It's always best to follow up... even when it seems like everything is already covered.
A patient of mine informed me that it was because of my persistent concern and prompting that he finally saw a surgeon for a biopsy that another doctor had been advising to "continue watching" for months... And it was because of my persistence and prompting that likely saved his life.
I had initially met C for a new patient checkup and cleaning and saw a suspicious, adherent white patch or "leukoplakia" under his tongue. I recommended that he see an oral surgeon for a biopsy. He initially made an appointment with my surgeon but canceled the visit. I followed up with him and he informed me that he had found his own in-network doctor to evaluate his tongue and that doctor had suggested that they watch it. C had thanked me for checking in on him and that he did have it addressed. I saw C six months later for his check up and cleaning visit. Again, I advised him that I was concerned about the white patch under his tongue and informed him that I thought it looked different from the last time I saw him. He again told me that he was seeing his own doctor regularly for it who recommended to "watch it" and he in fact had already followed up with that doctor several times that year for the "leukoplakia." I advised him that it concerned me and encouraged him to get it biopsied.
Six months later C presented for his recall dental visit. Before he was even seated or had his cleaning he insisted on speaking to me about the "procedure" he had done. It turns out that after our last visit and at my prompting C did see an oral surgeon to check the underside of his tongue. The surgeon initially told him "it didn't look like anything to worry about" but biopsied it just to be sure.
The biopsy results came back as malignant oral cancer- squamous cell carcinoma. C has since had ~20% of his tongue resected and two lymph nodes in his neck removed for biopsy to check for spread of the cancer. Luckily the lymph nodes were negative for metastasis. He is now checked by the surgeons regularly and closely monitored for recurrence of the cancer. C was very grateful to me and proclaimed "I just want to thank you."
I was so happy for him and relieved that he got it checked and had it taken care of. I just wanted to share the story.
"Approximately 48,250 people in the US will be newly diagnosed with oral cancer in 2016. When found at early stages of development, oral cancers have an 80 to 90 % survival rate. Unfortunately at this time, the majority are found as late stage cancers, and this accounts for the very high death rate of about 43% at five years from diagnosis (for all stages and etiologies combined at time of diagnosis), and high treatment related morbidity in survivors." - Quoted from www.oralcancer.org website. Early detection is critical. See more at: http://www.oralcancer.org/
Attached is an excerpt from an email I received from C:
"Approximately 2.5 years ago I was diagnosed with and treated for Oral Cavity Cancer that was the result of Dr. Quiong noticing a patch on my tongue. I had my surgery at NYU Oral Cancer Center, and in one week from today I am participating in and, in fact, speaking at the NYU Oral Cancer Walk." ...
"I continue to hope that more and more people and practitioners learn about and raise awareness of this disease and the importance of early detection. If it were not for Dr. Quiong’s vigilance and insistence that I take it seriously, I am honestly not certain where I would be today. Thank you..."