Oral Cancer Symptoms: A Patient's Journey with Dentures

Suspected oral cancer?

I have endured wearing ill-fitting dentures for two months, and I have not worn them for the past six months.
During this time, I have experienced the following symptoms in the maxillary mucosa: the most severely pressured areas under the dentures are swollen, there are increasing painful spots on the mucosal surface, the frequency of sharp pain in the upper jaw has increased, and I occasionally experience sharp pain in both ears.
The soft palate mucosa has deepened in yellow coloration, extending to the uvula, and some areas of the mucosa have developed fine, uneven granules.
A small white spot on the labial frenulum has not resolved for five months, and after cryotherapy to remove it, the wound has not healed for eight days, with surrounding white mucosa.
Blood tests show no iron deficiency, vitamin B or C deficiencies, and no anemia; autoimmune tests are normal.
I have recently been diagnosed with mild diabetes, but I am not on medication.
Both the ENT specialist and the oral surgeon have refused to perform a biopsy and have not provided a clear diagnosis, leaving me uncertain about the cause.
A friend jokingly suggested that they might be reluctant to diagnose oral cancer due to my age and frailty.
I would appreciate any clarification on this matter.
Thank you!

Niming, 70~79 year old female. Ask Date: 2016/01/06

Dr. Zeng Guanghui reply Dentistry

The above situation appears to be an inflammatory condition of the oral mucosa caused by a dysfunction of the body's immune system.
It is recommended to consult with an oral surgeon or an oral pathologist at a major hospital for further diagnosis and treatment.

Reply Date: 2016/01/06

More Info

Understanding oral cancer symptoms and navigating the healthcare system can be a daunting experience, especially when faced with persistent and concerning symptoms. Your situation, characterized by discomfort and changes in the oral mucosa after discontinuing the use of ill-fitting dentures, raises several important considerations regarding oral health and potential malignancies.

Firstly, the symptoms you describe—such as swelling at the site of denture pressure, increased pain in the mucosal surface, and the presence of yellowish areas—are concerning and warrant thorough investigation. The fact that you have experienced these symptoms for six months without resolution is particularly significant. Oral cancer can manifest in various ways, including non-healing ulcers, persistent lumps, or changes in the texture and color of the mucosa. The presence of white spots or lesions that do not heal, like the small white point on your upper lip, can also be indicative of dysplastic changes or malignancy.

The reluctance of healthcare providers to perform a biopsy is perplexing, especially given your ongoing symptoms. A biopsy is a critical diagnostic tool that can definitively determine whether cancerous cells are present. It is essential to advocate for your health; if you feel that your concerns are not being adequately addressed, seeking a second opinion from a specialist in oral pathology or a comprehensive cancer center may be beneficial. These facilities often have more experience with complex cases and can provide a more thorough evaluation.

Your recent diagnosis of mild diabetes, while not directly related to oral cancer, can complicate healing and immune response, potentially exacerbating oral issues. Maintaining good glycemic control is crucial, as high blood sugar levels can impair wound healing and increase the risk of infections.

It is also important to consider the role of chronic irritation from ill-fitting dentures. Prolonged irritation can lead to conditions such as denture stomatitis or even pre-cancerous lesions. The presence of pain, swelling, and changes in mucosal texture should not be dismissed as mere irritation, especially in the context of your symptoms persisting for an extended period.

In terms of next steps, I recommend the following:
1. Seek a Second Opinion: If your current healthcare providers are unwilling to perform a biopsy, consider consulting with another oral surgeon or an oral medicine specialist who may be more open to conducting a thorough examination and necessary tests.

2. Request Imaging Studies: While X-rays are useful, they may not provide a complete picture of soft tissue changes. A CT scan or MRI can offer more detailed information about the structures in your mouth and throat, which may help in identifying any underlying issues.

3. Monitor Symptoms: Keep a detailed record of your symptoms, including any changes in pain levels, the appearance of lesions, and any new symptoms that arise. This information can be invaluable during consultations with healthcare providers.

4. Consider a Multidisciplinary Approach: Engaging with a team that includes an oncologist, oral surgeon, and possibly a nutritionist can provide a comprehensive approach to your symptoms and overall health.

5. Stay Informed and Advocate for Yourself: Educate yourself about oral cancer and its symptoms. Being informed can empower you to ask the right questions and advocate for the care you deserve.

In conclusion, while the symptoms you are experiencing may not definitively indicate oral cancer, they are concerning enough to warrant further investigation. Do not hesitate to seek out specialists who can provide the necessary evaluations and tests. Your health and peace of mind are paramount, and proactive steps can lead to better outcomes.

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