It has been awhile since I have made an update related to skin cancer. I have been focused on enjoying life since my most recent treatment ended and have placed all those not so pleasant months in the back of my mind. That strategy was working quite well for me until I went to the Dentist for my regular checkup a few weeks ago. She noticed a lesion on the left lateral portion of my tongue. Her immediate thought was something as benign as Migratory Glossitis but due to my history with skin cancer, she felt I should be seen by someone for an evaluation of the lesion. I had already set up my yearly physical with my general practitioner for the following week so when I went to see her she referred me to an ENT surgeon for evaluation the next day.
When most of us think about skin cancer we think of lesions that pop up on parts of the skin that have been exposed to UV rays. Cancerous lesions on the tongue or inside the mouth caused by UV exposure is not something we usually hear about. Alas, the ugly beast can spring up inside your mouth in the form of Squamous Cell Carcinoma or Melanoma and According to the American Cancer Society, it can indeed be caused by too much sun exposure over time. This does not mean you need to run around in the sunshine with your tongue sticking out of your mouth in order to get it.
There are of course other risk factors that can be the cause of oral cancers such as smoking and excessive alcohol use, but in my case the risk factor would appear to be excessive UV exposure and the fact that I have a history of Basal Cell Carcinoma. Thus the concern and need for evaluation.
Now I don’t know your particular level of pain tolerance but mine is pretty high. When I had both the biopsy and then Mohs surgery on my face I barely felt the needles that injected the local anesthetic right on the side of the bridge of my nose. Things were very different when it came to my tongue. Think for a second about the times you have bitten your tongue, your lip, or the inside of your cheeks and how much that hurt and continued to hurt for some time. Now multiply that pain by one hundred. The needle stick was not fun. Fortunately my tongue went instantly numb.
I have this little anxiety thing about being unable to swallow. Going to the Dentist is difficult enough for me especially when there are suction tubes and a pair of hands and instruments all up inside the small space that leads to my airway. There I was sitting in a sterile room with drool spilling down the corner of my lip, a pair of gloved hands pulling on my tongue and holding it taught while poking and cutting and digging at the mystery spot. I could feel my intense need to swallow begin to rise and I could do nothing about it.
Add to that most uncomfortable mix the warm rush of blood and a wad of gauze stuffed in my mouth to stop the bleeding and well, you can probably imagine how I felt. Then There was the tug and pull of the suture needle that went around the wound and up through the center of my tongue. Not once, but four times. Yes, I felt a bit squeamish.
The anesthetic wore off two hours after the surgery. That is when I was reminded how much we rely on this funky looking mass of muscle for a variety of things. It was extremely painful to swallow, to talk, to eat, to drink, to sneeze, to cough, to blow my nose. My tongue was swollen and angry and it let me know.
For the first three days I could only handle a liquid diet. Protein shakes and water became my friend. The dissolving stitches worked their way loose within a few hours and I became brave enough to cut the long loose ends off by myself before they made their way down my throat. Did I mention how ugly my tongue looked? Ghastly ugly indeed. I have photos but I will spare you.
The biopsy results came back within 24 hours and fortunately it is a benign epitheleal tumor in the squamous layer. Yay! We now keep an eye on it over time just to make sure it doesn’t grow back into something malignant.
Beyond this little inconvenient interim reminder that I will most likely face additional skin cancers in my lifetime, my full body skin recheck appointment is not until mid-August with my Dermatologist. So after this painful biopsy spot decides to heal completely (it has been one week now and it still hurts to eat, to talk, to swallow) I will be back to living and enjoying life mindfully.
Did I mention that in the midst of all this fun I came down with a Streptococcus infection and am now on a regiment of antibiotics? The challenges never cease, but there is still a whole lot of beauty in this world to balance out the little patches of ugly :).
**A photo of a Sunflower because it is prettier than the thought of my tongue :).**
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