Anybody have any experience with this? I had an Dr. appt today and he took note of a red area at the back of my tongue. He has seen it before and wasn't concerned. Said it didn't look or feel like cancer. Today he said that it could be dysplasia and if it's still there in a month he will biopsy it. Regardless, I have a PET Wednesday so I don't have to sweat it for a month but I was curious if anyone had had a similar experience, did it turn to cancer etc... Do they remove it or just keep an eye on it???

Thanks,
George

OK so he's an experienced guy that has seen a lot and is really knowledgeable. Having said that, no one can, with the naked eye, tell you what is dangerous and what is not, not the best oncologist in the world. Only the guy with the microscope can do that. It could be just residual irritation from the post treatment issues that you likely have, or something else. A month is too long I think. Dysplasia can be high grade (very risky) or low grade - dangerous but not going to convert tomorrow or perhaps even ever. Just to be clear - dysplasia is the point between "I'm a normal cell, and I'm a malignant cell" so in cervical cancer the reason that they have made such huge progress against the death rate of the disease is because GYN's remove ALL dysplasia, and they do not "wait and watch" which posters here will tell you sometimes lets things prosper into something really bad. So given your history, and that previous oral cancer patients have the highest risk of transformation of dysplasia to convert to the dark side, the PET is a good idea. Just remember that a PET is not specific for cancer, and what you learn from it may or may not be helpful. I guess my question would be given that a biopsy is a no big deal (especially with what you have been through already), why not just do the simple procedure and let the pathologist give you a black and white, gold standard answer this week? What's the down side? Of course this has to be done after your scheduled PET or it will screw up the scan.

OK, the worry meter just went up a notch. I see my oncologist after my PET so I will push it with him. My ENT is the one I saw yesterday.

My ENT did say that he thought it was something leftover from the radiation and nothing to worry about.

Thanks Brian.

Please understand this: I am not insinuating he is wrong. Almost every patient that I talk to or actually see, has something weird about the area in which they had their original cancer, and that does not equal RETURN of disease. But I would not live with a feeling of uncertainty if it can be put to bed through a relatively simple process - that is what I am suggesting. We all do that emotional dance with this thing, mostly for protracted post treatment periods of time, and every time I get some weird bump, roughness, discoloration, in my mouth (which is frequently) I simultaneously get a bad feeling in the pit of my stomach. It stays around in my gut, and my psyche until it resolves on its own, or one of my reviewing docs gives me a black and white clinical answer.

you can never be too careful. Good advice.

Brian is so right. At 1st I had nothing on my tongue to worry about until someone wised up and checked it. I had asked no less than 5 Drs to check it for me. Naw, Jim , nothing to worry about and it will clear up.

[quote=Brian Hill]Please understand this: I am not insinuating he is wrong. Almost every patient that I talk to or actually see, has something weird about the area in which they had their original cancer, and that does not equal RETURN of disease. But I would not live with a feeling of uncertainty if it can be put to bed through a relatively simple process - that is what I am suggesting. We all do that emotional dance with this thing, mostly for protracted post treatment periods of time, and every time I get some weird bump, roughness, discoloration, in my mouth (which is frequently) I simultaneously get a bad feeling in the pit of my stomach. It stays around in my gut, and my psyche until it resolves on its own, or one of my reviewing docs gives me a black and white clinical answer. [/quote]

I gotcha. I'm really not that worried, don't know why I'm not, but I'm not. PET is in the can, now I just wait to see my oncologist and I'll get his take on the "irritated area" at the back of my tongue. I will push for a biopsy from him. How do they biopsy that area? Before I had the needle biopsy on a node in my neck. Do they scrape, needle, cut???

Thanks guys,
George

Two most common techniques are incisional or punch biopsy. The punch is a little 5mm cookie cutter that takes out a core, the other is just the guy taking a narrow v shaped slice out. For the most part these don't require stitch, but if they decide that the area is extensive, they may do several and that will take a stitch or two each to close up. There is a superficial brush collection system, much like a pap smear, but I am not a big fan of this for anything serious. Problem is that it gives you a mess of loose cells, not a core.... scrambled eggs. A pathologist needs to know the cells architecture - from which layer of tissue......

This is the page from the main OCF web site which goes into more detail

http://oralcancerfoundation.org/facts/detailed_biopsy.htm

[quote=Brian Hill]Two most common techniques are incisional or punch biopsy. The punch is a little 5mm cookie cutter that takes out a core, the other is just the guy taking a narrow v shaped slice out. For the most part these don't require stitch, but if they decide that the area is extensive, they may do several and that will take a stitch or two each to close up. There is a superficial brush collection system, much like a pap smear, but I am not a big fan of this for anything serious. Problem is that it gives you a mess of loose cells, not a core.... scrambled eggs. A pathologist needs to know the cells architecture - from which layer of tissue......

This is the page from the main OCF web site which goes into more detail

http://oralcancerfoundation.org/facts/detailed_biopsy.htm [/quote]

Ouch!

A tongue biopsy can be annoying while it's healing, but really should be no big deal. I shudder when ever some writes that their doc will wait and see or waits more than 2 weeks to see if something doesn't go away. You wrote that he's seen it before and he's not concerned. What?????

Nobody is trying to scare you, but you need to be tell him you don't want to wait a month. Don't accept anything less than an incisional or punch biopsy. I doubt he'd offer the brush, but they are unreliable (in my opinion).