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#192866 08-18-2016 01:50 PM
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I'm a 34 year old male. I have a small (maybe .5 CM) white rough / raised area inside my mouth on my cheek, towards the back of my mouth. It blanches when I press on it. I wouldn't say it's a hard bump - more of a slightly raised area than an actual bump and when looking at it it doesn't appear like a bump rather it feels that way. It is along - slightly above my bite line but to my knowledge I dont bite my cheeks. I first felt it with my tongue, randomly a little over 4 weeks ago. After it didn't go away after two weeks, I called and made an appointment with my dentist to have him look at it and that appointment is early next week. I know there isn't anything else I can do about it now but by that time, it will have been five weeks since I first felt it. Everything I read says when you have a nonhealing sore (even though it isnt actually sore) for more than 2 weeks to get it checked but by the time I made my appointment and was able to get seen over a month will have passed.

There is no pain at all, no soreness, no bleeding and it hasn't gotten any larger or smaller from what I can tell over the last 4 weeks. It's just stayed the same with no noticeable change. Given the length of time it's been so far, it has me slightly worried. Thinking the worst, if it were to be an oral cancer, would this still be considered "catching it early?". It makes me feel somewhat better knowing there is no pain and it doesnt appear to be growing but anxious at the same time because it isn't going away.

Given all of this, is my general dentist the best first option to take a look at this? If he wants it to be biopsied than I assume I'll have to make an appointment with an oral surgeon which means waiting more time for an appointment. I've come to learn from my limited research, how valuable time is when it comes to oral cancer. Is there anything else I should be doing?

Also, can lichen planus show as a small patch rather than white lines? Are there other benign conditions that would appear white and not go away with time?

Thanks so much!

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Hi, welcome to the forum.

I believe you have taken an important first step, which is to get an appointment with your dentist to look at the area. Like you said, it is possible that your doctor will refer you to an ENT to have it biopsied. Or, it may be nothing you need to worry about. Here we are just patients and caregivers who have gone through or are going through the treatment process. We are not medical professionals and do not have the training to diagnose (you wouldn't want us to do that anyway). I know it is worrying when something does not seem to be right but it would not help matters if you spend the next week or so worrying. Hang in there until you have your doctor's opinion. In the meantime, focus on the positives in your life and not the scary thoughts.



Gloria
She stood in the storm, and when the wind did not blow her way, she adjusted her sails... Elizabeth Edwards

Wife to John,dx 10/2012, BOT, HPV+, T3N2MO, RAD 70 gy,Cisplatinx2 , PEG in Dec 6, 2012, dx dvt in both legs after second chemo session, Apr 03/13 NED, July 2013 met to lungs, Phase 1 immunotherapy trial Jan 18/14 to July/14. Taxol/carboplatin July/14. Esophagus re-opened Oct 14. PEG out April 8, 2015. Phase 2 trial of Selinexor April to July 2015. At peace Jan 15, 2016.
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Welcome to OCF, NIL82ball!

There are many different noncancerous lesions that someone can have in their mouth. Just seeing whats on the surface does not necessarily mean its that size. More could be beneath the "spot". Hopefully, this "spot" is nothing serious and you wont need our site. If it would be cancerous then you are in the very best place for up to date and correct medical info and support.

Are you able to skip the dentist and make an appointment with an ENT? Some insurances require a referral so make certain you wont need one if you cancel your upcoming dentist appointment. Many dentists have gone their entire careers without ever seeing someone with oral cancer. Sadly, many dentists do not even do oral cancer screenings. You may need a biopsy to help determine exactly what the spot is.

You sound like a very logical type of person. Try to keep yourself extra busy with things that hold your attention and require concentration. This will help you from worrying too much. You do not need any extra stress right now so avoiding going there is the best aid to being less stressed. No matter if its caught early or late, it still needs professional attention (of course that is IF its cancerous) to find out what it is and make a game plan to eliminate it. Not all cancerous lesions hurt or bleed which is why many arent found until its been there for a long time. You are only waiting a few weeks from the date you originally found the spot to getting it checked. For most patients, that amount of time isnt enough to make a big difference is growth. Ive been here for 9 years and have seen lots of patients come and go, some who didnt have much of a chance are now thriving. So you see, you just never know what the future holds.

Hang in there and please keep us updated.



Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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Thank you! I really appreciate your comments.

I'm not sure if I can just skip the dentist and go right to the ENT. That's an interesting thought and one that didn't even cross my mind. At this point, my appointment with the dentist is Monday so I suspect having that first and then going from there is probably the best course of action?

Assuming there is a need for a biopsy, is an ENT the best option versus an Oral Surgeon?

Lastly, is there any benefit to me making an appointment with an ENT today just to get on the schedule - knowing they are likely busy and if the dentist isnt concerned I can always cancel it plus that would give me time to check with my insurance on a referral? I've gone to the ENT in the past and just made an appointment directly without being referred in and it was covered - not sure if that would be the same here.

Thanks again!

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Ive had biopsies done by both an ENT and an oral surgeon. For insurance purposes a biopsy and OC are medical not dental. Call your insurance company and find out what your best option would be. Just make sure you find an ENT that specializes in OC patients and not the type that primarily puts tubes in kids ears. If you are going to an oral surgeon, same thing. You want one who treats OC patients and not just TMJ or removing wisdom teeth. And yes, ENTs can get backed up with appointments. Since you are already an established patient and because of the nature of your office visit you shouldnt have to wait too long for an appointment with your ENT.

My concern or seeing a dentist is what I stated in my previous post. In my opinion, seeing a dentist seems like an extra step in getting the sore checked by the right person. Many dentists have not even encountered OC in their day to day exams and fillings, they focus on the teeth and tend to ignore the surrounding tissue in the patients mouth. Putting it another way... I wouldnt want a small engine mechanic who fixes my lawn mower changing the brakes on my car. They simply arent qualified for the job. Most dentists also do not preform biopsies but a very small percentage will do them.

Main OCF site --- Diagnosis/Discovery

Hope this helps!


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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Thank you again - very helpful.

So then, based on your comments regarding a dentist - which make perfect sense - if my dentist looks at the spot and isn't concerned, would you still go have an ENT or Oral Surgeon who specializes in OC take a look at it?

Is there a resource for finding what ENT's out there do just that or is it simply a matter of just asking them the question?

Thanks!

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Absolutely!!!

Not all dentists do continuing education like doctors. Thats why many who have gone thru dental school where they only briefly touched on diseases of the mouth tissue. Dentists primarily look at teeth and ignore everything else. Only in recent years (much thanks to OCF's efforts) has attention been paid to even do an OC screening. I dont mean to sound negative about dentists Ive just seen far too many patients come to OCF because their dentist never noticed something in their mouths for years and now its Stage IV. This is why I am cautious about telling OCF members to see their dentist. Please dont overthink what I just said and dont put yourself into that category!!!! You are aware of the spot and have paid close attention to any changes which makes you a strong advocate for yourself. Im still hoping what you have going on is nothing serious and will somehow resolve itself.

Good luck!!!!


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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Posts: 7
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Again - thank you! This is really insightful and helpful to me.

I just called and made an appointment with the ENT. Unfortunately they aren't able to see me until September 7th, unless there is a cancellation. I am going to keep my appointment with my dentist for Monday - I have no idea what his training and background is with oral cancer but he seems good and thorough and does always do an oral cancer screen at my 6 month cleaning visits.

I'm still concerned that by September 7th, it will have been 7+ weeks since I first noticed the growth / spot. It makes me feel like thats a really long time and if it is something bad, I'm missing the boat on getting rid of it sooner.

I have no idea if another ENT would be able to see me any sooner but if you were me would you look for another and try to get seen more quickly?

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It's going to be tough to find someone on a Friday afternoon. If I were you, I'd keep the September 7th appointment, & just go see the dentist on Monday. If he or she sees something of potential concern, maybe they can help escalate your case or suggest an alternate ENT that might be able to see you in a shorter timeframe.


Dx 2014Jan29 (42 yr old otherwise fit nonsmoker)
SCC tongue stage III T3N0M0
subtotal glossectomy, partial neck dissection, RFFF, trach, NG tube 2014Feb25 16 days in hospital
RAD 25 zaps 2014May5-2014Jun9
Back to work, paddling & hiking shortly afterwards
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I suggest calling the ENT next week and asking to be put on the cancellation list. Its fairly common to get bumped up when another patient cancels.

I agree with keeping your upcoming dental appointment. Your dentist sounds competent which is great to hear. Im very glad they do the OC screenings!!! If anything appear "off" ask your dentist to make a phone call to your ENT. That phone call could expedite your appointment as most doctors always will squeeze someone in who really is in need. Honestly waiting until Sept 7th isnt too bad. Its only a couple weeks and it shouldnt make much of a difference in your sore.

I should have asked you a couple questions before. If you use Listerine, stop using it. Any strong mouthwash that has alcohol in it should be avoided. I would also advise you to avoid alcoholic drinks and any tobacco use (even cigars, pipes, e-cigs, etc). Basically Im saying to avoid anything that will irritate your mouth. At your dental appointment ask your dentist what is the best mouth rinse to use when you have a sore in your mouth. Ive been using prescription peridex since I was diagnosed with OC in 2007. Its a little strong for me so I mix it with water but it still works great for me.

Good luck smile


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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