Hi everyone!

I'm 29 years old and a non smoker. Mommy to a beautiful 2 year old who still nurses due to rare food allergies. Of course all things that scare me medically happen on the weekend. While I was brushing my teeth last night I noticed a white/yellowish bump on the side of my tongue. It's painless and I have no clue how long it's been there. Definitely not an ulcer, I've had those and know how painful they can be!! I'd love any advice on who to see. I have a union dentist who I don't really trust knowledge wise.. Should I see an ENT, Oral Surgeon or who??

I attached some pictures - any advice would be appreciated!! I'm freaking out The picture is the same bump but all different angles. I'm scared it could be cancer..

Welcome to OCF. We aren't doctors but one common thing about most oral cancer is it does not grow much in a day or two. Most likely it is not oral cancer but watch it for a couple days and call the dentist office and ask if they perform screening for oral cancer. If they do, then go get it checked there. If not, an ENT is the next and better option to detect oral cancers.

I suspect you googled around and found this place. Please try to limit any more searching as 99% of what you find is BS and just scary nonsense. This place is backed up with medical experts.

Stay calm but vigilant. Remember oral cancer is very low chance cancer.

Don

Could it start like this? I'm just curious what else it could be? I'm terrified I was just hoping someone could help calm my fears. My dentist said she would look at it but would refer me to an oral surgeon if she didn't like the way it looked.

I would rush to the dentist. From what I see, you should work on oral hygiene more. Your tongue does not look healthy.

I understand your anxiety. Trust me, we all get it. Again, I am not a doctor but even if it was cancer and that is the extent of it, it should be pretty standard to remove at this point.

There is no way right now to help determine if it is cancer. The only way is for a medical professional to examine you and possibly perform a biopsy to make an assessment. The ONLY certain way oral cancers are determined is via a biopsy so no matter what you read or get responses here are not going to get you that answer.

So, back to anxiety. We know the feeling. What you have to try to do is to slow down the mind from going wild with the what ifs. You can totally freak yourself out, even having your funeral planned if you don't get control over your anxiety.

Take one day at a time. Remember, even if it is cancer, a couple days is not going to change anything in terms of diagnosis or treatment or outcomes.

It is much the same as driving down the road thinking every oncoming car is going to swerve over and kill you in a head on collision. You learn to manage these possibilities. You need to do the same with the little white dot being just another well little white dot. It is not going to kill you and almost with certainly it is not cancer.

Lastly, another standard saying around here is it is NOT cancer unless PROVEN.

Hang in there and do the best to remain convinced it is NOT cancer and one day at a time until you see the doctor/dentist.

Welcome to OCF! I have removed your photos. This site is made up of oral cancer patients and caregivers who will try to help you. Unfortunately we are not qualified to know from looking at a photo what is wrong (if anything).

My suggestion would be to get checked out by an ENT. Our "golden rule" around here is.... "Its not cancer until the biopsy says it is. Any sore you have had in your mouth for 2 or 3 weeks that does not heal by itself should get checked out by a professional."

Hope its nothing serious. Best wishes!!!

Thanks everyone.
Uptown I have a lot of dental issues could have a Mercedes in stead of the work I have had done in my mouth.

As for an ENT can I see any ol ENT? I'm in NJ and there's a bunch by me but only seeing regular stuff listed on their sites nothing about OC. Does there happen to be any list for recommended doctors in states?

No list of doctors on this site. Look for an ENT who preforms surgeries, they are the kind who have extra years of schooling and will be (hopefully) most experienced in treating oral cancer patients. When you call for the apt. ask if they treat OC patients and how often. You want someone familiar with mouth issues, not the type of ENT who mainly puts tubes in childrens ears.

So the ENT didn't want to biopsy today and said it looks benign. Like a little pimple but it's still painless. He said to come back if it's still there in two weeks. Is that okay? I've known about it a week but not sure how long it's actually been there.

Only thru a biopsy can the doctor determine for certain if something is benign or cancerous. As I stated above... any sore that has been in your mouth for 2 or 3 weeks and it has not resolved itself needs to be thoroughly checked by a professional. Wait it out and hopefully it will heal on its own.

Sounds like good and typical advice at this point. If it does not look gone or on it's way gone, then go back for certain. Usually the initial lap around the track is to take some antibiotics. Wait two weeks. No change then take a biopsy. Given it has been checked and seems quite small try to stay calm as best you can. Good luck!

My ENT did a brush biopsy today. How accurate is that?

I've heard both good and bad reports about brush biopsies. I guess about all you can do is wait and see what results come back from this biopsy. If positive, it's probably wise to do a conventional biopsy (tissue removal) for confirmation. If negative, I would still keep a close eye on the tissue, daily inspections, etc.

From your comments so far I'm still not convinced this ENT is experienced in oral cancer. Have you confirmed that? Many of these guys are not what we are looking for.

take care,
Tony

He actually didn't think the first ENT I saw knew anything. I went for a second opinion with this dr. The first doctor just told me our mouth does weird things and had no clue. The doctor took the brush biopsy said bad results 24hrs regular results 2 weeks and follow up 3 months. However I don't want this white thing which has absolutely no diagnosis on my tongue that long.

Paul, is that just referring to the soft brush or also the OralCDx brush test as well? I didn't see that mentioned there.

Often a brush biopsy will not have conclusive results. A surgical biopsy may be required.

Is that true for the OralCDx brush too Christine?

As far as I know, yes. From what I understand a brush biopsy picks up a bunch of cells at a time. It does not pinpoint an exact area. If this is the type of biopsy you have had done, dont be surprised if you have to have another more exact one if you get inconclusive results.

Thanks Christine.
I have the first ENT who was clueless that said he would do a punch biopsy on the 2nd if the spot didn't go away, and then the followup ENT who is knowledgable about oral cancer who thinks it may be some sort of fungal or something that may just be there forever. He did the OralCDx brush biopsy yesterday and said we'll see the results in 2 weeks. He doesn't seem to want to do a full on scalpel biopsy or punch biopsy. I spoke with someone over at OralCDx (something they normally don't usually do, but he did out of a courtesy) I watched a video and it shows the process. They told me they have a 2% fail rate, as does the scalpel biopsy. I'm not sure how true that is though.

I have no personal experience with them having had a punch, and an incisional biopsy once myslf, other than the usual FNAB's, surgical biopsies, but thought the article may have included the OralCDx, which is a trade name.

Here is an insurance article that mentions the OralCDx.

http://www.aetna.com/cpb/medical/data/600_699/0686.html

Personally a brush biopsy is a brush biopsy - name aside. That said the issue is this; it takes the surface ONLY. So you may have some dead skin, maybe some fungus - possibly inflammation, but it's what's underneath that may make a difference. My first biopsy came back inflamed tissue (and that was a surgical biopsy). The entire underside of my tongue was red, inflamed and painful but there was no indication of an ulcer or anything. The tumor was inside my tongue. Now it's unlikely this is the case with you as it is painless for you therefore anything going on is likely to be superficial. However. I would do as he says, get the results if they are negative for cancer, then keep an eye on the area, and if it changes go back immediately - if not do the follow up after three months. If you are still concerned after the results go for the punch biopsy on the second.
hugs and hopefully it's nothing.

I wouldn't trust what Oral Cdx tells you. Brush cytology which is a very old idea, has a way lower success rate of being accurate than you were quoted. It's been used in cervical sampling since the 1940's. There are a variety of issues with it. In my mind what Christine has already said, it's relatively superficial, which MAY be enough, but when it comes to this kind of thing I want a gold standard, black and white answer� what is it? That only happens when the pathologist has a really good representative sample. Part of getting that, you can not get with a brush system, no ones brush and there are several out there; and that is architecture. The layers of the cells from the upper epithelium down to the basal cell layer where all cells including cancer cells are born. When you do a punch or incisional biopsy all these layers are there in the proper relationship, and the architecture of them is intact. When you do a brush biopsy, you get scrambled eggs. A very important bit of information is missing.

I have personally banged heads with the owner of Oral Cdx for years. I think it has its place, for superficial quick looks at things which do not have the characteristics of a high risk lesion. More than that, I'm not a fan. But I butt heads with Mark at Cdx because of their misrepresentation of what this technology will and will not do, and the marketing rhetoric that passes for science in that company. There is a place for brush biopsy in the world of diagnosis (not discovery), but at the end of the day no one moves forward to treatment on a brush biopsy finding. If that is the case (it is), then the only argument for the brush is that it is way less involved, and is quick and to the point - but it is far from the equal of a punch or incisional biopsy which are the gold standards.

Thanks Brian. The second opinion doctor refuses to do anything until he sees the results from the brush biopsy. He first told me he thought it was fungus then during the brush biopsy visit said it is like a deep pimple. I don't want to hear what they think it is... I've known about it for two weeks and there's no sign of it going away so far.. Is scalpel or punch biospy better? I still haven't canceled the appointment for the punch biopsy on Tuesday. The first ENT said it should go away but had no clue what it was. They both swear it's not cancer but neither have a clue what it is.. I'm still freaked out and could have had answers by now. Do they just leave a hole in my tongue after the biospy? I just worry about infection since I'm allergic to antibiotics and still breastfeeding my daughter.

Punch biopsies are anywhere between 3-5 mm in diameter. So from the size of a BB to just a little larger. Most of the time they do not even put a suture in the 3mm punch holes and they heal in by what is called "secondary intent" by the body just fine without need for closure. Most of the 5mm ones do the same, but I have seen surgeons put one suture in for the heck of it. They heal from the bottom up, so do not be alarmed if the hole is still there for a few days. It should not bleed as the clot forms almost immediately and stays put if you don't mess it it all the time. (Most do mess with it, and there is some small blood on your tooth brush etc. for a few days if you do. For sure a fungus can persist for weeks even months, so our hard rule of checking anything that does't heal in two weeks is not an indicator for sure of cancer, but that the thing needs a definitive diagnosis. If it is some kind of viral, bacterial, or fungal infection great, now they know what it is and appropriate treatments can be initiated to deal with it. Scalpel and punch biopsies are equal, and up to the surgeon. A scalpel biopsy will probably take two stitches to close up. It isn't much more radical but the shape of the wound is more prone to slower healing without suturing. Whatever you have done, just gently keep it clean and infection should not be a concern.