Should I seek a second opinion? Oral Lumps. 22 F

Sorry if this is long;

I’m a 22 year old female ex smoker. I noticed a lump in the side of my tongue next to my old tongue piercing hole. I never noticed this lump before but I’d also never looked for it. I fiddled with it with my teeth for a couple of days and it grew about 3x the size. This concerned me as my dad had precancerous mouth cells and died of throat cancer. I also have a lump near the salivary glands on the floor of my mouth on the same side.

I made an appointment with my dentist and she checked the lumps and said while she doesn’t think they are cancer, she would refer me on the grounds she suspects it is purely because of my familial history with head and neck cancer.

A few days later I saw the head and neck cancer specialist at the hospital, he dismissed the lump on the floor of my mouth as my salivary gland draining point (this is not the lump I was referring to) and the lump in my tongue due to scar tissue from my piercing. I felt initially reassured by this but as I thought about it more I questioned why I didn’t get many answers. Why does the “scar tissue” swell and hurt when I irritate it etc? I would’ve at least expected a biopsy or some kind of scan as I did used to smoke. I also have some prominent lymph nodes on my neck which I’ve had scanned privately and on the nhs and have come back clear and not enlarged just prominent.

I don’t know whether I should opt to go private (when I can save up to) to investigate this further as I know I won’t get a second chance through the nhs as they are incredibly busy. I can’t help but worry about it. The swelling on the tongue lump has gone down but swells up again when I irritate it with my teeth. The lump on the floor of my mouth seems to swell when I vape occasionally and other times at random.

Any advice appreciated, thank you x

  • I worked in a dental environment for years (wasn't a dentist).

    Oral surgeons are experts in this, and the fact it's situated next to the piercing is good. Scar tissue is a common problem. Scar tissue can and does change with the passing of time, and as you're now finding out, scarring on the tongue or even the cheek can result in you unwittingly irritating it via your teeth or constantly messing around with your tongue.

    The lump on the floor of the mouth that sounds like a salivary gland, which you do have on the floor of your mouth. Many causes for the intermittent swelling. Could even be a very small stone or you have thick saliva. Being serious here, if it's a small stone, sooking a lemon or something very bitter can sometimes dislodge them. That lemon stuff folk used to put on pancakes is good.

    Oral cancer does not come and go. Oral cancer just gets larger, and gets larger quickly. So with that in mind, the surgeon is probably correct. But as it's your health, and ultimately up to you, seek a second opinion if it would put your mind at rest. Also remember, our tongues magnify things and what feels large with our tongues is usually a lot smaller.

  • Hello Pf010x and thanks for posting, 

    I do think it is reassuring that the specialist you saw wasn't concerned about these lumps and that the scan results assessing your neck nodes were ok as well.

    Irritation can be a cause of inflammation so this might explain the variable swellings in your mouth that go up and down. In general any type of head and neck cancer would be rare in a young person of your age. This is because cancer is much more common in older age groups - the longer we have lived for the more likely it is that our cells acquire the sort of damage that can lead to cancer developing and the less effective our cell repair mechanisms are.

    If paying to see another specialist gives you peace of mind, it might be worth it, but I suppose there is a chance that this might not work. Sometimes people can become very anxious about their health and seeing the doctor or having tests only offers some reassurance in the short term - anxiety can cancel out reason. I don't know if this applies to you but because you lost your dad to cancer it would be understandable to feel more anxious than average about it. I think you will have to decide what would work for you to be able to move forward, but bear in mind you have been assessed by a specialist.

    Give us a call if you want to talk anything over. The number to call is Freephone 0808 800 4040 and we are around weekdays 9-5. 

    Best wishes, 

    Julia