Hello,

Any comment that can help will be a big favor please. My father, 61, had voice hoarseness some 3 months ago which led to complete loss of voice, he could whisper though. We have had endoscopy in which doctor found a growth in left vocal cord and advised for a biopsy of the left vocal cord. Now we have had a biopsy and results came. Unfortunately in our part of the world money is everything and I am not able to find a fair comment on how to proceed for the treatment, because most of the doctors are doing it commercially here (no offense please, my personal experience only).

Biopsy report reads:

Microscopic Examination
"Sections show squamous epithelial lined fragments with papillary areas moderate to marked atypia and keratin pearl formation"
Diagnosis
"High grade dysplasia focally mounting upto Carcinoma in SITU"
Additional Note
"The biopsy submitted does not show sufficient subepithelial tissue for evaluation. Possibility of invasive tumor in the vicinity of biopsy site cannot be entirely ruled out"

Now I have few questions, I have searched for this online and I could understand it is a pre-cancerous symptom and should be treated to avoid further complications. However our doctor has advised us to have another biopsy as the report reads sample was insufficient. Early biopsy cost us a fortune, nearly, and I am in a spot of bother with another biopsy and then obviously the treatment would start afterwards.

Question 1 - Reading this report, how serious it looks?
Question 2 - How much percentage is the chance of having an active cancer now?
Question 3 - How long can we wait till we can start the treatment (days or months because right now we are in trouble financially), or, how long normally it takes for high grade dysplasia to translate into cancer (I know it varies but any idea in case of vocal cord?)
Question 4 - Now as our doctor is saying for another biopsy, is there any alternative?

Thanks