Q1. My dentist found a white spot under my tongue during my last appointment. I haven’t been to the dentist in seven years, so I don't know how long it’s been there. It’s underneath my tongue, all the way in the back, but actually is on the underside of tongue. It’s white, painless, smooth; it’s not raised, and it’s not a lump. It’s just a solid white circular spot maybe half the size of my pinkie fingernail. I’m 23, don’t smoke, don’t drink much, and I’m in very good health. I don't have AIDS or herpes . My dentist said the location worries him. I let a friend who is an ER doctor take a quick peek and said it didn’t look like leukoplakia. I have a biopsy scheduled about two weeks from now. Can you tell me what it might be, and how likely it is that it’s oral cancer?
一个白色区域在嘴里是平的,没有痛苦and smooth may indicate the presence of leukoplakia. Usually, these are white patches in your mouth that do not rub off, unlike white areas due to a fungal infection like画眉. The causes of leukoplakia are not completely understood but can be related to tobacco use (including smokeless tobacco), irritation from teeth and, in some countries, the practice of chewing betel nuts.
医生认为白斑成为一种预态的形式，尽管这些地区成为癌症的实际百分比约为5％至20％。Leukoplakia的所有区域都应该是成本的，建立一个诊断and to rule out a malignancy.
Treatments include cessation of tobacco products, repair of any teeth that may be contributing to the problem, and oral rinses with low concentrations of steroids to reduce the inflammation. Hairy leukoplakia, which is associated with艾滋病病毒和损害免疫系统的其他条件，不被视为过早性，并且与您的病情无关。
Q2. My mom was treated over the past year for squamous cell carcinoma of the tongue. The disease was stage IV. Her doctors have said that they did successfully treat the cancer. The chemoradiation therapy eliminated the primary tumor and eliminated cancer in the lymph node. I am still scared though. I read articles, and all of them have said the survival rates for this stage of oropharyngeal cancer is not very good at all. What can I do to ease my fears some? The chemo doctor told us that somehow the chemotherapy did not cause her white blood cell count to drop at all, and in fact it actually increased a bit to help fight the cancer. All of this is very confusing to me — her doctors saying they got it all and that she has a good prognosis, and the Internet articles saying that stage IV oropharyngeal cancer does not have a good survival rate at all. So please, if you can, give me some suggestions to help ease my fear and anxiety.
癌症是一种可怕的诊断，我不确定有什么我或其他人可以说完全让你的恐惧消失。但第一个规则cancer treatment是，当患者对治疗良好的反应时，患者的预后总是更好。这似乎是一个毫无脑子，但患者（有时医生）可以忽视这一点。
Staging for cancer is very important, and it has an impact on prognosis and treatment plans. One use ofcancer stagingis so that medical professionals can communicate rapidly and accurately between each other. However, it was never intended as something a patient should be focused upon.
此外，存活率基于来自许多不同患者的数据集中或平均在一起。事实上，两名具有相同暂停的患者可能不会具有同样的疾病负担。因此，在预后和长期存活方面，患有阶段癌症的一名患者可能与同一阶段的另一种患者不同。
如果你的母亲有一个很好的应对chemoradiation and there is currently no evidence of cancer, I would take that as a good sign. And careful surveillance from this point on will detect any potential recurrences early, and early detection is a key to long-term survival.
Fighting cancer is a long battle, and I encourage my patients and their families to celebrate every victory that comes their way.
Q3。我的未婚夫正在舌头上进行疗法/化疗治疗阶段癌症。他失去了唾液，味道，吞咽困难，早期进入治疗。治疗结束后多久将唾液，吞咽轻松和味觉回归？他们是否会处于同一水平，或者他们将永远受到损害？在任何地方都找不到这些答案。
Radiation therapy can affect healthy tissue as well as cancer cells. In the mouth,salivary glands以及舌头上的味蕾可以受到辐射的影响。结果可以是唾液（Xerostomia）的减少或完全丧失，味蕾的丧失和吞咽困难（吞咽困难）。
With newer intensity modulated radiation therapy (IMRT), a computer uses a CT scan to model a three-dimensional treatment plan that can reduce radiation doses to salivary glands and other important areas. In chemo-radiation therapy, the chemotherapy makes the cancer cells more sensitive to the effects of radiation. While this makes it easier to kill cancer cells, other healthy cells can also be affected, leading to increased incidence of mucositis. Mucositis is often described as like a very bad sunburn inside your mouth and throat. This can lead to difficulty swallowing as well as loss of taste and dry mouth.
Fortunately, most salivary function should return if the glands were spared during radiation therapy. Taste buds will also return, although many patients complain of a reduction in ability to taste things or having things taste strange (dysguesia). Dysphagia can be avoided by swallow exercises during treatment that prevents scarring of muscles used in swallowing.
With radiation therapy, the total dosage as well as type of radiation therapy given will determine the types and duration of complications. Ask your head and neck surgeon or radiationoncologistfor details.
Q4. I have a white sore on the side of my tongue that was barely there and is now worse. I went to the doctor when it was barely there, and she diagnosed it as a canker疮/fever blister. I have been using a regular mouthwash, but it doesn't seem to be working. Should I be concerned about cancer? Should I visit the doctor again?
Ulcersin the mouth can be caused by a number of different things including trauma (such as bites or burns), viral and bacterial infections, cancer or other systemic illnesses. Most of these ulcers are very painful but tend to heal on their own.
In general, ulcers that persist and continue to be painful after two weeks should be looked at more closely. Often, ulcers can take more than two weeks to heal fully, but the pain should get better as the ulcer starts to fill in. If your ulcer has not gotten better, or if you notice that it has grown in size or is starting to bleed, you should visit your doctor again for re-evaluation.
A final word aboutmouthwash：大多数漱口水都有大量的酒精作为它们的基础，有时可以刺激溃疡并使它们免于愈合。简单的盐水冲洗液可以像漱口水一样有效。
Q5。他们在丈夫的唾液腺中检测到一个小肿瘤。医生首先告诉我们，即使现在没有癌症，如果没有删除，他们往往会转动癌症。活组织检查大多是液体，但有一些异常细胞 - 不足以得出决定性。MRI揭示了非癌症肿瘤的所有“特征”。医生现在告诉我们，因为它缩小了，太小了，我们应该等待观看。这让我们都很紧张，因为他的第一个陈述。你有什么建议？
身体中有主要和轻微的唾液腺。轻微唾液腺是小细胞的小簇，以及嘴的屋顶和侧面，可以编号高达250腺体。主要的唾液腺配对并包括腮腺，在耳朵面上的侧面上发现;颌下腺，在下颚下方发现;和舌下腺，在舌头下方发现。
一般来说，腺体越大，腺体中的增长就越大，良好的腺体越多。例如，腮腺中80％的肿块（最大的唾液腺）是良性的。相比之下，患有次要唾液腺（最小腺体）的50％的肿块是癌症。
Fine needle aspiration — where a small needle is inserted into the tumor and cells are removed for analysis — is a common method of distinguishing between benign tumors and cancers. MRIandCT扫描can also help determine the size and location of the lesion.
Whether or not to undergo surgery depends on many factors, including the location, size and type of tumor. For example, even a small benign tumor in the parotid gland should be removed as it will grow over time and can become more difficult to treat.
In contrast, some small cysts can be watched over time if there is confidence that they can be easily evaluated. All cancerous lesions require treatment, whether it’s surgery, radiation or both. In general, these treatment decisions should be made in consultation with your doctor. If you are concerned about a specific treatment plan, my advice is to sit down with your doctor and discuss your concerns.
Q6。我一直把这些小白的东西放在舌头上，就像哎呀那样受伤。他们来吧。你知道他们是什么吗？我吸烟，因为我最小的儿子死于今年1月而缺乏睡眠。我不知道这是否会导致我的任何问题。我担心癌症。谢谢。
The mouth harbors many bacteria and viruses that colonize but don’t always cause infections. On occasion, a break in the lining of the mouth can allow an infection to occur. Most infections are self-limiting, meaning that they go away on their own, and usually clear in one or two weeks.
Viruses such asherpessimplex virus (HSV）与之相关cold soresand aphthous ulcers (canker sores) that can be very painful and persist for weeks. Some of these infections and ulcers can be associated with stress as this can reduce the immune system. If these lesions are going away on their own, they are most likely infectious in nature. But since you have other risk factors, such assmoking，我会有彻底的头部和颈部检查，以排除口腔癌和其他可能性。
In general, lesions that do not improve or clear up in a couple of weeks should be examined by your doctor.
Q7.最近，我的丈夫在用化疗和舌鳞状细胞癌基础进行了化疗和辐射后进行了双侧颈部解剖。现在他在脖子上有很多严重的严重紧张，并说它感觉像“扼流圈”。
Radiation and chemotherapy can cause increased fibrosis or scarring of the skin and deep tissues of the neck. Neck dissection, which removes cancerous lymph nodes and oftentimes the surrounding muscles and vessels, can induce even further scarring. The end result is a very fibrotic or "woody" neck.
Like your husband, many patients complain of tightness around the neck, and even a choking feeling. Fortunately, much of the initial tightness will resolve once the body has had a chance to remodel the scar tissue. This can take months, however. Physical therapy, including range of motion exercises, can help in many cases.
在辐射期间照顾你的皮肤也可以帮助最小化疤痕。产品如水水马丁烯（银磺酰胺）面霜 - 最初为皮肤燃烧设计 - 可能会有所帮助。吸烟，除了引起癌症外，将大大降低你的愈合能力nicotinecauses constriction of the small vessels of the skin and soft tissue.
Learn more in the Everyday HealthOral, Head, and Neck Cancer Center.
