I am a 69-year-old retired civil servant and active member of patient
representative groups.
Prior to the diagnosis of oral cancer I had for several years had periodic
check ups at the Royal London hospital Oral Medicine department. These started
when it was found I had lichen planus and continued through a period when it
was found by biopsy that I had pre-cancerous cells. In April 2003 a second
biopsy established that cancer had now developed.
Immediately cancer was diagnosed I was referred to the Oral and Maxillofacial
Surgery department and Mr Cheng, consultant with the renamed Barts and The
London N.H.S. Trust, Mr Cheng briefly explained the situation and set in motion
a long series of tests that lasted throughout May. The tests included routine
blood tests, etc, specific tests to establish the extent of the cancer and
additional tests to see if I was fit enough for an operation. The tests ended
with a two day stay in St Bartholomew's Hospital where I had an internal check
of my throat, nasal area etc plus further biopsies.
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Terry Kenny
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With the information gained from the tests, Mr Cheng and colleagues
including his Oncology colleague, Dr Sibtain were able to inform my wife and I,
not only what the situation was, but also what treatments were possible. We
were told of the worst case as well as the most likely scenarios.
The operation was planned for the 2nd June and involved the removal of a
section of cancerous jawbone and skin together with teeth that could be
affected by subsequent radiotherapy. As a precaution lymph nodes from my neck
were also removed in case cancer cells were present. The evening before the
operation, the ward manager made sure I understood what was happening and
checked that I understood the consent form.
I returned to the ward feeling a lot better than expected and for the rest of
my stay in hospital I was surprised to feel no pain. This does not mean I was
not uncomfortable but I did not need to use the self-administering analgesic
machine.
Because of my heart condition Mr Cheng had decided to replace the skin, etc
that he had removed by using the flexible root of my tongue and cheek i.e.
stretching it sideways and stitching it in place. There was a slight problem
with this in that a fissue opened up requiring me to be fed through a tube in
my nose for a longer than usual period.
With the wounds healing I went onto the next stage of my treatment i.e.
radiotherapy.
In order to ensure that the radiotherapy covers the affected area, plus a small
margin around it, careful measurements have to be made. These measurements also
have to take into account the organs that maybe affected by the rays as they
pass through the body. To achieve accuracy x-rays and lasers are used to
construct a model of the areas for computer programming. In order to ensure
that the target area is consistent a mask of my face was made and on this
information was marked. At each radiotherapy session the mask was placed over
my face and fixed to the bench on which I was lying. This meant I could not
move and cause the radiotherapy machine to mistarget.
As with my operation the worst-case scenario was pointed out to me, but again I
was fortunate as I suffered only slight ulceration in the front of my mouth,
loss of taste and some loss of salvia. Following the end of the 32 radiotherapy
sessions I did feel weak for a while but this soon passed.
Looking back over the last six months my main impression is one of gratitude to
all the professionals with whom I came in contact. This is, I know, a common
phenomenon but I feel gratitude not only for the treatment I received but for
the care that was taken at all levels to communicate and inform. To be well
informed makes the patient part of the team rather than the object and I am
sure speeds recovery.
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