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Sharp Health News

From the dental chair to the surgical suite (video)

Oct. 16, 2015

Darryl thought he was just going in for a dental cleaning, but his decayed tooth was just the beginning of a much bigger health issue. Darryl was diagnosed with a rare form of skull base cancer and was treated by Dr. Perry Mansfield, a head and neck surgeon specializing in tumor management, affiliated with Sharp Memorial Hospital.

Dr. Mansfield recently answered a few questions about Darryl’s story and how head and neck cancers are treated at Sharp.

What type of tumor did Darryl have?
Darryl had a rare form of cancer — called adenocarcinoma — in a small minor salivary gland adjacent to the maxillary sinus, which sits below the eye and next to the nose. This type of cancer represents approximately one case per 100,000 people per year.

Are there any signs or symptoms of this type of cancer?
Typically, this type of cancer will present dental pain, numbness of the cheek, bleeding inside the nose, nasal blockages and loose or decayed teeth. There is a general feeling that if a tumor is in the lower part of the sinus, the patient is more likely to have a better outcome. Unfortunately, Darryl’s tumor was higher up in the sinus, which carried a more difficult prognosis. In general, cancers that we can detect early do much better. Darryl’s tumor had a very broad reach into the surrounding muscle and bone structures, and was a late-stage tumor presentation.

Why do some cancers group rapidly while others don’t?
Different cancers have different rates of expansion depending on the individual type, which is often dependent on the genetic makeup of the cancer. Their genetic makeup creates the “template” that allows them to replicate more rapidly than others. A fast-growing cancer may have a doubling time of two to four weeks, while a slow-growing cancer may take four to six months, or even a year to double in size.

How is Darryl doing now?
Darryl’s outcome is very favorable at this point. He had a comprehensive and successful operation followed by a very carefully defined and developed radiation protocol, in which the radiation therapist and I worked collaboratively to define the fields of radiation to be very specific where the radiation went, hitting targeted areas but sparing vital structures such as the ear, brain, eye and spinal cord. That — in conjunction with good prosthetics that allow him to eat, talk and look normal — really played a large role in his success to date.

What’s different about how head and neck tumors are treated at Sharp?
We are fortunate to have a very broad, expert and multidisciplinary team of specialists here at Sharp that can tackle any head, neck or skull base tumor. We have some of the most sophisticated technology and surgeons to remove tumors through minimally invasive techniques with limited downtime and recovery time. We also have excellent radiation technology and chemotherapy protocols to deliver state-of-the-art treatments in a very directed way.

Perhaps most importantly, we present all of our cases at a team conference. Our head and neck tumor board reviews all cases — whether the patients are local, regional or international — so that all of our head and neck tumor specialists can provide expert analysis and recommendations.

These elements make Sharp one of the few and expert centers in the country that has the ability to treat these kinds of tumors.

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