A student who put her ulcers down to exam stress had to have two-thirds of her tongue removed after it was found to be cancer.
In a bid to give her as normal a life as possible, medics rebuilt Rachel Morton's tongue using her own thigh in a painstakingly delicate 16-hour operation.
Rachel, a keen baker, had ten different surgeries in one sitting to break her jaw, remove two-thirds of her tongue and lymph nodes, as well as her blood supply which can carry malignant cells.
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, Rachel had to relearn how to walk and talk, and remarkably didn't take any time off her studies, returning to online lectures just four days later.
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 trouble first started back in 2019, when Rachel started suffering from a few ulcers which she put down to stress.
She had them checked out, then over the course of a year the 21-year-old says the sores persisted and got progressively worse until they covered one side of her tongue and left it misshapen.
The medicine student also became extremely tired, and experienced dry, red and swollen lips and bad tonsil aches. The left side of her face also felt abnormal.
After various GP appointments, Rachel returned in November 2020 and was referred for a biopsy. Just days later she was diagnosed with tongue cancer at the age of 19.
Rachel, who is interested in pursuing a career as a psychiatrist, has several scars including a 'Harry Potter-like' one on her chin, one from a tracheostomy, and others on her neck, stomach and leg.
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.
Rachel, of Edinburgh, Scotland, 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.
"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 Rachel'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 misshapen she couldn't poke it out or drink alcohol.
Rachel 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."
Rachel 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 December 18.
Rachel 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, Rachel had surgery. During it, surgeons had to use muscle and blood vessels from her legs to reconstruct her tongue.
They first tried to take it from her calf but that wasn't viable to they used her thigh, meaning 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 about 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.
Rachel has since been working tirelessly with the Teenage Cancer Trust and along with the help of some pals, also managed to fundraise a whopping £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.
Rachel 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.
"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' but that's not how life is - everyone's so different and no body 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."
You can find out more about the Teenage Cancer Trust's work by clicking here.
Mouth cancer, also known as oral cancer, is where a tumour develops in a part of the mouth. It may be on the surface of the tongue, inside of the cheeks, roof of the mouth (palate), lips or gums.
Tumours can also develop in the glands that produce saliva, tonsils at the back of the mouth, and part of the throat connecting your mouth to your windpipe (pharynx). However, these are less common.
The symptoms of mouth cancer include: mouth ulcers that are painful and do not heal within several weeks, unexplained, persistent lumps in the mouth or the neck that do not go away, unexplained loose teeth or sockets that do not heal after extractions, unexplained, persistent numbness or an odd feeling on the lip or tongue, white or red patches on the lining of the mouth or tongue and changes in speech, such as a lisp.
Things that increase your risk of developing mouth cancer include: smoking or using tobacco in other ways, such as chewing it, drinking alcohol and infection with the human papilloma virus (HPV) – HPV is the virus that causes genital warts.
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