimes it feels as though I have a toothache, which I think is impossible since I have mostly fake teeth, implants, crowns and bridges all along the top of my mouth. I am not sure I have one real tooth up there. After looking thoroughly in my mouth I think I've noticed another sore that is not painful, on the back left side of my tongue.
Here are some discomforts and symptoms I've had for the past few years. Most of them, now I can contribute it to possibly being the big C. But not all of them. Unless there are symptoms I haven't read about. I'm sure everyone is different and goes through sickness differently though. Like I said, I have an appointment to get a biopsy done tomorrow, but any help or information is much appreciated.

Symptoms (or are they):
Sores (that won't go away) in my mouth (gums and now tongue)
Bleeding when brushing. (This happens rarely and only on the side of the sores on my gums)
Vomiting in the middle of the night. (usually at least once a month)
I went through a bout of bad strep throat that just kept coming back, about 2 years ago. I had it about 7 times in that one year.
Headaches that feel like they are just sitting there waiting to get worse. I feel like the headache never actually leaves. Also, I went through a bad bout of migraines that would form and stay behind my right eye. I can sometimes still feel the pressure there when I have a headache. (All right side - which seems connected to me).
I sometimes have difficulty swallowing, but like the bleeding, this is rare but does happen more than the bleeding does. It doesn't matter what it is I'm eating or drinking even, it sometimes feels like whatever it is, is in the form of a lump trying to get down my throat. I can actually feel the drink, or food in lump form traveling it's way down. It hurts. It sometimes feels like whatever it is, isn't going to make it's way down.

I'm hoping this biopsy comes back negative... but I just have this feeling it's not going to be. The hardest part about all of this, is the possibility of having to tell my parents that their daughter has cancer.
I live alone with 2 cats. I'm also afraid that once I find out the results and treatment options, I'll no longer be able to live so independently.

Keep calm and wait for your biopsy results. It can be a million things but you will know more AFTER the biopsy.

I hope the strep was treated properly. That s a lot of times over and over to give me comfort. Did you have a rheumatologist that tested you with the ongoing strep issues?

I had gone to an ENT who actually told me that I was wrong and that it wasn't strep throat. That I couldn't possibly know my own diagnosis. I told him that when I was younger I used to get strep a lot, and that I'm pretty sure it's strep. (I had the nasty white stuff in the back of my throat and all). He did a throat culture and sure enough it came back as strep throat. He tried to give me antibiotics once again to treat it, but by that time, I gave up on antibiotics because I didn't feel they were helping, especially with it coming back so frequently. Once I gave up on the antibiotics, somehow I stopped getting the strep throat. I haven't had it since then which is about 2 years now. I do once in a while have a slight soreness in my throat but nothing close to strep. However, I'm sure that wasn't the correct way to take care of that problem.

You have done the right things in scheduling a biopsy AND stopping the use of tobacco. Regardless of what the bio results are you must never use tobacco products again. We all hate the waiting but it really doesn't help one bit to let it get to you. Please keep us informed and let's hope it's not cancer.

Thank you both so much for your replies. I will definitely be back with the diagnosis of the biopsy once it comes in. I'm really glad to have found this forum either way. And I will remain tobacco free from now on.

Thanks again, your words are much appreciated!

Welcome to OCF. Sorry you have a fright on but if it gets you to stop smoking that is something good. Do let us know about the biopsy results; it is a very good thing to do at this point.

Welcome to OCF!

Congrats on quitting smoking!!! I know quitting is not easy but it could be a life or death decision. PLEASE... NEVER use tobacco again! Its not worth the risk.

Hopefully your sore is nothing serious. You are doing the right thing to get it checked. Only thru a biopsy will you know for certain what it is. Oral cancer tumors do not always hurt, mine didnt hurt at all. But other patients experience alot of pain. Hopefully its nothing serious!

It usually takes about a week to get the results from a biopsy. Hopefully it will be nothing serious and you wont need our group. But, if it would be cancer then you are in the right place for info and support.

Good luck!!!

Thank you so much for your kind words. As of now, I have to reschedule this appointment with a different doctor because of conflicts with insurance. I've decided to call all ENT's who take my insurance and go with the first available appointment that I can find. Finding an oral surgeon or dentist has proven difficult since I don't have dental insurance. The oral surgeon I had an appointment scheduled with doesn't take my medical insurance.

Not all ENT's are experts in treating oral cancer patients or doing biopsies. Some ENTs specialize in putting tubes in children's ears. Look for an ENT who has taken the extra years of schooling and now specializes in patients with oral cancer, not just seeing one every now and then.

ChristineB, thank you so much for your advice. I decided not to go with an ENT because I can't find one that will not just be 'taking a look and referring me out to an oral surgeon'. With that, I decided not to care so much about the dental insurance that I don't have, and just go with the oral surgeon I feel most comfortable with. I called their office today and the girl I spoke to recommended the oral surgeons assistant who actually specializes in oral cancers and the like. I have an appointment with him in just a couple hours. On the road to knowing more soon.

Thanks again to everyone for their well wishes and kind words.

I went to see the oral surgeon today. Turns out that the red swollen sore is there due to a failed root canal. So I'll be getting that worked on within the next couple weeks. The white sore, he wants to keep an eye on and check it at least every year. I have to go back in 6-9 months from now so he can check it. He says it seems benign but it may be precancerous and if there is absolutely any change to it, to run back and see him.

So the oral surgeon did not do a biopsy? From what I read you've had some sores for a few years already. Yes, the red area can be from a root canel, so I'm glad you are getting that checked out. Personally I would not be confortable waiting an additional 6-9 months to get it checked out again.

I was a non-smoker, moderate drinker and developed a painful canker sore on my tongue. I also had a lot of strep throat infections during my life and actually I thought the painful spots was due to strep again (had sore throat and fever). After it appeared (and wasn't really bothering me), I went for my regular dental check-up and cleaning. My dentist at the time did not mention the canker sore or do an OC screening.

When the sore still presisted, and I did some research on my own, and saw the words "cancer" I made an appointment with my primary care physicain. He said he has seen a few cases of OC, but my spot didn't present as any he had seen (plus I didn't have any risk factors). But he suggested I go to an oral surgeon if it didn't go away in a few weeks (gave me some topical medicine to use).

I waited about 1 week and made an appointment with an oral surgeon. I got the same response from him, but he did schedule me for a biopsy. I think he was more surprised than I was when he told me that little white spot was cancer!

If you want another opinion, consider attending one of the many OCF Awareness Events that are held around the country. A list can be found by clicking on the "More Ways to Help OCF" link that should be visible on the upper right side of this page. All OCF events offer free oral cancer screenings by dental professionals and some ENTs. The cost to attend the OCF events runs around $25 and supports a great organization. (Which supports this forum you are using).

You mentioned some issues with swallowing or the feeling os something in your throat. Did the oral surgeon address this problem? I don't believe they cover this issue or examine the throat, but an ENT does. An ENT can scope your throat in your office - an unpleasant procedure, but not painful.

I'm glad you quit smoking! Tobacco use contributes to a lot of health issues, plus it is an expensive habit!

The oral surgeon did NOT do a biopsy. Foolishly, I was semi okay with this since it was during work hours and I had to get back to the office. I didn't know if I'd be in pain after the biopsy. I should have persisted with it though. What the OS said was that since I've had that white sore for 4 years and it hasn't changed thus far, it shouldn't be such a concern. However he did also say that white spots are a cause for concern when it comes to oral cancer. I'm going to be keeping a close eye on this one. And also, I see that the event you speak of is being held in my state in September. I'm gonna go to that event and walk/run with them as well as go for that free screening. Thank you so very much for letting me in on that info!! Much appreciated.

I did tell him about my problem with difficulty swallowing food and beverage at times, but he didn't address it further. In regards to the biopsy, he did tell me that with how long I'd been a smoker, a biopsy is bound to show some abnormalities on the results. But isn't that what I'm looking for?

Its true that a spot being there for 4 years most likely is benign. However, some sores can be pre-cancerous. The pre-cancerous lesions may never turn into cancer or they could become cancerous after months, maybe even years. I would NOT trust an oral surgeons assistant in this.

As recommended previously, find a qualified ENT and get it biopsied. Only then will you know for certain what you are dealing with. I advise to not push this off. Oral cancer often shows no symptoms which leads to being discovered in the later stages making a successful treatment more difficult.

What state are you in and which walk are you planning on attending? Maybe I will see you there

"he did tell me that with how long I'd been a smoker, a biopsy is bound to show some abnormalities on the results"

That ranks right up there with the best of Dumb Things My Doctor Told Me.

Go to a real ENT.

Hi Christine!

I'm from NJ and will be attending the David Nastro walk held in Andover NJ.

I was wrong to call him an assistant. I didn't hear the receptionist correctly. He's another oral surgeon who works in the office I went to. He is medical and dental and works with a lot of oral cancer patients.

I would like to get this biopsy done just so I can put it out of my mind, ...or if need be, take care of it now, before it may be too late.

Hi David,

The problem I've been having with calling ENT's is that they keep telling me they will have to refer me out to an oral surgeon to do the biopsy. It's hard because I don't have dental insurance and would much rather the dental office of surgeons I'm most comfortable with, do the biopsy, but they've told me to wait it out and see if there are any changes. I'm thinking of just going back and telling them that I'm the patient and if I want a biopsy, they must do one for me.

Just keep being the Boss. This is your body and your life so be that squeaky wheel.

Jillie, I always attend the Andover, NJ walk Please make sure to look me up. I sit with the other OCF survivors. If you have time, check the Key Staff page, Im the last one. Susan Lauria (the Andover NJ walk hostess) is also part of the list.

Key OCF Staff

See you in September

Christine,

Great to hear. I will definitely be sure to come say hi!

Thank you for the info!

I finally was able to make an appointment with an ENT, who will not do the biopsy in his own office, but will be sending me to a hospital close by that will be doing the biopsy there. I decided not to go with the oral surgeon because for 1, he didn't want to do the biopsy in the first place and 2, I don't have dental insurance and this failed root canal (if that's even what it is) is already going to cost me an arm and a leg.

I'm hoping he's correct on that failed root canal. I haven't had any pain that would indicate something is wrong with that tooth. No pain at all actually. The second sore that formed is still there, but hasn't caused me anymore pain either. I've started on some antibiotics and will be getting the failed root canal taken care of this Saturday. In the meantime however, I was taking a closer look inside my mouth after brushing my teeth and have been keeping a close eye on my left cheek ever since. I noticed that I have weird patches that go from white to red and back to white. They almost look like circles, and if I brush my tongue over them, they do not feel smooth like the right side of my cheek does. I think the oral surgeon should have seen this when looking inside my mouth. This doesn't seem ok to me, but I'm not a doctor so what do I know. I would chock it up to maybe that's where my teeth or gums brush against my cheek, but wouldn't be the same for the right side of my cheek as well then.

Let's hope all gets resolved Sat.

All insurances are different, and dental insurance often only pays a small portion of dental issues anyway. I've had a number of procedures done by an oral surgeon, and some are covered by my medical insurance - such as a biopsy.

I'm glad you found an ENT to do the biopsy, and I truly hope that it proves to be something minor. Good luck with the root canal repair, and have the OS check out the patches you noticed.

You should be covered on the biopsy as this is considered an outpatient diagnostic laboratory test, covered under your medical plan.

The root canal problem. A root canal removes all the nerve so it would not be unusual for there to be no pain from the tooth. The red area indicates an infection and this may not create pain either, especially if you are on antibiotics that are reducing the infection.

If the failure means the tooth structure is bad and a place where infection can enter the tissue area then that does require fixing, not sure what but glad you are getting that fixed sooner rather than later.

Good luck.

Thanks for your input and the good luck. To be honest I only just started taking the antibiotics this past Monday. Mainly because I've been experiencing some stomach issues and didn't want to worsen them with the antibiotics which is usually how it goes for me. I've taken quite a few so far since I must take them every 8 hours, but this sore hasn't subsided any as of yet. Hopefully soon.

I honestly can't wait to get this biopsy once and for all because it seems everyday, I notice something else that's strange inside my mouth. I'm not sure if now my mind is playing tricks on me or what. Or possibly, the marks I'm finding on my cheeks are being caused from my teeth somehow. I'm sure that's a possibility.

Jillie,
There are different antibiotics and I have been told the ones prescribed to treat infection related to mouth and gum tissue are different.

A general antibiotic may not be the best thing to help the mouth area. Might want to check that out.

Thanks for the info!! I'll have to check that out. I'm on amoxicillin. Hopefully that's the correct one to be on.

Guess what just started for me today.... Strep throat. WHILE I'm on amoxicillan. I can't believe this. I've been on it since first thing Monday morning. I feel as thought I should not be getting strep throat while on a bacterial type of antibiotic. Because of how prone I am to strep, I know that's what it is. My glands are painfully swollen. It starts sudden and for me, always accompanied by a headache and incredible fatigue. And always produces that white stuff in the back of my throat. My mom wants me to go to see this ENT sooner and get the biopsy taken care of NOW...but it's impossible with work. I'm going to have to wait until this coming Wednesday and I'll be sure to tell the doc about this strep throat. Hopefully it is gone by then. I also have that appointment to fix the failed root canal tomorrow with an endodontist, so I'll be speaking to him about everything too. But does anyone have any thoughts...does this seem odd that I have even if it's only just a touch of mild strep throat, while being on such an antibiotic?

Call your doctor that prescribed the amoxicillin. I've had strep a few times and the strain you have may be resistant to amoxicillin so you may need a different antibiotic. That happened to me. Perhaps you can go to the doctor to confirm it is strep via a rapid strep test?

I'm taking Augmentin, Amoxiccilan/Clavulanate Potassium 875/125mg, for the tooth abscesses, infection, which gets to the bacterial infection that may be resistant with only Amoxicillin. Not saying it's the same, but the doctors know best, can do further testing.

Good luck.

Wow... Okay I read this all the way back from the beginning, hopefully your biopsy went well. I've never heard of an ENT passing off a biopsy to an oral surgeon. Often they don't do them in the office - they prefer to do it in a surgical clinic or the like - but they prefer to do it as opposed to giving the job to someone else. Realistically speaking they send you to an oral surgeon, who will do it, but the follow up to this dx if you get a result of "cancer" is surgical removal, possible reconstruction and ideally some kind of neck dissection. This has to be done by an ENT (too far out of the oral surgeon's skill set) so sending you off for just the test seems stupid, IMHO. And believe me if it's cancerous based on location- it should include even a partial neck dissection.
That said I am going to parrot Christine. Over a long period of time not likely it's cancerous. However if you read my history - I had a problem for 4 years! Two years to my first negative biopsy another two years to my positive one. This cancer can be crazy aggressive, but it can also be slow moving in some forms. I think that may have something to do with your immune system and life style. Or just that it is in a dysplasia or precancerous state. Regardless it should be dealt with. And even if it's a negative dx - if it doesn't heal you should be checked regularly. Hugs

Cheryid - 4 year ENT's who mostly see lots of ear infections and strep throats in kids, don't' do much in the way of surgical work (even small biopsies). They, like general MD's, and general dentist,s refer out to either a 6 year surgical ENT or an oral surgeon.

So how do you find out if an ENT is a 4 year ENT vs. 6 year surgical ENT? That is besides getting a referral from a doctor, recommendation from someone, or calling their office and asking? Is there a website that lists the doctor's credentials?

Their office will tell you if you call. But 6 year ENT's are all head and neck surgeons. They do surgery all week and recalls on surgical patients they have seen. In general while they know more about oral cancers than most, they are a refferal doctor and get most of their patients from someone else�including 4 year ENT's, general MD's etc. But when you call the doctors office you don't need to ask about his years of school or his years of residency ( surgical residency on top of regular) you just have to ask if he/she is a head and neck surgeon. With that question you know it all. But you really don't need to seek one out, just have your regular ENT refer you to the person they prefer for the biopsy. Taking a small sample of something is no big deal for the doctor or the patient, the person that really makes the calls is the pathologist that reads the sample. You won't interact with them and they will be picked by the person taking the biopsy.

Brian,

Thank you for clarifying the different ENT types. I honestly did not know that all ENTs were not also head and neck surgeons.

In my case, I first went to my primary care physician, who referred me to an oral surgeon for the biopsy, and when the biopsy came back positive I went to a local ENT (referred by the oral surgeon). This ENT was a head and neck surgeon in private practice with other ENTs. The doctors in this group did surgery 1-2 days per week and saw patients in the office the rest of the week. The patients they treated included kids needing tubes, allergies and other H&N conditions. Over the years I�ve been to 3 other ENTs all of which were also head and neck surgeons, located in larger cities and affiliated with major hospitals. I called the local ENT�s office right after I received the OC diagnosis to make an appointment with him. I was told the first available appointment was about a month away. I wasn�t happy with waiting that long (I wanted to see him NOW), so I went back into the oral surgeon�s office and had them call the ENT�s office � I then got an appointment that same week.

On the OCF forum I and others have often suggested to newbies who are worried they have oral cancer to seek out an ENT who is familiar with oral cancer (or something to that effect). Based on what you said it is probably hard to get an appointment with an experienced ENT/H&N surgeon unless you already have an OC diagnosis. My guess is that a lot of ENTs located in smaller cities or towns who are in private practice primarily treat other head and neck conditions.

Based on the many discussion I�ve read on the forum from newbies worried about having oral cancer, their concerns are often dismissed by their doctors particularly if they don�t fit the antiquated �oral cancer profile�. So what is the best advice we can give to these newbies? Yes I know they need a biopsy to find out definitively but it can take months to find the right doctor to do this.

I think that regardless of what basic specialty you look at, there is a wide curve on who knows what. I was seen by a general ENT, who with really obvious oral cancer symptoms put me on antibiotics for two weeks to no avail, and when that didn't get my neck lump to go down, he just wanted to switch antibiotics. I didn't know much about the ENT world in those days, and had never even heard of oral cancer, and I went to a second one (also a generalist). However this was an older guy that had practiced for a couple of decades, and obviously had seen a lot more. He got what was going on right away and on my first visit the fine needle biopsy of the node was done. Both generalist ENT's, two very different levels of knowledge.

Having said all that, I think that what people would prefer here (and me too), is that general MD's are not people's sole source of information when they have a problem, and they get the most first look opportunities. They seem to be the group most behind the curve, and take the longest to refer and get it right. Dental people are really getting pushed to get this right, but there is still a huge number of them disengaged from the oral cancer issue. I won't go on a rant here as to why I believe this is, but it is a fact. They know the basics, and certainly see a ton of oral lesions of all types. However peer reviewed published data shows that most oral cancers are found/diagnosed outside the world of dentistry. That just means that they are not looking to me, since referring suspicious tissue out to someone further up the food chain is so easy to do. I think that non surgically oriented ENT's are still a good call, but no more so than an oral surgeon. (Who is asked to biopsy lots of things by his referring generalists).

We have a problem in the US with enough people being up to speed about the OC problem, HPV, what oral lesions are dangerous, and not enough people referring suspicious things out instead of watching and waiting for the obvious to heal when it isn't going to. I lay blame across all specialties, because here on these forums we have been hearing it for more than a decade - people come and they have the same issues, misdiagnosis, lack of diagnosis, failure to refer when something does not resolve, and every doctor type except oral medicine specialists in dentistry, and head and neck surgeons, make these mistakes with too great a frequency and have dropped the ball.

So I guess you would call me an equal opportunity layer of blame, and ENT's are just one of many that could get this better.

Brian,

Great description of the landscape of the small pads of expertise amongst the quagmire of the mass of informed and unqualified.

Your post struck a cord in that it was random dumb luck that I found a highly qualified specialist who both my wife and I have unflinching and unwavering trust in all things oral cancer.

He is a head and neck surgeon and was selected to the fellowship program at MSKCC. So very fortunate to have someone so qualified and received specialist training in a world class institution.

We changed insurance recently and had to go around a few times to ensure our access to his network. No plans to switch, EVER.

Don

This discussion reminds me of a question - Professionals along the way have asked if our general dentist found my husband's lesion (BOT). He did not.

My husband had typical sudden appearance of enlarged, non-painful, cervical lymph node. Examined by Primary Care Physician and needle biopsy was performed the same week, after general surgeon in same office, was brought in to examine the node. Fortunately, the general surgeon was immediately suspicious of SCC based on presentation alone.

After positive results and CT, referred to oncologist & ENT. When scoped in office by ENT, lesion was not visualized. Another scope under anesthesia, still not visualized. Random biopsies obtained based on CT which picked up the tumor location.

My question - is it possible that the tumor was that deep that even under anesthesia it was not found? I ask in part because because we later found out that this ENT was not experienced in cancer (per above discussion) and we changed to one trained at MD Anderson.

It would be very common, especially in HPV+ oropharyngeal cancers, for the primary to be non visible or occult on physical visual exam with a scope. These things can be buried deep in the tonsillar tissue, the tonsillar crypt, or in the lymph tissue on the base of the tongue for quite some time before producing a surface lesion.

7-8 years ago doctors were calling these an "unknown primary" when you had a cervical node (which is never the primary) positive for SCC and an occult oral environment. We subsequently learned how these HPV+ cancers seldom present with surface lesions, and because they metastasis to the neck through the normal lymph drainage passageways very rapidly, the primary can be even too small to see in a scan. Everyone was shocked when OCF sponsored at study at Johns Hopkins and we determined that the primaries could be a small as 2-3 mm in size, and be spinning off mets to the cervical nodes. That was unheard of at the time, as usually a primary has to be much larger before it metastasizes. But the unique location of these cancers directly within the lymph chain allowed it.

Remember that all new cells, and cancer cells included, begin in the basal layers of the epithelium which is relatively deep in the architectural structure of tissue, and migrate towards the upper epithelium that you can see.

Note that a subsurface 2-3mm primary can be easily missed even by a CT scan that looks at slices of your body about 3-5 mm apart. And unfortunately these "unknown primary" patients got radiated in much larger fields unnecessarily since a specific target was not found. The most likely areas were nuked. Wild ideas were postulated at the time like, a person's immune system had finally kicked in and taken care of the primary leaving the node in the neck untouched. Really? A systemic defensive mechanism goes after one little thing and the other cancer locations it leaves alone? Nonsense. But we had posters here that were told that.

For a much informative but not hard science read, I found "The Emperor of all Maladies" a great book which in a very readable and entertaining way chronicles cancer treatment in the US from the 1940's to present day. It is scary to read about the things we were doing into the 1950's and 60's to people with no idea if it would work or not, no controls or even the idea of a proper clinical trial, including massive radiation dosages to the chest (and heart) of women that had breast cancer. Of course in the 1940's no one survived treatment. But it is all there to read and the formation of the American Cancer Society is well covered too, which had a few interesting twists in it. We have come a long way, but it just reinforces in my mind how far we have yet to go.

Thanks, Brian for a very clear explanation. My husband's tumour is endophytic and I have always wondered how that is significant. Now it is much clearer to me.

Thank you, Brian,

My husband fits the pattern you describe. His tumor size was considered small mass with relatively large node size. According to Dana-Farber Cancer Institute, this put him borderline for treatment with induction chemo. That was 6 years ago.

Brian, could your explanation be the reason my primary pathology was in situ but still metastasized to cervical lymph nodes?

I remember the ENT telling me that the only way he found Kevin's tumor was by, under anesthesia, putting his fingers down Kevin's throat and palpating his base of tongue area. He found that it was concave shaped. He then cut by feel since he couldn't see it. Three years ago now....

Uptown. Exactly these things are really small in some people but the tonsil and the lymph tissues on the base of the tongue and later l tongue boarders are part of the immune system/lymph system; and even a cancer small enough to be considered in situ is mature enough to cast off daughter cells - right into the lymph drainage passageways and down to the nodes, which are of course another step in the immune system components. They are designed to trap all kinds of detritus and cancer cells qualify.

Luckily SCC seems to stay in the regional nodes for some time, because if it did not, those drain further into the nodes in the upper body, which are close to vital organs. That is how mets that become terminal move in addition to the circulatory system.

This has turned into a very information discussion. Brian, thank you for your very knowledgeable input!

In light of the equal opportunity layer of blame theme this post has turned into, let's not forget that not all pathologists are created equal.

I found out the hard way! I had surgery #1 at a small local hospital and my biopsy slides were reviewed by the pathologist on staff. I was given the all clear. Well I found out months later that he "misread" my biopsy slides, and in one of them there was actually cancer at the margins.

This lead to months of doctor appointments (2nd & 3rd opinions), multiple scans and tests, and many sleepless nights. The recommended opinions started with more surgery and RT, to the final 2 options - RT alone or "watchful waiting". Surgery was ruled out by the doctors I consulted at this time.

I ruled out the "watchful waiting" option - just felt I needed to do something! So off to get fitted for my radiation mask and started the 7 weeks of RT. Looking back now and being now a more knowledgeable patient thanks in part to OCF, I'm not so sure I made the right choice.

Sorry to hear stories about serious mistakes such as yours. You always have to keep your antennae polished and your sniffer super clean to know how things seem to be going.

All the people involved with your health care are just that - people, human beings. We all strive to be 100% professional while on the clock but human nature has a way of affecting our daily performance, no way around it.

It is so vital to not only trust your doctors but also keep aware if you pick up on any off-kilter judgements or reasoning.

But this is nearly impossible when trying to simply digest all the chaos while undergoing diagnosis and treatment.

Hope all readers take notice and be on constant alert and not be shy getting other reviews if at all concerned.