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#20819 08-07-2006 06:48 PM
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TinaD Offline OP
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Hello! I am really new to this and have to educate myself. In May, I went for a regular dental visit and the dentist noticed some Leukoplakia on the left ventral surface of my tongue. The doctor referred me to an oral surgeon who did a biopsy on June
13th. The tissue sample showed dysplastic cells with "variable hyperkeratotic and dysplastic stratified squamous epithelium
overlying inflamed fibrous connective tissue and skeletal muscle". I had another oral surgery for that on July 20th to remove the remaining dysplastic tissue. Just got that pathology report. Due to the "multifocal nature of the dysplastic changes with increased mitotic activity within the basal region", I
have to see another doctor in 2 weeks.

Does anyone have input on this diagnosis and questions to ask doctors. The oral surgeon is really light on bedside manner and has no time to answer any questions. I have googled all these terms and have some idea of the situation.

I know this is not at all as serious as most of your situations. However, I would really benefit from your input.


TinaD
#20820 08-07-2006 07:36 PM
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Hi Tina,
and welcome to the forum. I am sorry that I cannot answer your question but others here have had leukoplakia issues and I am sure that they will respond to you soon.


Gary Allsebrook
***********************************
Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2
Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy)
________________________________________________________
"You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
#20821 08-08-2006 03:13 AM
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My husband was in a similar situation -- an oral surgeon's initial biopsy of a small leukoplakia (also discovered by his dentist) showed moderate dysplasia, but a more thorough excisional biopsy by an ENT showed cancer in situ and a bit superficially invasive. A followup PET scan showed no areas of concern.

When my husband got the second biopsy results he was immediately seen by an ENT at a comprehensive cancer center. That center's pathology department reviewed and confirmed the second biopsy slides; the ENT at the CCC had all the first ENT's notes and the PET scan report. The CCC doctor said that all looked good and will be checking him regularly (monthly for the first year, every two months for the second, etc.) from here on in.

You've come to the right place -- when I discovered this site, I did a search on "leukoplakia" both on the message boards and on the main OCF site and got a lot of good information. If you've been researching this, you'll know already that in many cases, leukoplakias don't become cancerous. But they can.

You may be lucky and never have this recur again. (And you are definitely lucky in having such a proactive dentist, as others here will tell you.) But it's worth getting checked out by a specialist -- I'd recommend finding an ENT who sees a lot of oral cancer patients. Before your appointment, ask if the doctor would like the biopsy slides re-read by the lab he or she normally uses. Also see if the doctor would like the oral surgeon's notes and the reports on both biopsies sent ahead of your appointment, or whether you should bring those with you.

Here's how OCF founder Brian Hill responded when I first asked about leukoplakia (emphasis is mine):

[quote]Leukoplakia is a PRE-cancerous condition that does not always move completely into malignancy. Dysplasia are those cells which are no longer normal, but they are not really malignant yet...an in-between state, so to speak. Dysplasias also do not always go completely over to the dark side, but they are a step in that direction... and having them removed, or watched very regularly is prudent. Dysplastic leukoplakias can often return after surgical removal, many times done with a laser, sometimes via a blade excision. Keep an eye on things even after the removal from now until forever.[/quote]I hope all goes well for you.

-- Leslie


Leslie

April 2006: Husband dx by dentist with leukoplakia on tongue. Oral surgeon's biopsy 4/28/06: Moderate dysplasia; pathology report warned of possible "skip effect." ENT's excisional biopsy (got it all) 5/31/06: SCC in situ/small bit superficially invasive. Early detection saves lives.
#20822 08-08-2006 03:40 AM
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Tina,

Don't under estimate your situation. Your situation is just as serious as any one else here. Glad you found this site. WELCOME

You are to see another Dr. what Kind?
I hope that Dr.. will answer your questions. Just tell him you need more information. My guess is that you are about to see a radiologist.

My story started with tongue. I had surgery on tongue to remove cancer with clear margins. A year later cancer back in neck stage IV. I had sore on tongue for about a year before I had it tested. I waited to long.

Glad that you are getting things checked out before to much time passes. You will find lots of information and help here. Don't worry you are not alone.

Take care
Diane


2004 SCC R.tip 1/4 tongue Oct. 2005 R. Neck SCC cancer/Chemo Cisplatin 2x/8wks. Rad. Removed Jugular vein, Lymph gland & some neck muscle. TX finished 1/20/06... B.Cancer 3/29/07 Finished 6/07 Bi-op 7/15/09 SCC in-situ, laser surgery removed from 1st. sight. Right jaw replacement 11/3/14. 9 yrs cancer free as of Jan. 2015
#20823 08-08-2006 12:59 PM
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Tina
Welcome to the forum. I sincerely hope you do not need us.. but ..if you do we will be here for you.
Take care
Marica


Caregiver to husband Pete, Dx 4/03 SCC Base of Tongue Stage IV. Chemo /Rad no surgery. Treatment finished 8/03. Doing great!
#20824 08-08-2006 03:30 PM
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TinaD Offline OP
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Thanks to each of you for your prompt and informative responses. The Oral Surgeon was very dismissive. He seemed reluctant to give me copies of the pathology report and finally did. I am scheduled to see a Dentist in 2 weeks. Based on previous posts and your guidance, I have asked my family doctor and my dentist for a referral to a ENT specialist with oral cancer experience. Compiling my list of questions based on the extensive information available on this site as well as on google. I'll keep you updated.


TinaD
#20825 08-09-2006 02:15 AM
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Given that both the University of Chicago and Northwestern have major cancer centers in Chicago, I'm sure you'll find an experienced ENT.

Do keep in touch.

-- Leslie


Leslie

April 2006: Husband dx by dentist with leukoplakia on tongue. Oral surgeon's biopsy 4/28/06: Moderate dysplasia; pathology report warned of possible "skip effect." ENT's excisional biopsy (got it all) 5/31/06: SCC in situ/small bit superficially invasive. Early detection saves lives.
#20826 08-11-2006 10:41 AM
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TinaD Offline OP
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Finally - I have an appointment with an ENT Dr - Harold Pelzer at NorthWestern's CCC on Sept 21st!! He has received a copy of my pathology reports which were from the Northwestern lab. My Family Dr has be a great support and is trying to get me an earlier apt as she knows him from med school.

Many thanks for the specific instructions from Leslie which I followed to the word - ENT, CCC, send report in advance, etc. I'll keep you posted and hope each of you is doing well.


TinaD
#20827 08-11-2006 11:06 AM
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In a previous post, I cited your luck in having such a proactive dentist -- you're lucky, too, that the biopsy results were done by a lab your doctor is no doubt extremely familiar with. (There are stories on thse boards of people whose biopsy slides appeared OK until they got a second or third reading by a lab at a CCC, where the pathologists who see this stuff every day picked up something suspicious.) And you're lucky that your family doctor is so supportive and helpful.

Here's hoping that luck continues! smile

-- Leslie


Leslie

April 2006: Husband dx by dentist with leukoplakia on tongue. Oral surgeon's biopsy 4/28/06: Moderate dysplasia; pathology report warned of possible "skip effect." ENT's excisional biopsy (got it all) 5/31/06: SCC in situ/small bit superficially invasive. Early detection saves lives.
#20828 08-13-2006 05:41 AM
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Hi Everyone,

My mother is 60 yrs old and was diagnosed with squamous cell carcinoma on her tongue about 20 days ago. She had partial glossectomy with neck dissection done. Fortunately the tumor was 1cm and had not spread to her lymph nodes.My question is---does she need any further treatment? Her surgeon says she does not but she is in India and I wanted a 2nd opinion here.Can anyone recommend a good ENT surgeon in the Northern Virginia/DC area?

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