How can I find an ENT who specializes in cancer? I guess an ENT is different than an oral surgeon?

Hi Dan,

Check out this link http://health.usnews.com/best-hospitals/rankings/cancer. There's bound to be a Comprehensive Cancer Center near you (or within reason). They'll have an entire "Team" of oncologists looking you over. If you get a Dx, make sure you get a 2nd opinion at a CCC.

Once you find a hospital, you can check out the staff and find details on the doctor, ratings etc....

"T"

Thanks fishmanpa. I'll call tomorrow to see if the Fox Chase Cancer Center or Hospital of the University of Pennsylvania has an opening in the next week or two for a biopsy.

Kelly, is a punch biopsy the most reliable? If it's not cancer, I don't want them to have to take a huge chunk out of my gum in the front of my mouth. Is a scalpel biopsy or brush biopsy less reliable?

A biopsy is taking only a very small amount of tissue. Just avoid doing the fine needle biopsy as it may need to be redone. Talk all the options over with the doc and have them do what you are most comfortable with.

Good Luck!!!


PS....Since you must be near Philly, there is the annual Philadelphia Oral Cancer Awareness Walk on April 6th. Come on out and help support this small non profit. Last year I was their speaker and this year I know they have a great speaker. Im not that far from Philly but I cant make it as I will be the speaker for the Scottsdale AZ walk.
OCF Events

Sure, I'll have to check that out

Dan,

I think a punch biopsy is about 3/16 in. diameter. Its fairly small and should only bother you for about a day. They do not go that deep and it takes less than a minute. its not big enough for a stitch.

Correction,

I think the punch is less than 1/8 in. Di.

Biopsy punches actually come in millimeters and there are two standards sizes, 3mm and 5 mm. Taking a small core with what is essentially a round razor blade is very quick and not painful. They press the little cookie cutter circle against the tissue and it cuts down a few millimeters. They remove the punch and grab the center of the tissue plug with a hemostat, pull on it a little tug, and snip it off with a pair of surgical scissors. Done. A couple of minutes tops. Depending on location they will use a conventional dental anesthetic like lidocaine to numb the area up first. Most are not even stitched up afterwards, or take one stitch only.

Brush biopsies are very unreliable, and do not provide the pathologist with the information that he needs. A punch or incision leaves all the layers of cells intact in their proper relationship ( basal cells on the bottom, upper epithelium cells on top. A brush biopsy gives the pathologist "scrambled eggs" of cells and some of the information is lost.

Hi everyone,

I talked to Fox Chase Cancer Center and they said that they were out of network with my insurance. I then called the Hospital at the University of Pennsylvania to schedule a visit. In the meantime, I went to another dentist for a second opinion on what the patch could be. This second dentist was in fact very adamant that it was not cancer! He said that cancer which begins on the "free gingival margin" is very rare, and that in his opinion I shouldn't even get a biopsy. I still felt I should get one, however on his advice (and technically against the advice on this forum to not use harsh treatment) I began "brushing the hell out of it" (his words) and also bought a water pick. Since then I have actually seen marked improvement! The patch has shrunk considerably, which means (I believe) that it was not cancer after all!

Dan,

I know you are anxious about this and the only way to determine if if is cancer is through a biopsy.

Now I'm not a doctor or a medical professional, but I'm an nearly 8 year OC survivor and have been to many doctors including ones at Fox Chase, Hospital at the University of PA (HUP) and Johns Hopkins plus my local ENT/surgeon and none of these doctors ever suggested that I "brush the hell out of it"!! Most dentists are trained to detect signs of oral cancer, but they will refer you to an oral surgeon or ENT for a biopsy. You are probably seeing "marked improvement" because you are removing the suspect cells because of the rough brushing. Please stop this!

When is your appointment at HUP? When you go there and want the ENT to examine this red spot you've basically destroyed it, what is he/she going to look at? They will likely not recommend a biopsy because of what you've done.

Using a water pick is OK provided you are not blasting the red area with the water. I use a water pick based on a recommendation of one of my doctors and was advised to use the lowest water pressure when you first start using it.

I truly hope it is not cancer, but please be patient until you see the doctor at HUP.