I thought my mouth ulcers were due to exam stress but it was cancer

I thought my mouth ulcers were caused by exam stress – but then I was diagnosed with cancer and needed my tongue cut out and rebuilt with my leg

• WARNING: GRAPHIC CONTENT 
• Rachel Morton, 21, suffered persistent ulcers on her tongue for over a year
• The student underwent ten surgeries to remove two thirds of her tongue 

A medical student who put her ulcers down to being run down from exam stress had to have two-thirds of her tongue removed and recreated using her leg when they turned out to be cancer.

Rachel Morton, who lives in Edinburgh in Scotland, said that she started getting ulcers on her tongue back in 2019, which she initially just put down to being busy starting university, but went to get them checked out.

The 21-year-old claims that over the course of a year, the sores persisted and got progressively worse until they covered one side of her tongue and it became misshapen.

She also became extremely tired, experienced dry, red and swollen lips, bad tonsil aches, and the left side of her face also felt abnormal.

After various GP appointments, Ms Morton returned in November 2020, was referred for a biopsy and just days later she was diagnosed with tongue cancer at the age of 19.

Rachel Morton (pictured above), who lives in Edinburgh in Scotland, said that she started getting ulcers on her tongue back in 2019, which she initially just put down to being busy starting university, but went to get them checked out

After the life-saving surgery, Ms Morton had to relearn how to walk and talk, and remarkably didn’t take any time off her studies as she was back attending online lectures just four days after it. The dancer of 15 years then had two rounds of chemotherapy, 30 rounds of radiotherapy and speech therapy for six months before she was eventually given the all-clear in June 2021

The keen baker had ten different surgeries in one 16 hour sitting to break her jaw, remove two-thirds of her tongue and lymph nodes.

The surgeons then used muscle and blood vessels from her thigh to reconstruct her tongue and the arteries and veins in her neck.

After the life-saving surgery, Ms Morton had to relearn how to walk and talk, and remarkably didn’t take any time off her studies as she was back attending online lectures just four days after it.

The dancer of 15 years then had two rounds of chemotherapy, 30 rounds of radiotherapy and speech therapy for six months before she was eventually given the all-clear in June 2021.

WHAT IS TONGUE CANCER?

Tongue cancer is a form of head and neck cancer.

Although the exact number of sufferers is unclear, around 12,000 people are diagnosed with a form of head and neck cancer every year in the UK.

And 51,540 new patients are diagnosed annually in the US. 

Cancer can develop in the oral tongue – the front two-thirds that is visible when you poke your tongue out at someone – which is classed as mouth cancer.

Or it can start in the base of the tongue near the throat, which is a form of oropharyngeal cancer.

Symptoms may include:

• Red or white patch that does not go away
• Persistent sore throat
• Ulcer or lump on the tongue that does not ease
• Pain when swallowing
• Numbness in the mouth
• Unexplained bleeding
• Ear pain (this is rare)

Most head and neck cancers have no clear cause, however, smoking, excessive drinking and the HPV virus are risk factors.

Early cancer (when the growth is smaller than 4cm and contained in the tongue) can be removed via surgery. 

Radiotherapy may also be required.

Advanced cancer may require surgery to remove the entire tongue, as well as chemo and/or radiotherapy. 

Source: Cancer Research UK 

Ms Morton, who’s interested in pursuing a career as a psychiatrist, has several scars including a ‘Harry Potter-like’ one on her chin, one from a tracheostomy, up her neck, stomach, and down her leg.

But the dedicated student doctor said she’s been fully embracing them – as they reveal how strong, resilient and powerful her body is to have fought and overcome such an aggressive cancer.

Two years after finishing treatment, the Teenage Cancer Trust youth advisory group member is now keen to raise awareness of tongue cancer’s symptoms and the importance of advocating for your health.

Ms Morton, said: ‘I really like my scars. It’s really important to incorporate them as [part of] who I am and I feel really proud.

‘I’ve always liked things that are a little bit messy or show a story. I like it when my shoes get a bit dirty and something breaks a little bit, it shows character, and I feel like that’s what my face shows.

‘I don’t tend to use make-up as much anymore because I don’t want to cover my scars and [don’t want to] feel like I have to [cover them], because it is what it is.

She added: ‘I feel proud of my body for being able to come through this. 

‘My scars are a part of me and they will be for the rest of my life, and it shows how resilient, strong and powerful my body is, and I want to reflect that within and do myself justice.

‘I was at a Teenage Cancer Trust conference and a lot of people were saying they’re not used to their bodies looking a certain way post cancer, I agree.

‘But we need to show ourselves so much love because where would we be without our bodies? They’ve kept us safe, alive, maybe not for everyone alive, but they’ve fought so hard and I can’t do anything but love my body for that..’

When Ms Morton’s ulcers first appeared as a fresher she had various phone consultations with the doctor and also saw the dentist, who both prescribed her antibiotics.

By the time she’d moved to Edinburgh to start her second year of university, they’d become so painful that her tongue had become so misshape she couldn’t poke it out or drink alcohol.

She said: ‘I had tongue ulcers over my 18th birthday, I couldn’t really drink alcohol because they were so sore.

‘When I’m a bit tired, run down or stressed with exams I seem to be a bit prone to ulcers anyway, so I kind of just put it down to that and starting university.

‘I went to the doctor and I’d been given some pain relief tablets, Bonjela and stuff like that.

‘I still had them a year later but I wasn’t too worried about it. I had so much other stuff going on in my life and it wasn’t really at the forefront of my mind.

‘At the start it was a couple of ulcers but over the course of a year they got bigger and spread, and covered the whole side of my tongue. They were really red, raw and painful.

‘I went through the process of going through loads of different [medical] people and not really being seen to and at one point a doctor actually said ‘there’s actually nothing else that we can do’.

‘I’d moved to Edinburgh and started getting really tired. At first I didn’t really pick up on it but I’d be doing an online class and would then just fall asleep after them.

‘And maybe like once a week my lips would get really red, dry, swollen and inflamed. I’d get a rash around it as well, it looked almost like I had an allergy [to something].

‘By that point I started getting really bad tonsil aches, I felt like I had a sinus infection or ear infection. Everything on the left side of my face and neck felt off.’

When Ms Morton’s ulcers first appeared as a fresher she had various phone consultations with the doctor and also saw the dentist, who both prescribed her antibiotics. By the time she’d moved to Edinburgh to start her second year of university, they’d become so painful that her tongue had become so misshape she couldn’t poke it out or drink alcohol

But the student doctor said she’s been fully embracing her scars as they reveal how strong, resilient and powerful her body is to have fought and overcome such an aggressive cancer

Ms Morton said she was being investigated for a range of conditions, such as hemochromatosis – an inherited condition where iron levels in the body slowly build up over many years.

She booked an appointment with a new GP in November 2020, who sent her for a biopsy and she was diagnosed with tongue cancer days later on the 18th December.

Ms Morton said: ‘The biopsy was probably one of the worst experiences of the whole thing – it was absolutely horrific. 

‘You’re lying there, they numb you obviously, but it’s the sound of the scissors cutting your tongue because it’s such a strong muscle, it really took a lot of force.

‘They told me they’d contact me in a couple of weeks and four days later I had a phone call, I’d just done an exam and they told me to phone them back as soon as possible. It was quite an urgent message.

‘At that moment I thought ‘I’ve got cancer, I know it’.

‘We went into the surgeon’s room and he had a box of tissues sitting there. There were all these little queues that made me think ‘oh ok, I know what’s going on now’.

‘He’d never actually spoken to someone as young as me with tongue cancer. He said he’s only ever treated those over the age of 60, usually male, that have smoked and drank their entire life.

Ms Morton, who’s interested in pursuing a career as a psychiatrist, has several scars including a ‘Harry Potter-like’ one on her chin, one from a tracheostomy, up her neck, stomach, and down her leg

‘As he was telling me that I had cancer, I don’t remember this but my mum does, he had this rash coming up as he was trying to tell us because he was just so uncomfortable. I felt sorry for him because it was a horrible situation.

‘It was a really surreal experience. You go into survival mode. You think ‘ok, this is reality, this is what’s going to happen, and I’ll get through it’.’

Exactly a month after her diagnosis, she had surgery. 

During it they had to use some muscle and blood vessels from her legs to reconstruct her tongue and the arteries and veins in her neck.

They first tried to take it from her calf but after that wasn’t viable, used her thigh, so most of her whole left leg had been operated on.

She had a tracheostomy for around four days after and a feeding tube put into her stomach for around nine months.

This was followed by two rounds of chemo and 30 rounds of radiotherapy, which she had five days a week for six weeks, as well as speech therapy for around six months.

Ms Morton has since been working tirelessly with the Teenage Cancer Trust and along with the help of friends, also raised £4,500 for the Little Princess Trust.

This month, The Teenage Cancer Trust is teaming up with 15 other charities supporting young people with cancer across the UK for the first Teenage and Young Adult Cancer Awareness Month.

They’ll be working to shine a spotlight on the distinct needs and experiences of young people with cancer, which are often overlooked, with one of the four themes being highlighted is body image.

She said: ‘The Teenage Cancer Trust has been amazing. They get to know you, you’re not a diagnosis, or a patient, you’re a friend and you talk about stuff outside of your health.

‘Even now when I go in for check-up appointments, they come down to talk to me and they remember things, they are good friends.

She added: ‘One of my key messages for medical professionals would be for them to look beyond the textbook, we’re taught in medical school that “this, this and this equals this”. 

‘That’s not how life is – everyone’s so different and nobody is the same so how can we reduce that to a textbook?

‘For those feeling that something’s not right, trust your intuition. If your body’s telling you something’s not right, it’s probably isn’t. 

‘We know ourselves and advocate for yourself – it’s hard, but you need to do it.’

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