I thought my mouth ulcers were caused by exam stress – but then I was diagnosed with cancer

A medical student had two thirds of her tongue removed and recreated using her leg after persistent mouth ulcers turned out to be cancer. 

Rachel Morton, who studies in Edinburgh, started getting ulcers on her tongue in 2019. 

The 21-year-old claims the sores persisted for a year until one side of her tongue was completely covered in them and became misshapen.

After struggling to get seen by doctors, Ms Morton switched her GP practice in November 2020.

It was then she was referred for a biopsy, before being diagnosed with tongue cancer on December 18, 2020, at the age of 19.

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.

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.

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.

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‘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.’

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.

‘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.