hello dr joshi
is it quite rare for a reccurence of scc in the mouth i had partial glossectomy of tongue last september and now have an ulcer on gums which has been there for 9 weeks i am haing a biopsy on 27th june what is the likelyhood of recurrence i am so worried i cannot sleep thanks. bev

Hello Bev

Often the ulcers are reactions of tissue damaged by the treatment but a biopsy is the only way of knowing. It is best to get things checked rather than ignored. Worry is inescapable at times like this - unfortunately, but do things to take your mind off and it will pass. You may find this discussion on 'return of my cancer?' helpful.


Brian Hill, who is a stage 3 oral cancer survivor and founder of the Oral Cancer Foundation, said the following in a post on a similar theme on the OCF message board:

quote:

While oral cancer has a higher recurrence rate than most other cancers, it is not inevitable that you will get it again. The first two years post treatment have the highest risk, at five years the statistics for most oral cancers to end up in recurrence drop to about a 13% chance. Then...get this, they start to go up again!!!! About 2% per year. This is a function of statistics and may not be your personal reality.

I too was shocked recently when (now approaching my 5 year mark) I thought I was statistically out of the woods. One of our advisory board members and I were talking about the numbers, and he says, "Well the bad news is it is going to start going up now (the chance of recurrence as a percent of those with previous SCC). What skews the statistics is that as you get older, your immune system becomes more incompetent and each passing year makes things worse as a result. There is also an issue of comorbidity, again related to ageing and your chance of developing other diseases.

These statistics are drawn from SEER numbers, and of course do not apply to everyone. The fact is that statically older people get this cancer, and it is only natural for their deaths at 70 or 80 or whatever to throw the death rate numbers. But diligence in early detection is the key word you need to remember. FOREVER you will be on recalls, and forever you will be waiting for the other shoe to drop. Hopefully it will not fall for decades, or at all...

Here are the actual facts without my editorializing. Getting a lung cancer or a cancer of the esophagus is strongly correlated with a previous carcinoma of the oral cavity. The actuarial incidence of second malignancies of the upper aerodigestive tract increases each year that a patient survives the index cancer. In the most quoted study, second primary cancers developed within 5 years of the successful treatment of the index cancer in one third (33.5%) of patients with stage 3 or 4 squamous cell carcinomas. A second study identified an overall 13.5% incidence of secondary primary malignancies in a study of 127 patients with head and neck SCC. Lung tumors accounted for the majority (41%) other head and neck cancers accounted for 35%, and esophageal accounted for the remainder (24%). Death rates from these secondaries are significantly influenced by the primary treatment, as a full course of radiation included in the first treatment precludes its use the second time around and treatment of the secondary is frequently limited to surgical intervention.

If you came to oral cancer through tobacco you are on the wrong side of these numbers, as smokers in general have poorer outcomes. The term "field cancerization" has been used to describe the carcinogens in tobaccos effect on large areas such as the aerodigestive tract. Oral cancer being only one of many sites that a smoker may develop a tobacco related malignancy.

Hope that helps.

Best wishes
Vinod