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Texas Woman’s Migraine Misdiagnosed as Stage Four Tongue Cancer
In a startling health ordeal, a Texas woman’s persistent migraine turned out to be a symptom of advanced stage four tongue cancer. Beth Riehle, a 35-year-old cocktail innovator from Austin, initially attributed her severe headache in December 2023 to stress, only to discover a life-altering diagnosis. Doctors initially suspected temporomandibular joint (TMJ) issues, highlighting the challenges in early cancer detection and the importance of recognizing unusual symptoms.
Persistent Pain and Initial Misdiagnosis
At the peak of her career as a bartender and cocktail designer, Riehle experienced a debilitating migraine that rapidly intensified. The agonizing pain expanded to her ear and jaw, accompanied by fatigue and tongue discoloration. “I constantly felt unwell, but not definitively sick,” she recounted, describing the perplexing onset of her symptoms.
Medical professionals initially diagnosed Riehle with temporomandibular joint (TMJ) disorder. This condition, affecting the joint connecting the jawbone to the skull, shares some overlapping symptoms with head and neck issues, leading to the initial misdiagnosis.
Shocking Cancer Diagnosis and Rising Trends
However, a biopsy conducted in March 2024 delivered devastating news: stage four squamous cell carcinoma of the tongue. This aggressive cancer, typically affecting older men with a history of tobacco use, claims nearly 13,000 lives annually in the United States. Riehle’s young age and lack of typical risk factors made her case particularly unusual.
The diagnosis of this “uncommon” cancer in a young individual coincides with a concerning rise in head and neck cancers across the US. Experts suggest factors such as increasing human papillomavirus (HPV) infections, alcohol consumption, and obesity are contributing to this upward trend.
Treatment and Impact on Daily Life
Now 36, Riehle shared her feelings of isolation, stating on TODAY.com, “It [feels] extremely lonely having a cancer most people my age don’t get.” Her treatment regimen included chemotherapy, radiation therapy, and a partial glossectomy, a surgical procedure involving the removal of 80 percent of her tongue.
The surgery and subsequent treatments have profoundly impacted Riehle’s life. She is currently undergoing speech therapy and rehabilitation to relearn fundamental functions like speaking and swallowing. “[Your tongue] is such an integral part of life – food, air, communication,” she emphasized. “I’ve had to relearn how to do just about everything your mouth functions for.”
Oral Cancer Statistics and Symptoms
The American Cancer Society estimates approximately 60,000 new cases of oral and oropharyngeal (throat) cancers will be diagnosed this year, resulting in around 13,000 deaths. These cancers commonly affect areas such as the tongue, tonsils, oropharynx, gums, lips, and salivary glands.
Common symptoms of oral cancer include:
- Mouth ulcers that do not heal
- Red or white patches inside the mouth
- Loosening of teeth
- Lumps or growths in the mouth
While migraines are not directly associated with tongue cancer, advanced stages of the disease can cause head pain radiating to the mouth. The average age of diagnosis for these cancers is 64, with a minority occurring in individuals under 55.
Unusual Case and Contributing Factors
Dr. Karen Choi, a head and neck surgeon at MD Anderson Cancer Center and part of Riehle’s medical team, acknowledged the atypical nature of her case. “It is unusual for someone who’s young, less than 40 years of age without the traditional risk factors to develop a tongue cancer like this,” Dr. Choi told TODAY.com.
She further noted, “Although oral cavity cancer typically affects the older male population, we are actually seeing a rise of this type of cancer in young patients.” While HPV is a significant factor in the increase of head and neck cancers, Dr. Choi confirmed that HPV was not the cause of Riehle’s cancer.
Tobacco use remains a major risk factor for head and neck cancers due to DNA damage caused by chemicals in tobacco products. It is important to note that in Riehle’s case, the exact cause remains undetermined.
Recurrence and Continued Fight
Following initial treatment involving 35 radiation sessions and chemotherapy, Riehle experienced a recurrence just two months later. New and severe pains across her forehead and neck, initially mistaken for radiation side effects, prompted a CT scan in September 2024, revealing a second tumor.
In December, she underwent a near-total glossectomy, resulting in the removal of 80% of her tongue and 75 lymph nodes. Despite a 50-50 chance of regaining speech, Riehle persevered.
Path to Recovery and Advocacy
Remarkably, Riehle is now cancer-free but continues to face significant challenges. She experiences limited mouth mobility and oral pain. Speech therapy is crucial for improving her speech and swallowing abilities. She is also considering a mouth prosthetic to enhance her speech clarity.
Amidst her health battles, Riehle found joy when her fiancé, Donald, proposed on the day she learned about her second surgery. “He made what was the worst day of my life also one of the most memorable,” she fondly recalled.
Riehle has undergone further radiation treatments and is actively advocating for oral cancer awareness. She has joined Young Tongues, a support group for young tongue cancer patients, and uses TikTok to share her journey and raise awareness.
Through her online presence, Riehle connects with others affected by similar conditions, providing support and visibility to an underrepresented group. “It’s been a powerful experience and an important reminder of vulnerability’s place in our lives,” she reflected.
A GoFundMe campaign has been established by her family to help with ongoing medical expenses.