Had a 6-month follow up visit with the oral surgeon on May 19 2020 who did the biopsy on my tongue last November (2019), with the pathology report coming back as Moderate Epithelial Dysplasia (full text below in original post). The lesion is now slightly larger, beyond the scar tissue of the biopsy sight, and more visible. Before I could see a difference in tissue texture adjacent to the while lesion, now there is more white colored streaking.

The original oral surgeon who did the biopsy is now referring me out to Oral and maxillofacial surgeon in Boston who specializes in Head and neck oncology for his evaluation. He noted in the referral letter that the dysplasia noted on the biopsy pathology report extended to the edges of the excision. He also noted that white lesion expansion.

With the whole COVID-19 thing going on (bless any cancer patients and caregivers dealing with the rigors of cancer treatment and recovery amidst the additional threat of that...) I was advised to wait until later in the summer to try to schedule the consultation appointment. Things kind of died down (before this latest resurgence) but Boston is starting to open things up a bit, so called and got registered with as a new patient today. I was unsuccessful in getting an appointment today, their "coordinator" (referred patient coordinator?) was given a message to call me to schedule appointment.

That was new and odd to me. Hate it when staff use terms of art and titles and don't explain what exactly this person does--every other appointment you call the doctors office, send them an email for the referral letter or whatever, and make an appointment.

The size of the lesion does seem to be larger, more white areas, and the round area with the unusually (doesn't match) texture is larger. Nothing huge, but slow growth. I've been taking iPhone pictures every month or so.

Not sure how backlogged this doctors appointments might be.

Curious to see if he will recommend additional biopsy of a larger region (in case as I mentioned in my original post--with the dysplastic tissue extending to the margins, if the source area of the dysplasia might be deeper or above/below left/right of the biopsy sight with perhaps more severe cellular atypia/dysplasia.

Also curious what he will thing about the toluidine blue dye to stain the lesion to highlight the tissue that isn't white, but different textured--to see if that area takes up the dye and if he will take a larger biopsy out.

The oral surgeon mentioned this new doctor may recommend laser ablation.

Who knows.

Literature review indicates moderate epithelial dysplasias have about a 10% chance of progressing to SCC. I'd imagine once all the atypical tissue has been removed then that 10% chance would go down to the baseline risk of any average person developing oral cancer.

I need to remember to ask him about the HPV virus. I've read that is big with throat cancer, not sure if it lines up with tongue lesions.

They did not test me for HPV.

Swallowing hasn't gotten worse--once in a while (few times a week) it feels like food is sticking in my throat more, and harder to swallow. Haven't gagged on any pills in a long while though.

Sorry no real questions with this post--no one really offered any thoughts on my last one. Kind of a note to myself to try and organize my thoughts for following up and getting this next level referral appointment scheduled to go in and be prepared to ask the doctor intelligent questions and make semi-informed decisions.

Not looking forward to another tongue incision, but would rather keep them coming as outpatient procedures with a few stitches then dealing with what some folks have to with invasive cancers (trying to catch anything nice and early....).

Not "worried" (don't lose sleep over it, don't think about it very often), but also trying to remain dilligent.

I'll update with what this other doctor says, and how things go from here on.

No pain or swelling or ulceration near the biopsy scar or extended white lesion.