Gina: Oral Cancer Survivor

Gina had been experiencing severe pain in her mouth, tongue, and gums. Unable to tolerate the pain, she sought out medical advice and was diagnosed with trigeminal neuralgia, a chronic pain condition that affects the trigeminal nerve.

After her diagnosis, she worked with a neurologist to help manage her pain. But, after three years the pain was getting worse until it became chronic and completely debilitating. “The pain was so much to bear—my personality began to change, my sleep patterns were awry, and I completely lost feeling in my tongue to the point where swallowing was just a numb sensation,” said Gina. Her world was turned upside down and she felt hopeless.

Gina noticed that a small spot had formed on the inside of her gums where her tongue would rest and her nerves felt irritated, as if they were pulling through her gum line. She was told this was just a side affect of the trigeminal neuralgia and there was not much they could do. Unhappy with that answer, Gina set out to get more opinions—and hopefully answers. She started with her primary care provider. After looking at her mouth, her doctor immediately referred her to an ENT for an exam and MRI. Gina was concerned by the request of an MRI and started to assume it was some type of cancer . However, her visit to the ENT resulted in a prescription for two Z-packs, and MRI results which showed that she had no cancer in her lymph nodes. Gina felt a sigh of relief but was still frustrated that there was no conclusive answer for what was going on. After some persistence, the ENT she was seeing recommended she make an appointment with a maxillofacial surgeon for an exam and biopsy, to find out the underlying issue of her chronic pain. 

During the exam, her surgeon noticed that her back molar was loose and scheduled her four days later to have the tooth pulled four days later and biopsy one of the affected spots. When the tooth was extracted, the surgeon discovered there was no bone holding the tooth in place. A panoramic X-ray showed that the bone in Gina’s mouth was literally being eaten away. A week later, the results of the biopsy came back and Gina made a call to Yale to see Dr. Saral Mehra, Assistant Professor of Surgery at Yale School of Medicine and a member of the Head and Neck Cancer Surgery Program at Smilow Cancer Hospital at Yale-New Haven.

Dr. Mehra was exactly what Gina was looking for. He proved to be a wonderful doctor with an amazing personality. He was generous with his time and guided Gina through the entire process with patience and ease. After the tumor board reviewed his findings, she was officially diagnosed with Stage 4 cancer, and it was decided that she would need her entire lower right mandible [jaw] removed. Gina finally had her answers but felt like she had wasted the last three years with misdiagnoses and incorrect treatments.

Dr. Mehra and the team of ENT surgeons he assembled performed a 13-hour surgery, which involved removing her entire right lower jaw bone, the floor of the mouth right next to her tongue, the nerve going through that area, and some of the salivary glands. Once the cancer was out, Dr. Mehra reconstructed the jaw bone and lining of her mouth by transferring tissue from her lower leg including the bone. “This was a complex procedure that involved transplanting her own bone and skin with its blood supply to the face to reconstruct her entire mouth. This transplant involved microscopic surgery to restore blood supply to the transplanted tissue so it would remain alive just as it did in the lower leg,” said Dr. Mehra. “The scars healed beautifully and you really can’t see them unless I point them out,” said Gina.

Gina stayed in the hospital for eight days to continue treatment and observation with the team of doctors right by her side. “I was a little uncomfortable in my own body. This was a huge lesson in humility—the whole process really put life in perspective for me.”

Dr. Mehra was meticulous and once he was sure that all of the cancer was gone, and she had recovered without any problems, he started Gina on the next step of her journey, which included radiation treatments. It was another challenge she had to overcome, but she did so gracefully and with an entire team supporting her. She started regaining her physical strength and began doing yoga, walking a mile per day, and going back to work full time.

“Dr. Mehra still answers all of my questions and even helped me connect my friend with another doctor for her breast surgery. He is such a great man…not just a brilliant surgeon. I will be forever grateful for his care and compassion.”

“My journey to recovery continues to be about the mind, as much as the body. But it wouldn’t have been possible without the care of Dr. Mehra and his team at Yale ENT. Each recheck is a mental challenge, but that comes with the territory,” she says.

She is feeling better about her diagnosis and adjusting to life as time goes on. She continues to push hard for the sake of her daughter. Gina walked away with some valuable life lessons and a newfound strength within herself. “Cancer makes you realize you are vulnerable to death and maybe a step closer…but you can't allow it to have power over you. I owe Dr. Mehra my life.”