Chicago news recently published a story about their very own celebrity chef Grant Achatz who suffered from Stage 4B squamous cell carcinoma of the tongue.
Grant Achatz, chef and co-owner of Alinea/Next/Aviary, approached multiple physicians throughout the country who essentially told him the oral cancer was terminal. In the end, he underwent treatment at University of Chicago successfully, though he certainly is not out of the woods yet.
There are several approaches in the treatment of tongue cancer, especially one as advanced as Mr. Achatz's, each with its own advantages and disadvantages.
In one approach is surgery first to remove all visible disease followed by radiation and chemotherapy to get rid of microscopic tumor cells. Surgery is huge... it entails removal of most of the tongue, involved jawbone, and removal of lymph nodes in the neck (neck dissection). Given how much tissue is removed, reconstruction of the defect is typically performed using bone, skin, and muscle typically taken from the arm (radial forearm free flap). Given how massive the surgery is, a tracheostomy as well as stomach feeding tube is placed. Hospitalization is typically 1-2 weeks long.
An alternative approach is surgery second. Radiation and chemotherapy is done first to shrink the tumor. Once this course is completed, surgery is performed to remove residual disease. The amount of surgery depends on the degree of residual cancer that is left. This course of action is what Mr. Achatz chose to pursue.
Regardless of what step is pursued, there are lots of side effects from cancer treatment including:
- loss/alteration in taste and smell
- dry mouth
- difficulty with swallowing
- stiff neck
- poor teeth (often they get removed prior to cancer treatment)
- leathery skin
Unfortunately, cancer being cancer, risk of recurrence is VERY high especially for stage 4 tongue cancer no matter how well the initial response appears to be. Regularly monitoring over the next 5 years is absolutely essential starting with an exam every 2-3 months for the first two years as that's when the risk of cancer recurrence is highest.
Source:
Celebrated chef gives back. WGN 3/22/12
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