Hi All,

My father (84 years old) had reconstructive surgery five weeks ago as he had squamous cell carcinoma that had spread to his right jaw and cheek. When they did all the testing before surgery they saw some some lymph nodes in his neck that looked suspicious. My father didn’t want surgery at first due to his age, but the other option would be narcotics and eventually a very horrible death. He decided to do it. It took awhile to schedule due to the large team needed. During that time he was on narcotics and out of his mind. It was horrible for all and especially my mom. The surgery took over 15 hours and was more than they anticipated due to having replace part of his cheek. Results show all cancer gone and no lymph nodes were cancerous. We have decided against radiation due to my dad’s emotional state and he doesn’t want to do it. He is done as he puts it. The reconstruction of the jaw had to come from his shoulder bone given the leg bone would not have been enough.


My mom is still alive and both of them have been living in the same house I grew up in. However, my mom has become forgetful since she fell in November. I have three siblings, but my mom and dad have always depended on me. Therefore, I am the one that has been making the decisions regarding drugs, care, etc while still trying to work a full time job and taking care of my 16 year old and three older children with 3 grandchildren. Needless to say for the past few weeks my life has been crazy to say the least.

We also found out after the surgery that my dad has vascular dementia, which they saw on a MRI before the surgery. I don’t know if that would have changed his mind, but it would have been good to know.

Dad spent three weeks in the hospital due to not being able to find a extended care facility that handles a trach and feeding tube. Also he needed a sitter a lot of the nights as he kept trying to get out of bed. Finally a facility took him. We moved him almost two weeks ago. He is having a tough time adjusting as he just wants to go home.

We had a post op appt last Wed with the reconstructive surgeon. He is physically healing well, except he can’t swallow properly. They did the swallow test over a week ago and he failed. The pudding went the wrong way and they said he can’t eat due to aspirating. The dr also mentioned he may never be able to as some patients can’t after this. Needless to say, this was new news as we were told two weeks after surgery he could begin with broth etc. I am devastated, but won’t give up as the most enjoyable thing my dad likes to do is eat. The speech therapist gave him two exercises. I told him to do non stop. From everyone’s experience, do you think he will be able to eat again?

The recovery process is so much more than we ever thought. Any others that felt unprepared and overwhelmed?

Thank you all for any help you can provide.

Aspiration (or worse, silent aspiration where the patient does not know he has aspirated) is dangerous. The patient may end up with severe pneumonia which may cause death, especially in patients who have been weakened by cancer treatment. That was what happened to my husband.

His esophagus was closed by scarring after radiation and he was on a feeding tube. Not happy with the situation, he sought out an interventional radiologist who did a new procedure on him to open up the esophagus. The whole time, while he was searching for the doctor, my husband was doing his swallowing exercises. After his esophagus was opened, he was able to eat very soft, puréed food. That, unfortunately, lasted for only half a year. He developed silent aspiration and kept having bouts of pneumonia. He was warned not to take anything by mouth. In general he tried, but I know there were times when he sneaked a sip or two of soda. He ended up with severe pneumonia and passed away.

I know how tough it is to not eat by mouth, especially on social occasions. We, however, need to balance the risks with fulfilling our desires. The swallowing muscles, if not used, become atrophied. That’s another that needs to be considered.

Welcome to OCF, Sab! Im very sorry to read what your father has been thru already! He is very lucky to have you helping him.

A mandibulectomy is a MAJOR operation!!! Ive been thru it myself and know how many struggle with their long recovery. Patients who have had this surgery after going thru radiation treatments will have a compromised ability to heal. Thats what I ran into among many other complications. A complete recovery for this very invasive procedure is 2 years. Even when I was 1 year out after having the surgery, I still had a long way to go before I needed to accept my current health being as good as it will ever get. But my case had complications and all kinds of things very different from most patients.

When discussing different patients histories and trying to make comparisons, it never is a truly accurate assessment. Everybody is different and no 2 people are ever the same theres just wayyyy too many things that arent the same like, age, other health conditions, availability of quality medical care, stage of cancer, exact location and size of a tumor, same intake, same height weight, living in the same general area, same marital status and allergies... I could go on and on listing things that make it impossible to ever get an accurate picture of a similar patients experiences.

Our site is made up of oral cancer (OC) patients/survivors and their caregivers. We do NOT have medical backgrounds, degrees, clinical patient experience, or extensive schooling learning about medical things. Our knowledge comes from first hand experiences of going thru some difficult situations and we pass along what we picked up along the way. That said its not really possible to know if your father will ever eat like he used to again or not. What one experiences another may not. Bets thing you can do to help your father is to keep in constant touch with his medical team and discuss anything that changes right away. Id also suggest you should read the main OCF site to learn more detailed info about OC. An educated caregiver is a very strong advocate for her patient

You may want to speak to his doctor and a dietitian about redoing the barium swallow test down the road. Most patients will recover and relearn to eat after most procedures. But, theres always an exception to every rule too. Ask the doc about high protein whey powder to increase your fathers daily protein intake. Protein helps to speed up healing so that may be a big help. It comes in powder form and is easily mixed with any liquid if your father gets his nutrition from a feeding tube he can still try the whey powder.

Wishing you and your father all the very best with his continued recovery!!!