DEAR DR. GOTT: In 1999, my dentist saw a discoloration on the floor of my mouth. He told me to see a doctor about it. The doctor talked me into having the spot surgically removed.

A while back, I remember reading in your column that, 95 percent of the time, discolorations in the mouth are nothing to worry about. Recently, I had a procedure done to see if I had oral cancer. That procedure revealed another abnormal area. I assume it is the same thing as what I had removed before but the doctors now want me to have the spot surgically removed with a laser.

I am hesitant and would like your advice. I have enclosed copies of both pathology reports, the first from 1999 and the second from a biopsy taken during the screening.

DEAR READER: In your first pathology report, the lesion was examined under a microscope. Abnormal changes were noted. These changes were labeled as mild to moderate squamous epithelial dysplasia. Primarily, this means that the flat, platelike cells in the interior covering of your mouth were altered in size, shape and organization. It was not stated that this was cancerous, but in my opinion, these changes were probably precancerous. Thus, having the lesion removed was a smart choice.Now, to the pathology report of your new lesion. According to the report, it very clearly showed that you have oral squamous cell carcinoma in-situ. This means that you have a malignant cancer that has not yet spread but unless immediate action is taken, it might.Follow your doctor's advice and have the lesion removed. You should also be under the care of an oncologist who can advise whether further treatment such as radiation or chemotherapy is necessary. He or she can monitor you closely after surgery to ensure that the cancer has not spread to other areas of the mouth or body.————————DEAR DR. GOTT: About two years ago, the right side of my thyroid gland became swollen. I had a biopsy, which was negative, and blood work that showed a high calcium level. My doctor didn't offer me any medication or options.Sometimes it bothers me to swallow because it feels as if there is a little knot in my throat. I feel really down, tired, have no energy and cry at nothing. I have made an appointment with another doctor, since my current one doesn't seem to want to help me. In the meantime, I am writing to you for your opinion.Oh, I don't think it's related, but I am also a diabetic.

DEAR READER: Your high blood calcium level may be the key. Primary hyperparathyroidism is a condition that causes one or more of the four parathyroid glands (located in the neck) to enlarge and overproduce parathyroid hormone (PTH). When this occurs, blood-calcium levels rise.There may be no symptoms or ones that are so mild they go unnoticed. When symptoms are present, they include depression, weakness, fatigue, aches and pains, loss of appetite, nausea, confusion, increased thirst and urination, vomiting, constipation, nausea and thinning bones.In 85 percent of cases of primary hyperparathyroidism (caused by the glands), the cause is a benign tumor on one of the glands, and 95 percent of all cases can be cured with surgical removal of the parathyroid glands. In some cases, primarily in people with secondary hyperparathyroidism (caused by something other than the glands), medication may be used.I recommend you discuss this with your new physician and then request a referral to an endocrinologist for further testing and treatment. The specialist can also assist you with your diabetes to ensure that you are under good control of your blood sugar and/or insulin levels (since you don't say which type of diabetes you have).