GRAEME Stewart thought nothing of the innocuous mouth ulcer he developed.
After all, it was just 2mm across and wasn’t painful. Surely it would eventually just go away.
Except it didn’t.
And when nothing he tried shifted the stubborn mark on his lower lip, the 49-year-old security manager knew something was wrong.
Graeme, who lives in Easter Road, said: “A week after I noticed it, it was still there. I went to the chemist and she gave me stuff to put on it – and it was still there. I went back to the dentist’s and he gave me mouthwash and tablets – and it was still there.
“I went back to the dentist another two times and I was quite adamant that I thought there was something wrong. It wasn’t that painful but it felt like it was getting deeper.”
Eventually his dentist sent him to the Edinburgh Dental Institute in Lauriston Place, where a doctor examined the spot.
He recalls: “She had a look and she disappeared and said ‘I’ll be back in two minutes’. She came back with a man in a suit and tie and he looked at it, and he said ‘I’ll be back in two minutes’ and they came back with the head surgeon, and he sent me straight away next door to get a biopsy.”
Although he had been concerned about the growth, Graeme said it took a while for the gravity of the situation to sink in. “I took my partner down there with me and she was a bit more concerned than I was, but as we were sitting waiting, it occurred to me that this could be serious.
“I went back to see him in three days and he said ‘It’s cancerous’. I think I was in shock more than anything, and when we came walking out it hit me then.”
Cancelling a planned holiday with partner Elizabeth, Graeme had scans to make sure the cancer hadn’t spread into his throat and then underwent surgery at St John’s Hospital in Livingston.
Surgeons had to move one of his saliva glands from below the floor of his mouth to the side of his throat, and he was left with a scar on the bottom of his mouth, though he has no visible scars.
He says: “They found there were more cancerous growths than they thought I had but they were able to remove them too. I woke up and it was incredibly painful – I went back four weeks later and said ‘Is it really supposed to be this painful?’ and he said ‘Yes, unfortunately it is’.”
Graeme stayed in hospital overnight and was given two weeks off work by employer Advance as he recuperated. For six weeks, he could eat only soft foods, surviving on a diet of soup and yoghurt.
There was one bright interlude amid the worry – as a result of his illness, he was reunited with 16-year-old daughter Lauren, who he hadn’t seen for eight years, since splitting up with her mother. They have since lost touch again, but he was grateful for the chance to see her. He says: “I think my father had told her mother that I was ill and Lauren wanted to see her dad, so I went to Broxburn to see her, and I took her to the beach for the day – I think she was worried.
“We only stayed in touch for a year or so, but I was delighted that I’d actually been reunited with my daughter, though life’s not always a fairytale.”
The good news is that, thanks to the early detection of the cancer, the operation was successful and Graeme is now in the clear. He now returns to visit doctors once every three months to check he’s still in good health.
There have been scares along the way. He says: “Probably eight months after the operation I woke up with a big massive swelling in my throat, so of course you think the worst. I phoned the dental hospital and spoke to my doctor, who told me to come straight to St John’s.
“I went for a biopsy and I had a blockage in my saliva gland and he injected it three or four times – total agony – and that unblocks the saliva gland and it went away.”
He is also now hyper-vigilant. He has given up drinking and smoking almost entirely – both risk factors for mouth cancer – and urges everyone to take good care of their oral health. “Now if I get a mouth ulcer or anything I go straight to my dentist, which is probably a pain for him, but I need to check it out. I say to my partner now if she’s got a mouth ulcer it gets checked right away.
“I’d say if you’re not sure, pester your dentist every time, that’s what your dentist is there for. I’ve been to mine maybe three times now, saying I’ve got an ulcer and he says to come and see him right away.”
While he might have known that something was wrong when his ulcer failed to heal, Graeme admits he had knew nothing about mouth cancer, and is incredibly relieved to have caught the condition early. “I’d never heard of it. I’ve had friends that had died of cancer, but never mouth cancer. If I hadn’t persevered with this I don’t know what would have happened.
“It could have been ten times worse for me – you can lose your tongue, your teeth, but because they’d caught it so early it was easy to operate on.”
Victor Lopes, the consultant surgeon who treated Graeme, agrees. He says: “I think that the key message really is about early detection because early stage treatment is fairly straightforward, whereas patients that present with late stage disease have much more complex treatment, much greater levels of complications and higher morbidity.”
Cancer survival rates are measured at five years after the illness has struck and Victor says: “If you can get it early you’re much more likely to survive – your chance of getting to five years is 80 to 90 per cent.”
Early diagnosis also means treatment is less invasive. He adds: “It’s the functional impact, the disturbance in eating, drinking, talking as well as the change in appearance.
“If you break your leg, you can put it in plaster, but with your mouth you’ve got to use it for pretty much everything that you do to interact with the world.
“But there are ways of dealing with it that are pretty effective, and early treatments are more simple – and the most important thing is that survival is much better.”