Hello--
My dad has a lesion on his tongue that has recently been biopsed and described as a "pre-malignant lesion." He has an appt with an ENT to discuss treatment options next week.

I've been trying to do research to prepare for this appt but haven't found much material relating to pre-malignancies in oral cancer. We're scared!

Is it typical that such a lesion would be removed? How difficult is it to have a tongue lesion removed? I know from what I've read here so far that this happens all the time... but this is a new world for us. Any advice much appreciated. We live in Minneapolis. Thank you--gwen

Pre malignant is just that. Not yet cancer. If it is small, it can be surgically removed. There are all grades of premalignant lesions, of many different types. Many that are low grade, only 10% of them, even untreated, never progress to malignancy. The path report should use the word dysplasia and high or low grade if it is moving from low to high grade, but even then, only 25% of all dysplasias move on to full malignancy. That will tell you a lot. Only a few are high grade dysplasia, those are serious.

If you are seeing an ENT, he is trained as a surgeon and he is going to want to do surgery. Please ask him for a copy of the pathology report and the people here can help you understand what this is - high risk, low risk - etc. Also if you wish to discuss this further, it would be helpful to know what risk factors your father might have, such as tobacco use.

For now, try to be calm, feel great that this was caught early whatever it turns out to be, as that means low risk of long term problems.

I guess this is the same as my Esophagus after 1/3 of my stomache was wrapped around it. I't called Barretts Esophagus and means it is precancerous and can turn to cancer but I get scoped quite often to keep an eye on it. It is biopsied everytime it is scoped. This has been going on since 1996 and I am doing fine even with the inflamation and soreness.

Thanks, Brian. I very much appreciate this information. My father's appointment is tomorrow, so we'll have more information then but the initial biopsy report said that it was a "pre-malignant hyper keratosis with mild epithelial dysplasia."

My father is 76 and has never smoked. We'll keep our fingers crossed that this is a situation that can be monitored but maybe doesn't require substantial action at present... My mother has kidney cancer and we've learned a lot about treatments that severely impair quality of life. We've also learned the importance of being educated and proactive in your own care -- so I am all the more grateful to have found this forum.

Thank you.
gwen

hyperkeratosis makes me think that it is rubbing against something rough ( chronically ) in the same area. Check for old restorations or something that is causing the hyperkertosis. If you find something like that, it can be polished down or replaced. If this is superficial like it sounds, it can likely just be lasered off. Many dental offices will do this for you, and are competent to do so.

My dad had his doctor's appointment yesterday and the ENT felt that the dysplasia was mild enough that it was a "reasonable" course of action to just watch it --and only intervene with surgery or a laser procedure if it gets worse. He suggested a follow up appointment in four months.

We were very relieved by this, and it seems like a sound plan to us. Does it seem reasonable to all of you experts?

Many thanks for your kind help.
Gwen