Hi Leslie

Thank you for the post

If I understand you correctly after having initial biopsy you came to know that it is leukoplakia, could you please tell me what made you to go for excisional biopsy. Did the ENT recomend it or just for precausion you had it.

Thank you for your time

My husband's dentist identified the tiny white spot on his tongue as a leukoplakia last April and then referred him to an oral surgeon for the initial biopsy. That report came back showing moderate dysplasia. It also specifically warned of a possible "skip effect" -- meaning that more severe dysplasia or cancer cells could be hiding in areas that were not removed in the initial biopsy.

Given that report, the oral surgeon referred my husband to a local ENT surgeon (not one at an NCI-designated cancer center, since cancer had not yet been diagnosed) for an excisional biopsy. That was done a month after the initial biopsy, and a larger area was removed. The report came back showing carcinoma in situ, with a bit superficially invasive.

After getting that diagnosis, my husband began to see an ENT at Johns Hopkins' Kimmel Cancer Center, about an hour away from our home. He was checked there every four to six weeks for the first six months and is now being seen every eight to 10 weeks. All good so far (knock on wood).

All the best,
Leslie

We've got some wrong info going on here. Squamous refers to the type of tissue that something is occurring on, nothing more. So carcinomas that occur on the squamous cells of the body are SCC. Hyperplastic tissues are common. These are tissues that have grown at a fast (more than normal) rate. In the world of implants we frequently see patients who are prolific tissue growers around the neck of new implants, and the hyperplasia causes the tissue to grow up around the implant and get in the way of the crown fabrication. It is usually just removed with a cautery and may have to be done repeatedly. This is not disease. Leslie's definition of hyperkeratosis is correct. This is not irritation, though irritation can be a cause of hyperkeratosis in some cases. We have to be really careful that we are giving people accurate information here. Clearly SCC has a path of gradual changes that may or may not be detected as final malignancy develops. These steps are well documented and understood. But realize that anywhere along this path things may stay idle for years or never progress further. So having an early step in the process is no guarantee that it will become more. This does not mean that you should be complacent; it means that you have to keep you eye on things and if changes take place, reevaluate what the cellular issues are at that point in time. I have a plaque on the panel of my plane and it applies to this as much as it does to flying. Eternal vigilance or eternal rest.

Leukoplakia can continue transformation to cancer. But only about 25% of the time is this true. Nevertheless, I am an advocate of having it lasered off as a precautionary and proactive process. It often returns. I know people that have had repetitive, annual laser removal of this sometimes precancerous lesion.

Avoiding biotechnical terms, I started having recurring white spots on my tongue over 15 years (1990 - 2005), which were removed and sometimes lasered, but in my case eventually a tumor started at that spot -- I had stopped smoking in 1970 (after eight years) and stopped all alcohol in 1994, but had a tooth rubbing that spot until the tumor started (my surgeries removed enough of my tongue in that area that it no longer contacts my teeth).