It has been quite a while since I have made an entry to the blog, and that is a really good thing. Over the last few years I have had several PT scans all showing some normal activity but nothing detecting any return of the cancer at the base of my tongue. But a subsequent issue has come up due to the cancer treatments. Osteoradionecrosis is a condition in which there is a significant weakening of bone structure due to high levels of radiation. This has been an ongoing problem but reached a critical point a few weeks ago.
In May of 2012 an impacted wisdom tooth had to be removed and it was determined that antibiotics would take care of any of the infection. The tissue looked like it was healing OK but unfortunately the infection has remained in my bone for almost a year. Infections are nearly impossible to eradicate in highly irradiated tissue and bone structure. Over the course of last year, the infection would cause swelling and a great deal of pain and a round of antibiotics would calm the infection down but not get rid of it. This all reached a critical point a few weeks ago when there was another outbreak from the infection. A visit to my oncologist and a new X-ray showed a dramatic loss of bone structure in my jaw both from osteoradionecrosis and the infection. The diagnosis is stage three osteoradionecrosis.
I was referred to Dr. John Coniglio in Rochester and he concurred that the situation has reach a critical stage and will be doing surgery on April 15th at Highland hospital in Rochester to try to improve the situation. The surgery is called a mandible resection, and they will take bone and tissue material from my left fibula and cut out the bad jaw tissue and bone from my jaw and replace them with the good healthy tissue and bone. The surgery is complex and will entail a 7-10 day hospital stay with 6 to 8 weeks recovery but the prognosis is good for a full recovery! The team of doctors perform this surgery 4 to 5 times a month and have really perfected it. Unfortunately if I wait any longer the infection could cause a life threatening situation. This surgery is the best chance I have to leading a healthy life with the post radiation jaw I now have!
One thing that is a little alarming is how many head and neck cancer survivors are developing osteoradionecrosis ; somewhere around 15%. Dr. Coniglio mentioned that this is because many cancer patients choose not to have surgery to remove cancerous lymph nodes and therefore the radiation levels are higher to take care of everything. In my case I did have surgery but the primary site was the base of my tongue which is a difficult area to remove a tumor so higher radiation levels were required.
We are keeping a positive outlook about the surgery and will be really happy when it is over. Peggy will post an entry after the surgery to let you know how things are progressing. Since I will have a trach tube for breathing for the first week, it will be impossible to talk with anyone but I will be able to send notes. As always I so appreciate all the positive thoughts that are coming our way from so many of you. It means more than you know. Here’s to a bright Spring !!