Eric: Tongue Cancer Survivor

As an aspiring vocalist, 17-year-old Eric Bowles was excited to begin taking vocal lessons in February of 2009. At the time, he was focused on what most teenagers think about―school, friends and, of course, his singing.

By mid-March, Eric had found a sore on his tongue. Thinking it was a canker sore, he showed it to his mother. Believing the same, she told him to use warm water and salt to help it heal. Within a week, it had gotten worse.

Coincidentally, Eric had a routine dental visit scheduled that week. Before his routine X-rays, Eric showed the dental assistant his tongue. “She was clearly alarmed,” Eric said. “She left the room immediately to get the dentist.” After looking at the sore, the dentist referred him to an oral surgeon. At that moment, Eric and his mother began to realize the sore might be something more serious than they thought.

The oral surgeon suspected Eric had tongue cancer and removed some of the tissue to have it analyzed. The biopsy came back positive for squamous cell carcinoma, a common form of epithelial cancer found in the mouth and throat. What was rare in Eric’s case was its presentation in someone so young, since such cancers usually occur in patients in their 50’s to 70’s who smoke and drink alcohol. This cancer can also be caused by Human Papillomavirus (HPV), but Eric did not test positive for HPV. HPV usually affects patients who are in their 40’s and 50’s. Eric fell into a growing trend of oral cancer patients, in their late teens and twenties, whose numbers are increasing in this country and who share no known risk factors for the disease. Upon better understanding the cancer, Eric’s oral surgeon felt that Eric should work with an ENT surgeon who specializes in head and neck cancer and referred him to Dr. Clarence Sasaki, the Charles W. Ohse Professor of Surgery at Yale.

While under Dr. Sasaki’s care, Eric and his mother attended the Tumor Board at Yale, which consisted of several top cancer care specialists. The Tumor Board reviewed Eric’s case, medical history and lifestyle to create a personalized treatment plan for Eric.

The Tumor Board recommended a partial glossectomy and supraomohyoid neck dissection to spare Eric’s speech and swallow functions. Because Eric’s cancer was 12mm thick, it carried a 60–70 percent likelihood of spreading to the lymph nodes in the neck. A function-sparing nodal dissection was chosen to avoid injuring major nerves, muscles and vessels.

“Everyone at Yale was really great. I felt comfortable with their plan of action because they knew what they were doing. I actually had my surgery the same day,” said Eric. Dr. Sasaki performed the surgery with frozen section guidance in which individual layers of the affected area are removed and tested for cancerous cells. These layers are removed until the cells test negative for cancer. This technique helps ensure that no more tissue is removed from the tongue than is necessary. Planning to continue pursuing his dream as a vocalist, this type of minimally invasive surgery was particularly important for Eric. Other surgical options included dose-escalated chemo radiotherapy, which was not chosen for Eric because of his young age. This treatment, which also would have been effective in curing his disease, would likely have affected his salivary function, dental and swallow health and permanently stiffened his neck muscles. These side effects would have prevented him from pursuing his dream as a professional vocalist.

After the surgery, Eric’s mom was able to stay in the hospital room with him for his five days of post-surgical recovery. “When I was in the hospital, I never worried. Everyone was so informative, and I always knew exactly what was happening,” he remembers.

Eric feels grateful for the comprehensive and personalized care as well as the immediate attention he received from Dr. Sasaki and his team. “Everything happened so quickly that I was able to focus on getting rid of the cancer instead of dwelling on the fact that I had cancer. It didn’t really hit me until I was receiving radiation. Then I realized, ‘Wow, I had cancer!’”

Eric began his radiation treatments on July 8, 2009, shortly after he started a summer job working for a local Parks & Recreation Dept. “I had radiation scheduled 5 days a week for a total of 30 treatments, so I would go to work all day and then go to the hospital for my radiation treatment. My attitude was just to deal with the cancer head on and move forward,” Eric said.

While Eric could not take vocal lessons while receiving radiation treatments, he was able to resume them.

Eric remains cancer free and plans to continue the pursuit of his singing career.