He's choosing that particular lab at OS because they look only at oral tissue samples. It's not that a conventional full service pathology lab can't find oral cancer, since the characteristic cellular changes are common to all malignant cells. It is because if it is not cancer, and is something that isn't deadly, it would still be important to know what it is (there are hundreds of things to choose from) so that if there were any long term issues, or that it was a precursor cell type to something that was coming down the road other than cancer, these guys have seen it all and you would know what it is. You will get a very specific diagnosis of what's what. Good call on his part.

Also don't worry about the depth. Punch type biopsies, which are very common, are actually at least an eighth to a quarter inch deep in areas where the soft tissue is that thick. The tissue has many levels/layers from the deep basal cells to the actual outer epithelium. Seeing all the layers in their normal architecture position is important. (This is why I am not a big supporter of brush collection systems, since they just give you scrambled eggs and no architecture. Did that bad cell come from the top or the bottom of the soft tissue layer?). Determining where the non-normal cells come from in the layers of stratified tissue tell the diagnostician/pathologist a lot. Cancer pretty much always starts in the basal cells deep in the tissue, and in most oral malignancies, finally migrates upward to the outer epithelium where you finally get to see something. If this is something that is only in the upper epithelium, it likely isn't cancer even without looking for the tell tale cellular changes.

We are discovering that in some HPV positive SCC that the typical migration of the cancer cells towards the surface may not take place. So getting a full depth biopsy is a good thing. It heals in very quickly.