Scarless Surgery Performed To Remove Cancerous Oral Tumour

To deliberate on the rising numbers of oral cancer cases and to highlight the advancements in the treatment modalities of oral cancers, Max Super Speciality Hospital, Vaishali, organised an interactive session today.

Briefing about the case of a young businessman, the gathering emphasised the advent of advanced treatment modules, which have improved the outcomes of head and neck cancers and are paving the way as the latest breakthrough in the treatment of such cancers.

Suffering from stage 2 oral cancer, he successfully underwent scarless robotic reconstruction surgery at Max Institute of Cancer Care, Vaishali, where his functional and aesthetic outcomes were not compromised. This surgery took a team of 6 doctors who worked on the patient for over 7 hours.

"Sharing the details of the procedure, Dr Pawan Gupta, Director - Surgical Oncology (Head & Neck) at Max Institute of Cancer Care, Vaishali said, “The surgery involved removal of the entire one side of the jaw bone with soft tissue and the neck nodes. The tumour had extended around the jaw bone and to the neck nodes. 3D CAD CAM reconstruction of the extent of the disease was done, and models were made for the extent of resection. Pre-operatively patient was enrolled on the tobacco cessation program, jaw opening exercise and chest physiotherapy. At surgery, no incision was put on the face. The jaw bone was replaced by the leg bone with microvascular anastomosis of the supplying blood vessels, which was preplanned. The surgery was extensive, but intricacies were put in to maintain the aesthetic and functional aspect of the patient. The results were mind-blowing as there are no scars on the face, and he is able to eat and speak normally."

The patient who initially observed a mouth ulcer that didn’t heal, feared it to be cancer. He got into the habit of chewing tobacco under the influence/pressure of his friends, enjoying unaware of the consequences. He decided to visit a local doctor in Moradabad, who referred him to a local dentist, who was swift to diagnose the condition but was afraid to tell him. The dentist instead advised him to meet Dr Pawan Gupta, a reputed and well-experienced cancer surgeon at Max Institute of Cancer Care, Vaishali.

“My fears were coming true, and I did not want to be diagnosed with cancer. And, of course, I knew the treatment outcomes would be ugly with a disfigured face, unable to socialise, eat or speak properly. My suspicion came true when the biopsy reports confirmed the lesions to be cancerous. I was devastated, but the gentle and friendly approach from Dr Pawan Gupta was a lot assuring. He explained the extent of the disease, and luckily the cancer was still limited to only one area of the oral cavity. He assured me that I needed to undergo surgery, but the surgery would be such that people would not be able to know that I had surgery done. Thanks to Dr Pawan Gupta and his innovative ideas. The team support – Plastic and reconstructive surgeon, Intensive Care, Anaesthesia, Physiotherapy, Dietician, Tobacco Cessation and oral care experts, and of course, the latest equipment at MICC Vaishali is changing the way oral cancers are treated” said the patient.

“We assured him that with the new techniques and equipment at Max Institute of Cancer Care, Vaishali, we would give him a scarless face and complete rehabilitation with swallowing, speech and aesthetic look. The patient was immobilised for 72 hours in the ICU. Post-operatively his rehabilitation exercises, including – mouth opening with TrisCaRe, swallowing therapy and speech therapy, were started. He received his food through a pipe which was inserted through his nose. He recovered quite fast and was discharged in 7 days when he had started taking oral food, and the nose tube was removed” added Dr Pawan Gupta.

While tobacco usage remains the prime reason for the development of oral cancers, though preventable, attributes to over 90% of such cases. According to recent data from the Indian Council of Medical Research’s (ICMR) National Cancer Registry Programme (NCRP), one in three cancer cases belongs to one of the BIMARU states. Of the total cancer cases recorded in the country in 2020 (22.5 lakh cases), 7.5 lakh cases belonged to Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh, of which UP had the mainstream contribution of over 4.6 lakh alone, which is maximum from a single state in the country. According to Globacan data 2020, Oral Cancer is the second most common cancer overall and the most common cancer in males. Oral cancer is the sixth leading cause of mortality worldwide, and over 35% of them is contributed from Uttar Pradesh.

Dr Gaurav Aggarwal, Senior Vice President (Operations) at Max Hospital, Vaishali, said,” Due to lack of awareness, people usually neglect the early symptoms and often reach a hospital at an advanced stage of the disease. It is important to understand and spread awareness about cancer treatment and the ways to prevent it with slight lifestyle modification and self-examination. While better and more advanced technologies are available, it is equally important to spread the message of early detection as the symptoms get neglected & are diagnosed late. Common symptoms like mouth sores that don’t heal, difficulty and pain while swallowing, and a reddish or white patch that is persistent inside the mouth, should not be ignored. Ignoring such symptoms can lead to the development of lumps and can convert into malignant tumours causing cancer.”