Physician assistant helps oral cancer survivor cope with rare diagnosis
Whenever Jessica King returns to Houston for an appointment at MD Anderson, she has to make one stop before she leaves: a visit with Jill Flynn, a physician assistant who cared for the Kilgore, Texas native during oral cancer treatment.
In August 2018, Jessica began feeling pain on the left side of her jaw. Assuming it was a tooth infection, she mentioned it to her dentist during a regular cleaning. Her dentist noticed spots on her gums and recognized them as oral cancer symptoms. Jessica immediately scheduled a biopsy and cancelled a family trip. The biopsy results confirmed the spots were, in fact, a sign of oral cancer.
She called MD Anderson and had her first appointment in September 2018. Jessica, who was 31 at the time of her diagnosis, had traveled the three hours to Houston by herself while her husband stayed home to care for their four children. She cried in the restroom before her appointment. Her anxiety didn’t ease any when she learned more about her diagnosis. As her doctors in Kilgore had told her, Jessica had a type of oral cancer called squamous cell carcinoma of the gums. But the biopsies performed at MD Anderson also showed she had proliferative verrucous leukoplakia, a rare and aggressive precursor to oral cancer. She had tumors in her gums, under her tongue and in her jawbone.
Physician assistant eases anxiety about oral cancer treatment
Jessica didn’t know how she would undergo treatment without her family by her side. But all of that changed she was met Flynn.
Flynn had worked in Head and Neck Surgery alongside surgeon Jeffrey Myers, M.D., Ph.D., for more than six years and was familiar with cases like Jessica’s. She recognized Jessica’s anxiety and struck up a friendly conversation. Soon, they realized they shared a hometown and knew some of each other’s friends and family members. Jessica found solace in the connection she and Flynn shared and immediately felt at ease.
“It's important for patients to know they're not just here to sit in a chair and talk about cancer. This can be a scary time,” Flynn says. “We have to bring the human element to the treatment process.”
Undergoing oral cancer surgery
Jessica’s care team knew they needed to act fast.
One week after her first visit, Jessica prepared for a nine-hour surgery. Myers and his team performed a tracheostomy, a surgery that makes an opening in the trachea to help patients breathe easier. Myers also removed the left side of Jessica’s jawbone along with the tumors from the floors of her mouth and tongue. Oral oncologist Richard Cardoso, D.D.S., removed eight teeth. Plastic surgeon Peirong Yu, M.D., performed a vascularized fibular flap, where she added a bone from Jessica’s leg to reconstruct her jaw and a skin flap from the same leg to reconstruct her floor of mouth and tongue. Jessica spent six days recovering in the hospital with a feeding tube before returning home to Kilgore.
Facing radiation therapy away from home
A little over a month after surgery, Jessica started six weeks of daily radiation therapy treatments. Although she hated to spend more time away from her family, Jessica pushed forward. Her husband packed up the family RV, and Jessica moved to a Houston RV park while he stayed home with their 15-year-old twin boys, 13-year-old son and 10-year-old daughter. Each Friday, she drove home to be with her family.
“We did what we had to do to keep the family unit going,” Jessica says.
Still, Jessica struggled with side effects from radiation therapy. She had significant radiation burn and severe throat and mouth pain. Plus, she missed her family.
Through it all, Flynn acted not only as a liaison between Jessica and her care team, but as a friend. She was the support system Jessica needed, especially when she was so far from home.
“It’s comforting to know I can call or email if something doesn’t feel quite right,” says Jessica.
Facing recovery – together
Jessica’s recovery has been filled with ups and downs. Although she’s still on a diet of soft foods and liquid purees, she doesn’t need a feeding tube. She’ll soon be able to expand her diet, thanks to a customized prosthesis that she’ll soon have inserted. She’s needed several rehabilitative prosthetic fittings since the tissue in her mouth has continued to change after radiation. To counter these changes, the oral oncology service has custom fabricated a framework that engages her existing teeth to help support, retain, and stabilize her prosthesis.
Jessica is still in contact with Flynn, and the two communicate a few times per month.
“I am really happy that we could help,” Flynn says. “I just wanted her to know that we would get through this together.”