Even active duty military personnel have options. Having done a little time in the military medical service, I have some, if dated, experience here. You can go outside the system. Of course this is on your own insurance or money, not the military's. You can get the military to pay for it if the treatments which you need are not available within the military system, or you can show that what they would provide is not currently accepted standard of care where you are. If it involves treatment at another facility, TAD to that facility is possible at full pay. You can petition to be sent to Bethesda for instance, where the NCI is located. Regarding further delays, this is unacceptable, and a request by you to the chief medical officer of the facility you are stationed at for more rapid diagnosis, etc. is acceptable and in order. You are informed now enough to know that this moves quickly. If you have abnormal, dysplastic cells in your biopsy, and a cervical node that is abnormal, the clock is ticking. The doctor you are currently seeing is out of touch. He obviously is not up to speed with the current spike in non smoking oral cancer patients in their thirties and forties that we are seeing around the country. If your chief medical officer does not endorse your requests you can move further up the chain of command to the base commander. Realizing that every time you jump up the chain of command in the military it can piss off people you jumped over

Thank you Brian for writing with all of your wisdom and support. Well I called the Doc back today and told him my concerns. He told me that still I should not be concerned. He said the finding on my biopsy was "abnormal" and that it didn't state anything specific. He mentioned that at this point he is not concerned and that it is his duty to follow up ONLY because it said "abnormal". He said that it could be so many different things such as my immune system or a food alergy. He said that since I'm not an "80 yr. old man that has been smoking and drinking for most of his life" then he's not as concerned. When I mentioned that more people are getting cancer at an earlier age, he just said that when you get a freckle that doesn't mean you have "skin cancer" and should not be concerned with every little thing different with your body. I told him that my CT scan would not be for over a month and he said not to lose "one wink of sleep" over this. He said "I don't know who you are talking to but they haven't seen what I see and if they aren't a DOCTOR then they just don't know". So my question now is, what is the difference from an "abnormal biopsy" and "pre-cancer" like he mentioned the other day? Also, he put me on Prednisone. Does this do anything? One more thing, I read about swollen lymph nodes. Can your lymph nodes swell (become cancerous) before cancer is detected through a biopsy of the mouth? The lymph node on the same side as the red patch is a hard lump about the size of a quarter. It is always there and has been for the last month (when I first noticed it). I mentioned this to the doctor and he didn't seem concerned at all. I get the feeling that he thinks I'm worried and bothersom for no reason. Am I just been a "worry-wart" or should I still be concerned? I've lost so much sleep thinking that the doc just doesn't know. I just don't know what to think or do anymore. Thank you so much for listening...I don't know what I'd do without you all.

The transition from normal cells to malignant cells has an intermediate stage call dysplasia. Dysplastic cells do not ALWAYS become malignant, but they do more often than not. Some labs call dysplastic cells abnormal, it

Misty, You can tell your doctor that my husband, who was 37 when diagnosed, never smoked and rarely drank. He was one of the healthiest persons I have ever known, yet he was diagnosed with Stage IV squamous cell carcinoma. He found his by a swollen lymph gland in his neck area. I would find another doctor if you can, if nothing else, he should be sensitive to your feelings of being uncomfortable waiting. I think he is definetly not up on medicine in the head & neck area.

Misty,

I hope by the time you get this message you have had some response and action on the part of your doctor. I am a 30 year old non smoker, non drinker female and I was diagnosed with carcinoma in situ of the tongue. I was very lucky that my dentist caught it. Unfortunately I waited over 6 weeks for my appointment with an oral pathologist who took one look at it and told me it wasn't good. She did a biopsy that day and I had outpatient surgery within 9 days of my biopsy. The biggest mistake I made was waiting the 6 weeks to get the biopsy. If I could do it all over again I would have pushed harder to get an earlier appointment. It sounds like you have more symptoms than I did....I didn't even know I had anything on my tongue. Please don't wait to get your doctor to respond to your needs.....take action.
Ever since my diagnosis I have learned to be more assertive with my doctors.
I wish you all the best.
Sandra

Misty:

I agree wholeheartedly with Brian's comments above. As a nurse practitioner, I can tell you that the MD's comment about only needing to follow up because the result is abnormal is inaccurate.The obligation of all primary health care providers is to provide our clients with results (in a timely fashion), explain those results in a way a lay client can understand, and refer if necessary to specialists if further exploration is needed.Please also keep in mind that some general practitioners are not particularly skilled at interpreting biopsy reports and CAT scans pertaining to oral cancer due to lack of training.In my partner Dave's case, even his GP whom we both adore,gave us false hope about Dave's CT that read "tonsillar enlargement & one enlarged lymph node". He was going to chalk that reading up to an infection but luckily the final word came from our ENT who validated that those findings were consistent with those in tonsillar cancer. The lesson-a trained eye is key.

I also agree strongly that the sequence and rationale for the CAT scan is incorrect. If yo have a positive finding in your node on exam, that is abnormal regardless and mandates both gathering of more information to assess the cause AND tight follow-up within a short time frame, especially if the node is firm, non-tender, and of long duration.

My suggestion is to obtain a copy of your biopsy (I don't know how the military works but a copy should be given without question and cannot be denied because it is YOUR medical record) and seek counsel from an ENT.

PLEASE keep us posted &

Best of Luck,

Kim

Misty,
I'm new to the board, but have a few thoughts. My daughter has never smoked and is basically a non-drinker, unless having a couple wine coolers a few times a year counts. She is 28 and has Stage 4 tongue cancer.
She started having ear pain and a sore throat in May of this year. Our dentist does do a thorough check of the throat, cheeks and tongue at every cleaning, but he saw nothing in June. The throat wouldn't get better and she started having trouble swallowing and felt a lump in her neck, but the family doctor could see nothing. That was in June and again in July. She finally said "enough is enough", she couldn't take the pain anymore and demanded to see a specialist in August.
He saw nothing, but ordered a CT scan. The scan showed NOTHING. But by that time, she could actually see something in her tonsil socket. So he did a biopsy and it was positive.
PLEASE, PLEASE go to another doctor. Do not wait any longer. You have to know for sure in order to have peace of mind. And, God forbid, if it is cancer, you need to start treatment ASAP.
Sorry for the long post and I don't mean to scare you unnecessarily, but I agree that your doctor is not on the right track and you need to see a cancer specialist.
Take care,
Rosemary

Hello all and thank ALL of you for posting to my question and concerns. This web site has been extremely informative as well supportive through my ordeal. I'm sorry it's been so long since I've posted but I have been trying for a few weeks to log on with no luck. Today has been the first.

To bring you up to date...well I got my biopsy results back that were inconclusive. They showed "abnormal" cells that they couldn't determine if they were reactive of dysplastic. The pathologist said that an ongoing site that has been there that long usually is not good. So the Dr. should be concerned and follow up. So, they sent me for a CT scan that didn't show anything. So my Dr. was just going to wait and see me again in the future. I asked him if I shouldn't be more concerned because now I've had this "problem" for 10 months!! To my surprise, he informed me that he only took a "very small" piece of the very edge of the site. He said that if he does another biopsy, he'll take the whole thing. I thought about it for a minute. If the first biopsy was definitely nothing, and I still had the problem, then I wouldn't want another biopsy. But since they aren't sure, we're going to do another biopsy. I just want to be sure...and sleep well for a change.

I can't believe I have to go through this whole thing again. I waited over 3 weeks for my results last time and he said to expect the same this time. Ugh! But I guess I should know definitely next time.

Please wish me luck!

Hi Misty:

It is really good to hear back from you with an update. I was wondering what happened to you?

I am wondering if the same MD who initially saw you is doing the repeat biopsy? Having a sample the MD feels confident about is the first step in the diagnostic process and it feels a bit funky to me that the MD felt his first sample may not have been adequate.

I recall your red tape about seeking care but is there a way you can assure that both the repeat sample is adequate and check with a pathologist personally to be sure he/she agrees? A pathologist always has to sign off on a sample that is analyzed so you should be able to speak directly to that person. Good news that the CT scan is negative.

Keep us posted,

Kim

Misty:

I forgot one MAJOR point: stomp, bump, grind, and push to get your biospy results within a realistic and timely fashion which is usually 3-7 days. Under the circumstances, I would accept no less that expedited service military or no military. To be truthful, I'm still not comfy with this MD's cavalier attitude and I think you need to set a stern tone that he take your health and well-being seriously. Or, even better, find someone else if possible.

Kim