Following the Rise in Oral Cancer and Treatment

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Dr. Steven Wang, associate professor in the Department of Otolaryngology at The University of California, San Francisco (UCSF) Medical Center discusses the rise in oral cancer and treatment options for patients. He explains the complexity of tongue cancer care, which can be a challenging disease to treat, requiring surgery and then intensive therapy to regain speaking and eating skills. Christine Schulz, a tongue cancer patient, shares her experience with this illness and her inspiring recovery story.

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Please remember the opinions expressed on Patient Power are not necessarily the views of UCSF Medical Center, its medical staff or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:

Researchers are noting a rise in the incidence of oral cancer.  Hear from a tongue cancer patient who is living well, and a head and neck surgeon, about current trends and treatment for oral cancer.  It's all next on Patient Power. 

Hello and welcome to Patient Power.  I'm Andrew Schorr.  This program is sponsored by UCSF Medical Center. 

Oral cancer, it is on the rise, cancer that shows up in your mouth, on your tongue, in your throat, around the neck as well, in the lymph nodes.  Doctors are studying what could be going on.  We're going to hear about that from a leading UCSF medical expert in a minute. 

But I'd like to start the program with someone who faced this beginning in 2009.  Christine Schulz joins us.  She was a kindergarten and first grade teacher in Morgan Hill, just down below San Jose, California.  Christine, tell us about your diagnosis.  What did you notice? 

Christine Schulz:

In the summer of 2009 I noticed a small bump on the right side of my tongue, and was not alarmed.  Just didn't know what it was, had never heard of tongue cancer before. I was about to visit my doctor for just my normal annual physical, and I thought, well, I'll mention it to him.  So I just happened to be going in to him at that time, and I went in, and he looked at it, and his reaction let me know real fast that it was something quite serious.  Basically, that's how I found out.  I had a small bump towards the back of my tongue. 

Andrew Schorr:

Now, had you been a smoker? 

Christine Schulz:

I had not.  I dabbled a bit in college years and years ago, but definitely not a smoker. 

Andrew Schorr:

Well, as we're going to learn in this program, we'll find out that a lot of the increase in this cancer is among people who haven't or don't smoke. 

Christine Schulz:

That's right. 

Andrew Schorr:

We'll hear more about that from our expert.  You found your way to UCSF Medical Center, and the doctor, the surgeon who will be our guest in a minute, Dr. Steven Wang, that led, in your case, to major surgery on your tongue, and eventually reconstruction, and also, then of course radiation and chemotherapy.  We should mention I know people say, well, maybe you have a British accent.  That's because a good bit of your tongue was removed, right? 

Christine Schulz:

More than half of it. 

And then rebuilt with, it's called a flap but it is the skin off the upper part of your arm by your wrist.  They remove that and use that to rebuild your tongue. 

Andrew Schorr:

The art of this is, first getting the cancer and removing it, and both through surgery and radiation and chemo, but also major reconstruction, to give you, your mouth back, right? 

Christine Schulz:

Yeah.  So that you can talk and swallow and do all that with whatever is left in your mouth. 

Andrew Schorr:

Now, we should mention to our audience that it took a while, and you went through a lot of rehab, and really were not in the teaching field, your profession, for two years.  But you are back now—

Christine Schulz:

I am. 

Andrew Schorr:

—teaching science, at least part-time, to those little kids, right? 

Christine Schulz:

That's right.  And I love it, just a blessing to be able to be back in the classroom …At first there are a lot of internal questions-- not quite sure if you're going to be able to go back, but to be able to be back and do it well, is so wonderful. 

Andrew Schorr:

Would you say that the doctors at UCSF and the rehab specialists gave you your life back? 

Christine Schulz:

Of course they did.  They saved my life.  I mean, if I wouldn't have went to my doctor right then, who knows if I would ever have gotten here.  This is the most tragic thing that's ever happened to me, but somehow the steps, and where I was at the time, got me where I needed to be with some experts that knew exactly what they were doing, had the confidence, gave me the confidence to say, all right, this is possible and to move on from there.  And of course they absolutely had a hand in saving my life. 

Andrew Schorr:

Right.  And you have little kids of course who appreciate you every day, but you have ten-year-old twin boys—

Christine Schulz:

I do. 

Andrew Schorr:

—who just treasure their mom, I'm sure too.  Let's meet your doctor, Dr. Steven Wang, who is, of course, a head and neck surgery specialist, and he is an associate professor in the Department of Otolaryngology at UCSF Medical Center.  Dr. Wang, let's just start this way: To hear Christine tell her story and know how well she's doing, that must be what it's all about for you as a head and neck surgeon. 

Dr. Wang:

Oh, of course.  It's very gratifying to be able to see someone like Christine, who had to go through a very complex operation and treatment, to be able to be functioning as well as she has been doing, and I actually look forward to seeing her.  I still follow her about every two or three months.  It's always great to see how well she's doing. 

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