In December 2019 I noticed Anthony's left cheek was swollen, you can kind of see the above picture. So I made and appointment with his doctor to get it checked out. The Doctor didn't think much of it and diagnose it has a swollen gland inside of cheek. He proscribed some antibiotics and said it should be gone within a week.
After the antibiotics were all used up the swollen cheek was still there, so we scheduled our second appointment with the doctor and he referred us over to the head and neck specialist. The head and neck specialist prescribed a 10-day steroids treatment and sent us on our way. Around halfway into the treatment we didn't notice any change in his cheek and requested for further treatment. The doctor then referred us to get a MRI scan.
MRI Scan, CT Scan, Biopsies
Once the MRI happened things started to move at lightning pace. You have multiple doctor appointments with specialist that are lined up all over the place and they want to see you as quickly as you can.
The MRI scan did confirm with the doctor that there was some sort of mass in his jaw. The doctor said it could be benign (non-cancerous) or malignant (cancerous) and he will like to get a CT Scan so they can better identify the mass and a Biopsy so they can see if it is cancerous or not.
The CT Scan did show up as some kind of tumor and after the Biopsies were performed they identified it as a high grade Undifferentiated Sarcoma. Undifferentiated Sarcoma is a type of soft tissue sarcoma’s that grows quickly and spreads to other parts of the body.
Once the doctors identified that your child has cancer you are referred to the Pediatric Oncology department.
During these test it is one of the toughest emotional periods in which you will ever have to go through. It is normal for you to cry throughout the day and you find many nights where you are crying yourself to sleep at night. You jump to answering any telephone number that calls you knowing that it may be a doctor to give you updates or trying to schedule an appointment. You do a lot of reading up on cancer, treatments, experiences others have gone through, and you learn about something called survival rate which becomes a reality that you must face. The reading helps educate yourself on what the doctors are explaining to you and sadly there are more articles out there where the outcome is death. At one point during this journey I realized that reading was doing more emotional harm to me that I made a discussion to stop reading up on cancer. Reading caused me to lose hope and hope is everything I need to push through this journey Anthony and I are going through.
The doctors want to approach the treatment very aggressively, however we are in a unique position because of the Pandemic that is just being caused by Covid-19. The Doctors need to hold curtain surgical procedures and are catering a plan around this.
Instead of conducting surgery right away to remove the tumor, they want to start on a Chemotherapy plan where we do four (4) Chemo sessions. Each Chemo sessions will consist of 3-day straight of Chemo. They will then give Anthony a rest of 2-3 weeks before they start the next Chemo sessions. Then after the forth Chemo session he will have a few weeks of rest to gain his straight so they can perform a complex surgery to remove his tumor. Then after surgery he will undergo Chemotherapy some more to hopefully kill the reminder cancerous cells that may be floating around.
The doctor said the surgery is going to be very complex. They are putting together a team of few surgeons. One will be to remove the tumor from his jaw and the other will be to reconstruct his jaw and face. They said it will be an all-day surgery where they normally can perform two open heart surgeries by the time they can complete this one.
The tumor removal is going to be very complex because the surgeon will need to cut his jaw bone in half and remove it from the joint that connects to his skull. He doesn’t know how much needs to be removed since they have to make sure they can remove a safe margin of the bone that is cancer free around the tumor. He has to separate the nerves that run through the side of his head from the muscles and skin and they have to separate major blood arteries. Because Anthony is 9-year old, it complicates things even more because everything is much smaller and this is the first time they will have to perform this type of surgery on a child in the 30-years they have been doing it.
The reconstruction surgeon then needs to come in and remove the small fibula bone that is in Anthony’s leg. She will then need to reconstruct this bone and replace it where the bone in his jaw once was. Because they do not know how much bone is going to be removed from the jaw, the surgeon will be doing this on the fly. She will then need to cut a full-thickness skin graft from his leg, which is a layer of skin that has the tendons and nerves in it and then reattach it to the inside of his mouth. This is very complicated because they will need to attach this skin graft to a major blood artery so that it can supply blood. If it does not respond to attaching, they will then need to try again until it works. The surgeon then needs to hook all the blood veins and the rest of his nerves back together.
There are numerous complications that can happen and because Anthony is undergoing Chemo, his body will not be as strong as they like and the healing process will be longer.
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