March 26, 2019
Oral cancer survivor: personalized maxillofacial prosthodontist treatment helped me
BY Kellie Bramlet Blackburn
When Patricia Lines came to MD Anderson for her first appointment in 2012, she was impressed by the way all the different parts of her care team worked together to create her treatment plan. From her oncologist to her surgeon to the oral oncology and maxillofacial prosthetics team, each one of them was familiar with her case and had discussed the best treatment for her squamous cell carcinoma of the premaxilla, a type of oral cancer. Throughout her cancer treatment, they continued to give personal and tailor-made solutions.
“During my cancer treatment I was totally at ease with the people taking care of me,” she says. “I knew they were going to do the right thing. I just knew it.”
Choosing MD Anderson for oral cancer treatment
Patricia received her diagnosis in August 2012. For years, she had suffered from a chronic infection near her front teeth. No matter how many times it was treated, it kept coming back. Finally, her dentist performed a biopsy. The results showed Patricia had cancer.
Local surgeons outlined a neck dissection surgery and a tracheotomy.
“That just didn’t sound right to me,” Patricia says.
She decided to seek a second opinion at MD Anderson. Here, the first thing she noticed was the coordination of care. Back home in California, she had to travel from facility to facility to talk to an oncologist, then a surgeon and then a dentist.
“At MD Anderson, everyone was under one roof,” she says.
Her care team recommended that she participate in a clinical trial for a chemotherapy drug, and a complete neck dissection would not be necessary. Instead, her surgeon performed a biopsy of the lymph nodes and removal of the tumor by resecting the entire upper jaw, also called the maxilla, and floor of her nose.
Gratitude for MD Anderson’s dentists
During her surgery, several of Patricia’s top teeth had to be removed and replaced by a surgical obturator, a prosthesis that fills the void left by surgery and artificially replaces lost tissue and teeth. This allowed her to speak and swallow. Ten days later, the surgical obturator was removed and she received an interim obturator specially made for her by a team of MD Anderson maxillofacial prosthodontists led by Mark Chambers, D.M.D.
As Patricia began to heal from surgery and then underwent six weeks of radiation therapy and chemotherapy treatment, the shape of her mouth changed, and with it the whole appearance of her face. With each change, her MD Anderson maxillofacial prosthodontics team made updates to her obturator.
“They’re magicians,” she says. “They’ve done what no one else could do.”
Eventually, Patricia lost the two remaining upper molars that had anchored the prosthesis. With so much radiation to this area, this had seemed inevitable. This time, MD Anderson maxillofacial prosthodontists Ruth A. Aponte Wesson, D.D.S., along with Richard Cardoso, D.D.S, worked with their lab teams to create a new prosthesis called a definitive obturator. It used the sinus cavities and the anterior floor of the nose space as retentive areas to help the prosthesis stay in place.
“It’s magic,” Patricia says. “I couldn’t be more delighted.”
Life after oral cancer treatment
During cancer treatment, Patricia experienced her share of ups and downs. During radiation, she became so dehydrated that she had to be hospitalized and put on a feeding tube. She temporarily lost the ability to taste and needed speech therapy to reduce and eliminate facial lymphedema. She looked all over southern California to find treatment for these side effects, but found that MD Anderson was the best place for her specific needs.
She never doubted that this would all be worth it. She was told from the start that it wouldn’t be easy, but she could beat cancer. With that in mind, she knew she could face anything.
Twice during her treatment, she met with plastic surgeon Matthew Hanasono, M.D., to discuss the possibility of a bone graft and reconstruction. While the surgery could improve her long-term quality of life, recovery would take more than a year. At age 73, Patricia and her doctors decided that wasn’t the best way to spend her time.
Now, Patricia makes the most of her second chance at life. Thanks to her MD Anderson oral oncology team, she’s able to eat -- and taste -- whatever she wants, and she can swallow and speak clearly.
She and her husband take frequent trips. The latest was to hike amongst the gorillas in Africa. She even mentors other cancer patients through myCancerConnection, MD Anderson’s one-on-one cancer support community. Patricia tells the patients the same thing she was told: beating cancer isn’t always easy, but it’s worth it.
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TopicsClinical Trials Oral Cancer
I knew they were going to do the right thing.