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Path to Diagnosis: Part II

This is the second part of the stories of late diagnosis collected and collated by Olwen Williams. These two illustrate how pretty obvious signs of cancer can be missed until it is too late for an easy solution. 

As we build up to WHNCD, we will publish more stories about aspects of the cancer to raise awareness. 

Anne

Anne, a widow from Dannevirke in her 60s,  went to the GP with a swollen nose which the doctor treated with antibiotics.  She took ill one day and was transported by ambulance to hospital having a suspected silent heart attack. She was given the all clear for everything except her nose. The hospital said it should be lanced as was an abscess and that her antibiotic should be changed. But nothing was done and she sent home.

She continued  going to her GP who kept changing antibiotics with no success.

One Wednesday the GP said that she feared it was cancer, but did nothing and told Anne to come in for IV antibiotics on the Friday if it hadn’t cleared up. She wouldn’t be there, but a locum could take care of Anne.

Anne duly showed on the Friday to see the locum, who refused more antibiotics, phoned the ENT department and sent through photos. This started a roller coaster. On Monday she was at the public hospital having biopsies, Tuesday was a CT scan of head and chest with dyes and on Friday she met the plastics and radiation team as well as oncologists.

She was told that day that she definitely had cancer and was put in the care of Professor Swee Tan. Ten days later  she was Hutt hospital having the tumour removed.

Anne has an aggressive form of squamous cell carcinoma for which she has had two surgeries so far. Currently going through radiotherapy in Palmerston North, she faces two more reconstructive surgeries in Hutt Hospital. The surgeon has had to make a rotational flap out of Anne’s cheek tissue in order to patch the defects in her nose and mouth.

In spite of all this Anne is looking well and staying strong. If only her cancer had been found earlier.

Maureen

Maureen was diagnosed with SCC of the tongue in 2007 at age 60, after many years of an inflamed mouth and oral lichen planus, an auto-immune skin disease characterised by white lines and patches. Her lichen planus settled onto one side of her tongue and was extremely painful for over two years during which she saw her GP and dentist many times as well as well as an oral surgeon and dermatologist.

Because the oral surgeon visiting Rotorua deemed it bog standard lichen planus, other practitioners went along with his diagnosis and no-one suggested a biopsy until Maureen asked to see the oral surgeon again. This cancer was excised at Waikato Hospital but the margins were not clear and she was told that her mouth had suffered a “field change” with a recurrence highly possible.

Two years later,a symptomless repeat cancer occurred in the area of the scar tissue and Maureen had major free flap surgery in Auckland in 2009. At the end of 2013, a new primary was found in the cheek (buccal mucosa). The symptoms were unexplained toothache and some mild pain and bleeding in the gum.

Long standing mouth lesions, unexplained toothache, pain and bleeding all need to be investigated.



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