Johns carcinoma diagnosis and treatment

68-year old retired investment banker John first realised something was wrong when he detected a lump on the side of neck in June 2020. At first he assumed it was a swollen tonsil, but as the lump began to grow he realised it might be something more serious.

After voicing his concerns, John’s sister who works in healthcare suggested a biopsy was done privately and he was given a referral by his GP. 

Within 48 hours of his biopsy he received the news that the lump was in fact a carcinoma, a common form of cancer which begins in the tissue that lines the organs and grows into a solid tumour. John’s diagnosis was a shock to him – although he’d had a benign tumour a few years ago in his eardrum, he was otherwise fit and healthy. 

He was recommended Ear, Nose and Throat (ENT) Surgeon Professor Francis Vaz and made an appointment to see him at The Harley Street Clinic’s Head and Neck Centre. “I saw him within a week of my biopsy and he was an extremely impressive person”, John said. 

Following his meeting with Professor Vaz, John was referred for a number of scans and this concluded with a second biopsy, where Professor Vaz took a larger tissue sample from the tonsil and the surrounding area. “It was as excellent an experience as I could have hoped for and the whole thing happened as quickly as possible”.

At that point, both John and Professor Vaz were hopeful that the bulk of the cancer had been removed as part of the biopsy, but there could still be a few cancerous cells left. It was therefore decided that John would benefit from 5 weeks of radiotherapy, as well as two chemotherapy sessions. 

Once he had recovered from the pain and swelling of his biopsy, he underwent a second overnight procedure known as a percutaneous endoscopic gastrostomy (PEG). This involves placing a feeding tube to ensure patients can receive nutrition through to the stomach when they have difficulty swallowing. By September 2020, he was ready for his chemo-radiation treatment, under the care of Clinical Oncologist Dr Ruheena Mendes at our dedicated Leaders in Oncology Care (LOC) centre at 81-83 Harley Street. 

As part of his treatment he was required to wear a radiotherapy mask during the procedure to avoid movement and accurately target the treatment. “Radiotherapy is brutal. Psychologically, it’s really tough because your body’s natural reaction is to want to tear it off your face.” 

After the first week the physical symptoms start to emerge too, such as swelling and wounds around the neck. “Dr Mendes and the team, including all the radiotherapists were excellent and all very friendly. So were the nurses and people who dressed my wounds – all of them showed empathy as well as efficiency and I never felt like I was just a number to them”. John also lost weight and experienced a diminished appetite but praised the support available to him. “I was cared for well, and if I raised concerns about the side effects, they were dealt with. Pain relief was also available when I needed it”. 

His radiotherapy concluded in October 2020 and he has since been seen regularly by Professor Vaz and Dr Mendes to monitor his recovery, using a nasal scope to check the site of his carcinoma. “As I would expect from clinicians of that eminence, both Professor Vaz and Dr Mendes have been incredibly supportive. I cannot fault them.”

John admits that his recovery has been gradual and took longer than he expected. “While I’m generally well now, it has taken time to overcome difficulties eating and swallowing and suffering from a dry mouth. I’m adapting though, and while I don’t chew on a big steak I eat more fish and stews instead”.  

John, a married father of three and an avid hillwalker, was finally able to undertake long hill walks within six months of his treatment and in April 2021 he managed to complete a trip walking across Wales. 

Find out more on The Head and Neck Centre at The Harley Street Clinic