Hello,

I'm a 33 year old otherwise healthy male. I have a 12 year history of (episodic) heavy chewing tobacco and alcohol use. I've quit both for periods of time ranging from 3-6 months. Anyway, I was always concerned about the impact of these negative habits on my oral health, and so I had the Velscope performed at least twice yearly during cleanings and other dentistry procedures. Nothing suspicious was ever found.

40 days ago I went for an oral exam with a new dentist. She did a thorough visual/physical oral cancer inspection and found nothing concerning. She also did the Velscope, which found nothing either. I stopped chewing tobacco on that day.

Several days ago I randomly discovered a small (1/3 size of pencil eraser) soft papule type thing (very slightly raised) on my upper inner cheek, around my back molars. It's a dark maroon color. It almost seems like it's filled with dark blood. No pain.

Given my history of high-risk behaviors, I went back to this dentist to have her take a look. To my surprise she said this growth was present 40 days ago, during her last evaluation (she never mentioned it to me at the time). She said she wasn't concerned at the time and figured it was something along the lines of a varicose vein. The Velscope didn't "light up" on it, so she wasn't concerned.

She inspected it again and noted that when pressed the growth "blanches" normally, which suggests no malignancy. I thought it might be a mucocele, but she said it wasn't. She is referring me to an oral surgeon to get his opinion. This spooked me a little, because I was expecting her to be able to visually/clinically diagnose it.

My questions are:
- If this was a cancerous growth, does it stand to reason that the Velscope would have detected this 40 days ago?
- Does my description of this growth align with how oral cancer presents?
- Has anyone here experienced a similar type of growth?

Thanks so much for your time and help.

Welcome to OCF! Im sorry you are here due to having an undiagnosed growth in your mouth. Hopefully it is nothing serious!!

Im VERY glad to read you are not using tobacco anymore!!! CONGRATS!!!! All tobacco is dangerous and chewing tobacco is one of the worst. Chewing tobacco goes right into the bloodstream when its put inside the mouth. Theres tiny shards of fiberglass that cut into the sensitive gums enabling the tobacco along with all the added poisons to get absorbed. I hope you have permanently stopped using all forms of tobacco.

To answer your questions first please understand our organization is made up of people who are oral cancer (OC) patients/survivors and caregivers. We do not have medical degrees, years of medical training, clinical patient experience, the patients entire medical history, or the patient in front of us to examine and ask questions (not that any of this would help anyway). Im sorry but we are not qualified to give anyone a medical opinion, especially not over the internet. As a 3x OC survivor who has interacted with thousands of OC patients/survivors and caregivers over the past 12 years, I will try to help or at least point you in the right direction.

... The Velscope identifies abnormalities in the mouth. It does NOT differentiate what is cancerous and what is benign. Any inflammation, sore, infection will light up just like a cancerous tumor would do. You just never know what will light up and what wont. If the person doing the exam didnt shine the Velscope directly on the spot then absolutely yes it could have been missed. Its also possible the spot wasnt showing when you had your exam. Heres more info about the Velscope....

DentisrtyIQ, Velscope 2011 article
DentistryIQ, Velscope 2012 article

... Oral cancer can present itself in many ways. Some patients have pain while others do not. For some they have a mild earache or a sore throat. The OC symptoms are easily missed due to most patients not having any major change when they first have cancer. Some patients have a spot, sore or an open lesion while others do not. OC can be anywhere in the mouth, or throat which helps to make symptoms harder to notice. Heres alot more info about OC's random symptoms from our main site...

Main OCF Site, Understanding Oral Cancer, Diagnosis

... What one patient experiences, another may not. This makes it very difficult to compare patients, even similar tumors. There are sooooo many variables its next to impossible for any 2 patients to be the same. Taking a bunch of people who are all the same age, weight, height, ethnicity, profession, living in one particular area within a few miles of each other, marital status, tumor location, same exact symptoms, everyone eats the same foods, takes the same medications, has the same other medical conditions, even using the same doctor... on paper these people are so similar its like they're carbon copies and they could be interchanged. BUT!!! (theres always a BUT!) These patients are still individuals who have their own unique bodies and immune systems where one could have cancer and the next patient does not. Some people are just genetically predisposed to get cancer and others are not. Theres no rhyme or reason why it affects one but not another. Genetics is part of why the "everybodys different" slogan makes comparisons ineffective.

One thing to remember, a tumor requires a biopsy to determine exactly what it is. Experienced doctors cant even tell for certain what mouth spots/sores/lesions are by looking at them. They can guess but without doing a biopsy its just an educated guess. A biopsy will be at least 2 weeks... waiting a week (if you are lucky to get in that quickly), the procedure and a week until the final results are processed. Any sore someone seeing in their mouth that does not resolve itself within 2-3 weeks should get checked by a professional. Best thing you can do is to go get it checked out by an ENT who specializes in treating oral cancer patients. You do NOT want to get an ENT who primarily puts tubes in childrens ears. The average person has different spots or sores in their mouth from time to time that heal on their own. Theres all kinds of non-cancerous things a spot or sore could be besides cancer. Hopefully yours is nothing serious.

Best wishes!!!

I'm glad you are going to someone with more education on the mouth! I taught thousands of dental students (orthodontics) and know that an oral surgeon is far more educated and knowledgeable on these things.

Congrats on giving up the tobacco!!! I cannot say that enough. My husband would not listen to me when I told him that I had seen lesions on teenager who chewed tobacco. He never thought it would happen to him and today he turned 57 yrs old but cancer has made him look like he is 80 yrs old. Keep us posted on what you learn.