I’m sorry for your troubles, Tomswife, but welcome!

Scans may not catch everything, particularly when it’s below a certain size, but at least they found it from a biopsy, which I’m not certain which type, maybe an excisional biopsy? This may ir may not have clear margins, but the ENT wouid advise.

Most hospitals/doctors use the NCCN Guidelines for Head and Neck Cancer, specifically tongue, for testing, treatment and follow-up. Mine was in the oropharynx, stage 4, and is a different area, somewhat different treatment and testing, but similar in certain aspects as both are most likely squamous cell carcimoma 90% of the time. That should be on the biopsy report.

Yes, there are different grading, pathologically, usually designated by a small “p” before the TNM grading. Clinically it’s a small “c” and after surgery, a small “s” and that can be changed surgically by the TNM grading, usually downgraded. You will find out the TNM grading from the biopsies and or from the ENT.

Don’t let the staging bother you, its just a treatment gauge, number, and other things may be as important. I was stage 4, like many other patients here, and currently cancer free as I’m waiting for my 5 year mark, and wish your husband well too!

Treatments will be guided by the TNM grading, physical exam, and condition of the patient, but I haven't looked at the treatment options in the NCCN guidelines lately for oral tongue cancer or know all the particulars, but it’s basically surgery, plus or minus radiation and chemo for later stage cancer.

Where you are treated matters too! UVA, sounds like University of Virginia? I’m not from that area, but double check it’s a comprehensive cancer center or cancer center, highly rated in head and neck cancer, if not, one can always travel to one to be treated, if applicable, or confer by telephone/computer to work one with your center.

There is a listing of member hospitals with the NCI, NCCN designation, and yearly rating of hospitals with The US News Report Best Hospitals 2018 listing. Being treated at a high volume center in your particular cancer can make a difference, and know first hand from experience.,

There’s more to cover, but I think this may be enough for now. You can also go through the diagnosis, testing and treatment pages here to become familiar with them, and if you have any questions, ask here, besides with your doctor.

Good luck!