How a Second Opinion Gave One Neck Cancer Patient a Second Chance
Prior to his diagnosis, Steve L. was a man who lived life to the fullest. He loved his family, as well as his successful career as an IT specialist; he also enjoyed a healthy, active lifestyle. That all changed, however, on March 7, 2014, when he noticed a lump in his neck. Understandably concerned, he began to seek out medical advice.
Three days after he discovered the lump, he went to see his internal medicine doctor. He was scheduled for a CT scan the following day and was sent to a specialist for a fine-needle biopsy.
Then the doctor that performed the fine-needle biopsy delivered the bad news: Steve had neck cancer – not only that, it was the worst possible type, in his opinion. And when Steve asked if he should retire to enjoy what remained of his life, his doctor said yes.
It Was Time to Seek a Second Opinion
After his initial diagnosis, Steve was referred to an ear, nose and throat specialist who was a frontrunner for conducting the necessary surgical procedure. Despite the fact that Steve was disappointed by the doctor's bedside manner, he booked the surgery, not wanting to waste time.
In retrospect, Steve advises, "Definitely bring a family member to go with you to some of those appointments. You're pretty much preoccupied with the worst thing about it, so you've got to keep your head about you when you're in with these doctors."
Steve’s sister, who had accompanied him to the appointment, felt he should seek a second opinion. So she connected with a doctor who immediately contacted MedStar Georgetown University Hospital. Not long after, Steve had an appointment set with Bruce Davidson, MD, chairman of the Department of Otolaryngology-Head and Neck Surgery at MedStar Georgetown University Hospital.
Renewed Hope for Recovery with Dr. Davidson
Dr. Davidson biopsied the tonsil lump, but at the time of surgery, pathology did not find any cancer, so he proceeded with a neck dissection to remove the known cancer in the lymph node.
“These cancers that present in lymph nodes in the neck are called Cancer of Unknown Primary,” says Dr. Davidson. We try hard to identify the original cancer and usually it is in the tonsil or the base of tongue. In this case, we could not identify the cancer on biopsy. In fact even when we pursued tonsillectomy, the cancer was too small to be seen on pathology at the time of surgery. It was only found after further careful study by the pathologist.”
During the neck surgery, Dr. Davidson removed approximately 40 lymph nodes from Steve's neck and discovered cancer in only one of them.
The team then removed Steve's tonsils. There was no obvious tumor in the tissue removed. However, when the tonsil tissues was comprehensively evaluated by pathology, they did indeed find cancer in the left tonsil.
So with a small cancer in the primary and a single lymph node, surgery alone can be curative. However, a wider resection around the tonsil area would be required in order to avoid the need for radiation therapy. Steve went back to Dr. Davidson, who proposed a radical tonsillectomy on the left. After his surgical treatment, Steve has done well. He has undergone PET-CTs for two years. Each time, the results have been negative.
Reflecting on His Treatment and Looking Forward
Today, Steve is in good health once more. "So far, I've been very happy with what they've done. I've lost no mobility.”
As a survivor of throat cancer, Steve has learned a thing or two. "Definitely take your pain meds," he advises, "I learned that one the hard way very early on. If you're in pain, you're going to heal slower."
Most of all, Steve stresses the importance of cancer patients finding a doctor they like and trust. "Don't be afraid to fire your doctor," he says. "Don't be afraid to research your doctor.”
While Steve eventually found his way to Dr. Davidson, the beginning of his diagnosis was rocky, and he credits Dr. Davidson with being a thorough, meticulous professional. "He's a very brilliant man.”
“Cancers of the throat are increasing,” Dr. Davidson notes. “Many of these are in individuals like Steve, who are in the prime of life. While some of these tumors are treated with surgery and radiation and others are treated with chemotherapy and radiation, his case demonstrates a successful treatment using surgery alone.”
Thanks to Dr. Davidson, Steve is looking forward to the many years of good health and great times that lie ahead.