Dear All

I received this email and hope some of you may be able to advise further.

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I am a registered nurse living in central New York.

My youngest brother B who has bilateral cleft palate and lip was diagnosed with throat and base of the tongue cancer. This cancer presented with ear pain, swallowing and aspiration problems. It took the doctor over four weeks to suspect it because my brother was not truthful about his cigarette and drinking habits. My mother has sent a full history including a diagnoses of cirrhosis and squamous cancer five years prior but the doctor was to busy to read this. Also the doctor did not have the proper scope to look in the back of the neck. This should be routine equipment in a physician's office and part of a general exam. My brother lost his teeth in his 20's due to his cleft treatment and therefore did not have contact with a dentist who I believe may have picked this up a lot earlier. B had a modified neck dissection followed with radiation and chemotherapy. Today he is two months post treatment and living with a tracheotomy which hopefully will be temporary. B has a swallowing problem at present and will be going to speech therapy for exercises. He uses a peg tube for nutrition and just prays the cancer won't return. My question is will there be hope of him having the trach removed or will it be permanent if he doesn't regain swallow. He has quite a bit of neck hardness post radiation. He quit smoking and is drinking non-alcoholic beer.

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Dear G

Sorry to hear about your brother's cancer. Your brother's surgeon should be the one to advise on the tracheotomy. The neck stiffness is a common complication of the treatments due to the scarring - he needs to keep flexing the neck best as possible and massaging creams to soften the skin.

Is your bother drinking his non-alcoholic beer orally or taking it through the PEG tube. After surgery to the tongue, speech and swallowing are affected and he will need assistance of the speech therapist. See what is advised.

This tongue cancer patient's story and website may be of some help to you and your brother. If your bother likes to drink beer. There's a link to different non-alcoholic beers . Each of the beers has quite a different character!

Sorry, if I haven't been of much help.

Best wishes

Vinod :coffee:

Dear All

I am sharing another email about tongue cancer and hope others concerned will benefit .

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I have a lump come up inside my tongue; there are no signs on the tongue externally. Is this worth seeing someone about?

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Dear L E

A similar question was posed in Dr. Hoffman's column on allHealth.com. and his answer applies equally to your question.

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Q: I have recently noticed a lump in the right side of my tongue, approximately 1 inch back from the tip. I cannot get in to see the doctor for a few days because of the holidays, and was curious if you could help me narrow it down. It does not hurt, nor does it protrude from my tongue. If I pinch my tongue, I can feel it in there. In size, it is about the size of a pea, or possibly a fraction larger.

A: One of the odd little facts about the tongue is that cancers arise far more frequently on the borders (sides) of the tongue than on the dorsum (top surface) of the tongue. The bottom surface of the tongue can also occasionally give rise to cancers, especially in folks who chew tobacco.

Small tongue cancers usually look like ulcers (small craters with """raw""" centers) but can also be nodular (a nodule is a firm ball). Since this lump is on the right side of your tongue, my first concern is that this might be an early tongue cancer. The only way to know for certain is to have the lump biopsied. Your doctor will inject a little bit of local anesthetic into the area of the lump and will then cut out all or part of the lump. This is not much fun, but neither is it as painful as it sounds.

The main risk factors for tongue cancer are tobacco use (smoking or chewing) and alcohol use. Tongue cancer tends to occur in older folks, but young people� even teenagers� have been diagnosed with tongue cancer. Survival of tongue cancer is critically dependent on early diagnosis and treatment-- so do not delay in seeing a doctor! Tongue cancers spread rapidly to the lymph nodes of the neck; even for very small tongue cancers, the doctor must consider treating the neck (either surgically or by radiation therapy) to eradicate lymph nodes that may be cancerous.

Could this be something other than a cancer? Certainly. In particular, if you are a nonsmoker, nondrinker, chances are this is not a cancer (but you should still have the lump evaluated quickly, since the few cancers that arise in nonsmokers/nondrinkers tend to be even more aggressive than usual!) There are numerous benign (noncancerous) tumors of the tongue, including tumors that arise from vascular, salivary, or muscle tissue. Occasionally, infection may cause a tumor-like lump in the tongue.

So... see a doctor QUICKLY. And if you do use tobacco or drink excessively, this little lump (even if it is not a cancer) should serve as a wake-up call for you to QUIT.
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My advice is the same - ask your dentist to feel your tongue and refer you to a specialist if he agrees with you about the lump. Let me know how you get on.

Best wishes
Vinod :coffee: