Hi. I'd like to describe my situation in the hopes that someone might share some thoughts. First a bit of background: I am a 44 year old male with a ten yearish history of using dip tobacco which I quit 15 years ago. I have a habit of running my tongue along the inside of my lower lip and about ten days ago I noticed a lump on the far left side of my lower lip. I believe that it is a swollen gland as there is a (non swollen) gland in almost the exact position on the right side. Obviously thought, that's just specuation. It's hard to guess the size but it's probably just less than a cm in diameter. One bit of strangeness is that within 24 hours of having noticed the lump, a secondary lesion developed nearby and about a cm or two towards the midline. This one was much harder and very small; about the size of a large grain of salt. At some point on the night I noticed it, the smaller lesion just kind of 'deflated' and I thought that it was going to go away. However the next morning it was back and hasn't changed since.

Based on what I've read on this board (and other sites), the smaller lesion sounds like a mucocoele. It seems really hard to imagine that the two lesions aren't related. I have made an appointment for next week with an ENT, but I do have one specific question and I'd love to hear any useful general input anyone might have. My specificc question regards the ENT. If he deems a biopsy is necessary, is that a procedure that any ENT can do in the office? Or might he have to refer me to someone else?

Thanks in advance for any responses.

Not all ENTs will do biopsies, same with treating oral cancer patients. Some ENTs specialize in putting tubes in childrens ears.

Its usually a 3 step process to getting a biopsy in the US. First appointment is the initial consultation. They will discuss 3 ways you can have the biopsy, asleep, with a local numbing shot or without anything. They will talk about a punch biopsy or an excisional biopsy. They will check your insurance (this is a medical procedure, not dental) coverage and try to get a pre-approval. The second appointment is the biopsy, if being put to sleep you will need a driver. The third appointment is when you get the results. The 3 appointments are usually about a week apart. It is frustrating to have to wait up to a month from the time you make your appointment until you get the results. In a few instances the ENT will go ahead and preform the biopsy on the first appointment, but thats not always the norm. This same thing goes if your doc refers you to an oral surgeon.

I suggest if you want to know the ENTs office procedures, call and ask. The office staff should be able to tell you if the doc does biopsies or if they send them out.

Good luck!!! I hope its nothing serious.

PS.... Here is a link to the main OCF pages for more biopsy info.


Biopsy Info from main OCF pages

Thanks Christine for that information (and the link in the following post). I have a feeling that the ENT I scheduled my appointment with is of the 'puts tubes in little kids' ears' variety. Unfortunately, I live in a very small, rural town and the nearest city of any size at all (where I've scheduled my appointment) is only 90,000 people and my insurance only lists three ENTs. Anyway, we'll see what he has to say about it. I'm still pretty optimistic. Thanks again!

I suggest you call the ENTs office and specifically ask what the doc specializes in. If its the tube in ears type then you are wasting your time and money. That type of ENT is not going to have the knowledge to be able to help you. Keep looking, try calling the other 2 docs your insurance company listed.

Best wishes!!!

Good morning RS - welcome to the family.

You only have two replies to your post, but they are both from probably the most knowledgable member in our family. Listen to what she says, for she knows of what she speaks.

Here's hoping your problem is not cancer, but if it is, you have found a wonderful family to help you get through it.

Tony

[quote=ChristineB]I suggest you call the ENTs office and specifically ask what the doc specializes in. If its the tube in ears type then you are wasting your time and money. That type of ENT is not going to have the knowledge to be able to help you. Keep looking, try calling the other 2 docs your insurance company listed.

Best wishes!!! [/quote]

I did ask that when I called and got kind of a vague answer. However, based on the what I was able to ascertain on the internet, the other two options *clearly* fell into the 'tubes in kids ears' category. So I picked the least bad option. Anyway, the appointment is in five days so we'll see what he says.

Thanks again for taking the time to reply!

[quote=n74tg]Good morning RS - welcome to the family.

You only have two replies to your post, but they are both from probably the most knowledgable member of our family. Listen to what she says, for she knows of what she speaks.

Here's hoping your problem is not cancer, but if it is, you have found a wonderful family to help you get through it.

Tony [/quote]

Thanks Tony for the welcome. I've been reading a great deal on the forum and it does seem like a great community. Hopefully though, my stay here will be very brief Have a great day.

RS - getting vague answers is quite common in this field. Doctors deal with all types of patients, from the ones who ask no questions and don't want to know ANYTHING about their cancer all the way up to those who want to know EVERYTHING (and don't spare any of the details along the way).

When you ask your first questions they don't know where you are in the spectrum, so they usually give a shorter (in your case vague) answer. If that satisfies the patient, they're done. If you are more of the want to know everything persuasion, then it sounds vague and curt.

When that happened to me, I just told the doctor I needed more detail as I wasn't satisfied with the answer. I had decided that doing that was just part of advocating for myself, something I learned here on the forum. Without even missing a beat the doctor restated his answer in more detail and that satisfied me. More importantly, every question after that got the more detailed form of the answer.

Later, my doctor said that they actually like the patients who advocate for themselves, they are better patients that better understand the process and treatment and usually get better results than those who are mentally uninvolved in the process.

Hi Again. I just thought that I'd update the thread. I saw the ENT yesterday and he wasn't particularly worried about the lesion. He said that it was probably a mucocele, which was more or less what I had come to expect based on a week of googling photos. He gave me the option of having it removed (on a subsequent appointment) which I accepted and that will happen next week.

One thing that did strike me a little bit strangely was that he didn't even palpitate the lesion. He just had me hold back my lip so that he could look at it with what I assume was a large microscope hanging from the ceiling. But maybe that's normal. In any event, I left the office feeling pretty relieved.

Thanks again to everyone and I wish you all the best of luck.

So glad to hear this reassuring news, rs1971. I assume the doc will biopsy the tissue he removes, I think that's pretty typical for any growth of this type. Palpating these lesions may not yield much information but in any case certainly wouldn't be as definitive as a biopsy.

[quote=Mamacita]So glad to hear this reassuring news, rs1971. I assume the doc will biopsy the tissue he removes, I think that's pretty typical for any growth of this type. Palpating these lesions may not yield much information but in any case certainly wouldn't be as definitive as a biopsy. [/quote]

Hello. Thanks a lot for that and yes, I'm assuming that pathology is SOP for anything that they excise. I'll definitely double check though.