I HAVE A TUMOR IN MY MOUTH, SHOULD I GO FOR A BIOPSY?

This morning, I had a patient consulting in my ENT clinic for a large neck mass on the right, as well as pain and difficulty in swallowing. When I looked inside his mouth, I saw a firm mass on his right tonsil, extending lower to the back of his tongue. As a cancer surgeon, I did a biopsy was done on the tonsillar mass. The results came back from the laboratory as squamous cell cancer. This patient was diagnosed with tonsillar cancer with neck node metastasis, a type of oral cavity cancer.

With over half a million cases of oral cancer diagnosed per year worldwide, it is important to emphasize early diagnosis and treatment for these cases.

Oral cancer, cancer surgeon palawan, head and neck cancer, mouth ulcers, oral cancer risk, dental health, oral hygiene, ENT surgeon, cancer prevention
Oral cancer, oral cancer surgeon, head and neck cancer, mouth ulcers, oral cancer risk, dental health, oral hygiene, ENT surgeon, cancer prevention

So, what should be done if one has an oral cavity lesion?

If you have a lip or mouth ulcer, or a red or white patch in the oral cavity that does not go away in 2 weeks, it is important to have yourself checked by your ENT doctor to assess. Have an ENT consult also for any neck discomfort, difficulty in swallowing or teeth loosening, or ear pain. These may also be symptoms of oral cancer.
At the clinic, your ENT doctor will check your mouth for general health, for any loosening of teeth, for any lesions. He or she may use a tongue depressor, or a laryngeal mirror to check for the extent of the ulcer or lesion. Your ENT doctor will ask for history of alcohol or tobacco use, family history of cancer or  poor oral hygiene. Diagnostics will be done if there is any oral lesion that looks cancerous, in addition to risk factors.

Cancer Surgeon: WHAT ARE THE FURTHER TESTS FOR ORAL CAVITY LESIONS?

1. ENDOSCOPY 

Your cancer surgeon Palawan may request for an endoscopy of your upper aero-digestive tract to further assess the extent of any oral lesion that extends beyond the back of the throat. This is done either in the ENT clinic or the endoscopy unit of the operating room. A flexible tube with a lighted camera at the tip is passed into the throat or the nose to examine how much the cancer has spread beyond the mouth into the oropharynx or back of your throat.

Oral cancer, oral cancer surgeon, head and neck cancer, mouth ulcers, oral cancer risk, dental health, oral hygiene, ENT surgeon, cancer prevention
Oral cancer, oral cancer surgeon, head and neck cancer, mouth ulcers, oral cancer risk, dental health, oral hygiene, ENT surgeon, cancer prevention

2. RADIOLOGIC EXAMINATION
Your ENT doctor may also request further tests such as a CT scan, MRI, or PET scan. These can help map out the extent of the tumor, and to predict diagnosis as well as help plan out the treatment for you. The picture on the left shows another patient I had with a cancer on more than half of her tongue with neck node metastasis. Diagnostics are helpful for your cancer surgeon especially when the lesions are small or cannot be detected with either clinical examination or endoscopy.

3. BIOPSY by a Cancer Surgeon

During a biopsy, your ENT surgeon removes a small part of the tumor or suspicious tissue from your mouth or oropharynx. This sample is then sent to the lab to be studied under microscope by a pathologist, who checks for cancer cells or signs of a pre-cancerous risk. This biopsy may be done in the clinic or operating room, usually under local anesthesia, but may need general anesthesia if the tumor is deeper in the throat.

There may also be 2 options for the biopsy, an incision biopsy of the oral lesion or the neck, or your ENT surgeon may do a fine needle biopsy of the neck mass first.

Biopsy

When dealing with oral cavity lesions, it is important to consult with your ENT surgeon immediately so he or she can do the proper examinations, diagnostic tests, so prompt treatment and management can be started.

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Dr Ruth Estimar ENT doctor ENT surgeon Puerto Princesa Palawan