I have a persistent (comes and goes) lesion on the rear left side of my tongue, on or near my lingual tonsil. It is concerning me because a dentist looked at it, wasn't too concerned but said that if it wasn't gone in a couple of weeks to have it checked out to rule out cancer. (After I asked if it could be cancer.)

At times it really hurts, and feels deep, way back in my throat. If I had to show where I felt the pain, I would poke under my chin, just next to the rear of my left jawbone. It's hard to describe, but it's deep in there. Looking at the tongue, you hardly notice the lesion (though the dentist totally saw it).

I had my internal medicine doc take a look at it, but he used tongue depressors and basically overlooked it. At one point, he actually pinched the area with the depressor without realizing it while trying to get a better look further back in my mouth. He said it looked like a cold sore/HPV (Whcih I've never had before) and gave me a prescription for antivirals. I am concerned he didn't know what he was looking for and don't trust his cursory inspection. I'd like to be seen by a specialist.

Now I want to know whether it would make more sense to see an ENT or an oral surgeon to have a look at the lesion? My first thought was an ENT, but after the doctor's office experience I called a dental office and they suggested I call an oral surgeon right away.

Is it better to see an ENT or an oral surgeon, or should I pursue both? I am sure it will take me a bit to get an appiontment with either, and I would rather get answers sooner than later. I feel paranoid but at the same time, I don't want to mess around. I continue to take the antivirals that were prescribed to me, but I'm not sure why I am taknig them. The doc didn't even test me for HPV before writing the prescription.

Welcome to OCF.

The symptoms you describe could be attended to by either the oral surgeon or an ENT. Make sure whichever doctor you select, they treat oral cancer patients and not specialize in putting tubes in kids ears (ENT), or pulling wisdom teeth (oral surgeon).

An oral surgeon will probably recommend to remove the sure. That is if the sore is present when you are examined. This is a good thing as oral cancer usually does not come and go, the tumor would stay present at all times and grow with time. Just remember... when you have surgery and they remove whatever it is, it cant be put back. A wide margin would be taken to ensure they get every cell of the sore. Surgeons always will recommend surgery, radiation oncologists always recommend radiation, etc. I suggest whoever you get checked out by that you get a second or even third opinion before you decide which path to take.

At this time there is no reliable test available to test for HPV.

I hope its nothing serious. Best wishes!!!

Christine,

Thank you for writing me back so quickly. I appreciate it as you can imagine that I am a little anxious at the moment.

Based on what you are saying, I am leaning toward pursuing the ENT route first, as would prefer to avoid surgery at first if that is not necessary. I have had chronic bronchitis/laryngitis for the last several winters, so I have thought to see an ENT before. I am going to make a call to the referral service at my local hospital and work on getting that appointment. To be honest, I'm not sure if the lesion has come and gone, but the pain certainly has. I hope it's nothing serious too. I will do my best not to let my imagination run away with me.

Thank you again for answering my question, and I will be sure to update here.

It could be any number of things that are not serious. A biopsy should be done to determine exactly what it is. An ENT would be a good choice for getting that done. It will take at least a week before the results get back. that will be the longest week of your life! Hang in there, you will soon know whats going on and get it taken care of.

Good luck!!!

jgb,

If I may be so bold, I'd like to suggest that you modify your approach to this condition. I suggest that your priority should be defeating this disease, not what kind of treatment would be preferable.

This is not a disease that you want to use half-measures, or "good enough for Government work" approach. For this, you want to bring every weapon in the armory to the very first battle; because (and I don't want to alarm you) if you don't decisively get it the first time, you may not get another chance to beat it decisively.

Good luck to you,

Bart

My cancer was on my lateral tongue (the mobile part). I had a painful canker sore for a few months, and while the sore may have been there for a while, I didn't always notice the pain. I first went to my family doctor, who referred me to an oral surgeon who did a biopsy in the office. When the biopsy confirmed I had cancer, he then referred me to an ENT who did the surgery (hospital, but as an out-patient!).

Based on where you said the lesion is (back near tonsil), I would go to an ENT rather than an oral surgeon. An ENT should be able to scope your throat with an instrument during your office visit to get a better look. A biopsy would be needed and I'm not sure that could be done in the office based on the location. As Christine said, look for an ENT who is familiar with oral cancer.

Take it a step at a time and a day at a time. Right now you don't know what is wrong and the first step is to find that out. Hopefully it is not cancer and easily curable. If it is cancer, you are already ahead of the game in that you already found OCF, the best source of information and support!

Wishing you the best!

I don't know why the doctor gave you an antiviral either, if HPV was suspected? As mentioned, there is no routine testing for oral HPV, may visually see a wart that can be HPV 6, 11, that is non cancerous, and occurs in other areas too, but to my knowledge, antivirals are not the course of treatment. There are over 150 different types of HPV, with about 15 of them being high risk to possibly cause cancer, and it's mainly HPV-16, that may cause oropharynx cancer, mainly tonsil, base of tongue, in 1% of the people exposed to it, and the majority of people's bodies fight off the disease within two years. HPV oropharynx cancer, doesn't usually present itself with an ulcer, unlike tobacco related cancer or pre-cancer does, but that doesn't mean a co-infections or disease can't be present, and most times it can be something other than cancer. Anyway, antivirals are for viral infections like HSV-1, HSV-2, and anti-fungal for Candisis like thrush, a fungal infection, and antibiotics are for bacterial infections, others too, usually the first course of treatment most doctors prescribe to patients presenting with head and neck symptoms like most of us were, for some reasons, since it may resolve whatever it is, but I'm not a doctor. I would see an ENT, preferably one with cancer experience.

Good luck with everything.