Bizarre symptom I ignored that was actually stage 4 cancer at age 35

A Texas woman’s never-ending migraine was actually a sign of stage four cancer.

Beth Riehle, 35, was at the height of her career as a bartender and cocktail designer in Austin when she was hit with a migraine in December 2023. 

The excruciating pain quickly worsened and spread to her ear and jaw. She was also hit with fatigue, and her tongue became slightly discolored.

‘I always felt like I wasn’t feeling good but wasn’t necessarily sick,’ she said.

Doctors at first assumed Ms Riehle’s symptoms were due to issues with her temporomandibular joint (TMJ), which connects the jaw to the skull.

However, a biopsy in March 2024 revealed stage four squamous cell carcinoma in her tongue, which kills nearly 13,000 Americans a year and usually strikes men over 65 who use tobacco.

Doctors are unsure what may have caused Ms Riehle’s ‘unusual’ cancer at such a young age, but her diagnosis came as head and neck cancers have surged in the US.

Experts blame rising infections like human papillomavirus (HPV), alcohol use, and obesity for the increase. 

Ms Riehle, pictured here in the hospital, had to have 80 percent of her tongue removed when her stage four tongue cancer returned

Ms Riehle, now 36, told TODAY.com: ‘It [feels] extremely lonely having a cancer most people my age don’t get.’ 

Along with chemotherapy and radiation, Ms Riehle had to have 80 percent of her tongue removed and is relearning how to speak and swallow. 

‘[Your tongue] is such an integral part of life – food air, communication,’ she said. ‘I’ve had to relearn how to do just about everything your mouth functions for.’ 

Oral and oropharyngeal (throat) cancers are estimated to strike about 60,000 Americans this year and kill nearly 13,000, according to the American Cancer Society. 

These usually affect the tongue, tonsils, oropharynx – the part of the throat behind the mouth – gums, lips and salivary glands on the roof of the mouth. 

Symptoms usually include mouth ulcers, red or white patches in the mouth, teeth becoming loose, and lumps in the mouth. 

While migraines, like in Ms Riehle’s case, have not directly been linked to tongue cancer, later stages of disease can cause head pain that radiates down to the mouth. 

The average age of diagnosis is 64, and only one in five of these cancers are found in people under 55.  

Dr Karen Choi, as head and neck surgeon at MD Anderson Cancer Center in Texas and one of Ms Riehle’s physicians, told TODAY.com: ‘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.

‘Although oral cavity cancer typically affects the older male population, we are actually seeing a rise of this type of cancer in young patients.’

The rise in head and neck cancers has largely been associated with higher rates of HPV, which is spread through oral or penetrative sex. 

About 42million people in the US have been infected with HPV and an estimated 98 percent have been exposed to it. However, most infections go away on their own. 

Dr Choi confirmed HPV did not cause Ms Riehle’s cancer.  

Tobacco use is one of the strongest risk factors for head and neck cancers, as the chemicals in cigarettes and cigars damages DNA in the tongue and gums, increasing the risk of cancerous tumors forming.  

After her diagnosis, Ms Riehle underwent radiation 35 sessions of radiation five days a week and chemotherapy once a week for seven weeks. 

But two months finishing the treatment, a new symptom appeared. 

Ms Riehle said: ‘I started having terrible shooting pains across my forehead and neck. I assumed they were delayed reactions to the radiation.’

But in September 2024, a CT scan revealed her cancer had returned, and there was now a second tumor. 

In December, she underwent a near-total glossectomy, a surgery to remove all or part of the tongue. 

Doctors removed 80 percent of her tongue and 75 lymph nodes in a 12-hour operation, and she was given a 50-50 chance of speaking again.

Ms Riehle is now cancer free but has to do speech therapy to improve her ability to speak and swallow after having most of her tongue removed

Mouth ulcers that don’t heal, a hoarse voice and unexplained lumps in the mouth are all warning signs of mouth cancer

The same day Ms Riehle found out she needed surgery, her fiance, Donald, proposed. 

She said: ‘He made what was the worst day of my life also one of the most memorable.’  

Ms Riehle underwent another 30 sessions of radiation after her glossectomy. She is now cancer free, though the disease has taken a toll on her body. 

She struggles to open her mouth fully due to tightness in her jaw and has painful sores in her mouth. 

Ms Riehle also attends speech therapy to improve her speech and ability to swallow. She hopes to eventually have get a mouth prosthetic to make her speech clearer. 

Her family is raising money on GoFundMe for her medical expenses. 

As she works to regain her voice, Ms Riehle is also advocating for oral cancer awareness. She founded a group called Young Tongues, which offers support to young people with tongue cancer, and posts TikTok videos about her diagnosis. 

She said: ‘I’ve had people who have undergone the same surgery as me find me and show appreciation for giving a voice to a group of people who aren’t necessarily represented.

‘It’s been a powerful experience and an important reminder of vulnerability’s place in our lives.’