Mr. X, the 77-year-old gentleman was being evaluated for his sudden change of voice quality over the last 6 months. After an initial ENT examination, he was found to have a small growth over his vocal cord (voice box). A biopsy sample was taken which confirmed the presence of cancer. Further scans reported no other abnormality. He was diagnosed with Stage I cancer of the voice box. He was referred to me for radiation treatment.
Till this, Mr. X was like any other patient coming to me for radiation. And stage I cancer would have been treated with a small field of radiation and most of the patients will remain cured forever. However, his course of treatment and life changed when I started his radiation planning and noticed a small gland on his neck that was not detected earlier. Immediately I started reviewing his previous scans in more detail and could find that the small gland was present earlier as well but was considered an innocuous infectious gland. However, looking at the gland’s nature, I was doubtful and wanted to further investigate it. Mr X was explained about the situation and an USG-guided FNAC was done from the neck gland. To my assumption, the report came out to be positive for cancer.
The final stage was converted to stage III rather than stage I and now the entire situation changed for Mr. X. Rather than small field radiation alone, I decided to treat him with radiation and combination of a targeted agents. Although he was 77 years at that time, he was a fit 77-year gentleman able enough to accept and undergo the treatment. I was confident in the care we provide at our hospital and to take care of any anticipated side effects.
Mr. X came for his last follow-up after almost 9 months after his completion of treatment and follow-up scans and laryngoscopy showed the absence of any disease in his body. He is cured of Stage III cancer.
Mr. X is fortunate that my meticulous observation and timely intervention led to a correct diagnosis of the stage of cancer and treatment. Missing the neck gland would have left him treated and failure of treatment and essentially his chance of cure would have remained a mirage to him. I am happy that he has followed my advice and accepted the treatment I had recommended for him and accepted the anticipated side effects. His case is one of the best examples of meticulous radiation planning and a great team effort. I am thankful to him and his family for keeping their faith in me. I am also thankful to my other colleagues for entrusting my opinion and to my junior colleagues for their constant support and care of the patient.