Welcome to The Oral Cancer Foundation! You are very fortunate to have your biopsy come back as dysplasia. I know it can be worrisome as dysplasia often comes back after it is removed and it can progress into oral cancer (OC). The chance of your dysplasia ever becoming OC is very slim but it can happen. We have had some of our members whose OC started out as dysplasia but not too many.

You didnt mention what kind of doctor you were seeing. Im not sure why your doctors assistant would encourage patient to do this "free" testing. Is this doctor and their assistant a specialist? If so what type? I have seen so many doctors over the past 11 years and I dont think I ever had an assistant instead of one of my regular doctors. Something else that I wasnt quite sure about in your post... normally biopsies are done to rule out cancer, not non-cancerous lesions like dysplasia. Oral cancer (OC) can be especially tricky to discover unless there is a visible tumor, often there are no major symptoms. Who would suspect a mild ear ache or a hoarse, scratchy throat could be a symptom of OC and is easily overlooked. Even the most experienced OC specialists need a biopsy to test for certain what exactly a spot or sore in someones mouth is. OC tumors can appear very similar to other non-cancerous lesions.

As far as your dentist following your dysplasia thats up to you. Ive seen a few of our members over the years who were not diagnosed with OC but have some other mouth issue for their dentists to keep an eye on them. I dont think an oncologist would take on a patient who does not have cancer, instead they are being referred there as a result from a 5 year malignancy prediction test. Its usually an ENT who treats oral cancer patients is who follows up things like this. Unfortunately, many dentists focus on only seeing the patients teeth and nothing else. Surprisingly quite a few dentists are not experienced with oral cancer tumors or OC patients. If your dentist is on top of things and has experience working with oral cancer patients then they could be all you need to monitor your dysplasia. I would have a chat with your dentist prior to allowing them to monitor your dysplasia. The last thing a patient wants or needs is for a change in the dysplasia to get missed as the dentist is more focused on the teeth. You can also check it one a month yourself and check in with a specialist if you notice any changes. Some patients wouldnt have the self control to only check their mouth once a month. If the patient is constantly checking their mouth, its unlikely they would notice their lesion slowly changing. Kinda like seeing your baby every day you wouldnt notice subtle changes but someone who sees the child every few weeks can spot the changes right away.

As far as the testing of your biopsy sample goes, sounds like its something newer. Im not a big fan of statistics. The odds for my survival were stacked against me, even my doctors did not expect me to survive. I think I had around only a 15% chance of survival. Anyway, I luckily did survive and next month it will be 11 years since my first OC diagnosis,. When I see a number like 49% it makes me think its pretty much a 50-50 shot. I suggest talking your situation over with the doctor who suggested the "free test" to predict your future chance of malignancy in greater detail. This is probably a newer approach that could work but there are so many other variables that come into play when trying to predict cancer appearing within the next 5 years. I would want to know how long this extra testing has been around specifically for dysplasia. If its hasnt been at least 10 years with a wide sampling of patients over at least 10 years then its hard to take the statistics very seriously. I dont know how a blind or double blind study would pertain to this type of testing or if it has been published in peer reviewed medical literature. Its very possible this type of testing which I think I may have heard of for other (more well known) types of cancer is just getting started for OC. Make yourself a list of questions prior to seeing your doctor.

Sorry, but my medical knowledge is mostly about OC and not other health conditions. As far as blood pressure spikes, in someone who has not been thru OC treatments Im not familiar with any info. In OC patients/survivors who have undergone radiation treatments, they can develop huge fluctuations in their blood pressure.