Husband was told today that his jaw bone would be removed & replaced by a bone from his leg, in addition to a metal plate; I read somewhere that "donor" bones are sometimes used in neck surgeries. Is it possible to use a donor bone instead of his own bone? I was too upset today to remember to ask the surgeon this question.

I was told that to ensure the highest possible likelyhood of success they would only use my own bone. No chance of rejection that way.

I had a little more than 40% of my jaw rebuilt using titanium and fibula from my left leg. I limp, and walk with a cane BUT...I am alive, my jaw functions about 90% of what it was before cancer, you can't even see the scar unless I point it out to you, and did I mention...I AM ALIVE.

It's not an easy surgery. I was on the table for 17 hours. I spent 12 days in hospital, but I was eating soft foods by the time I left. I woke up able to talk, and had issues during recovery...at least up to the point when I started radiation.

It will be O.K.
It's not going to be easy, but it will be OK
Wayne

Emmylou,

I had this same surgery 4 years ago and it's a fact that it's better to use the bone from his leg. My leg is a little weaker than the other one if I want to run, and it gets tired after a long day but if I'm just walking during a normal day, no one would know I was missing one of the bones. My jaw works fine, not much different from the real one, just a little stiffer.

As Wayne said, the surgery is long and tough but he will get through it just as many others have before him!

Wayne & Minnie: Thanks for your prompt responses. I understand a little better now. So encouraged to know that both of you have survived your brave battles against "IT"! Were either of you Stage IV at time of surgery? Thanks again!

Emmy,
Yes, I was a stage IV when I had my surgery. I also had a neck disection and radiation.

Minnie: May I ask, how long were you actually in surgery? How long did you stay in the hospital following surgery? How long after surgery did you have to wait for chemo/radiation? Did you get replacement teeth? Forgive me for so many questions! I am so happy to hear a Stage IV success story!

I was also a stage IV cancer. I had 17 hours of surgery ( mandiblectomy, free flap elevation(fibula) free flap from forearm for tissue and blood supply, skin grafts from thigh, radical neck dissection, 56 nodes removed, Trach)
and was out of the hospital in 12 days.

It would have likely been a shorter stay but I had a heart attack about 20 hours after I came out of surgery, and that set things back a good bit.

I had a 6 week course of IMRT 10 weeks after surgery, and that was the part I could have done without. It was brutal...way tougher than the surgery.

I have spent several hours today reading archived posts, and can only find TWO posters referencing SCC Mandible. Is this cancer location unusual? Dr. says he will remove jaw from mid chin to right ear. I can see with the naked eye that the cancer has already spread toward the front gums, just in four weeks! I'm scared to death! Surgery is not scheduled until July 19, almost three weeks more. No results from PET/CAT scan done last Wednesday. Any idea of how long it takes to get these results? If the cancer has metastisized to lung, will this change the course of treatment already discussed? Buzz' doctor is on vacation until July 9. I'll go nuts before then! thanks for your time! I really appreciate any info you are willing to share. Lois

Can I give some advice?
Sit down,lean back, close your eyes and take a few deep breaths. Seriously...you'll feel a bit better.

You will probably see/hear some PET results early in the week. If there is metastic processes going on, it will likely change the treatment course since they have to address the metastices as well as the primary. It may add chemo to the mix treatment wise.

I think that you're research is fairly accurate. Oral cancer is relatively rare to begin with, and when it invades the mandible as opposed to the tonsils, or base of the tongue seems to me to be fairly infrequent.

My mandible was removed from midline of my chin to just below the TM joint. That is the point of critcal decision; if the joint is invaded, it cn't be effectively reconstructed to functional form. It often changes the procedure in that case; since the function of the joint is critical to chewing, without it there is no more chewing.

An all liquid diet doesn't need the rigid jaw, and to reduce the surgical trauma and "legacy" problems of bone removal, they may opt to replace the jawbone with dense muscle tissue from the thigh.

That makes the physical appearance acceptable, but there is no real functionality for eating. Talking is OK, though, and the appearance is close to normal.

Why is he waiting that long for his surgery? At sage IV, time is pretty critical, and waiting for a doctor to get back from vacation....well, I think personally I'd be getting a different Doctor, but that's me.

Cancers grow at a fixed rate. If it takes "X" weeks for it to grow from 1cm to 2cm, it takes the same amount of time for it to grow from 4cm to 8cm.

I had 5 weeks between diagnosis and surgery, and my tumor (the part that was visible) grew from something that was the size of the end of my finger to something that was 6cm long.

It does appear that it's "speeding up"...it's not, it's growing at the same rate as it was all along.

I will keep you in my thoughts. If there is anything that you want to ask about in more detail, or have any "what's it like after treatment" questions, send me a private message and I'll pass along my email and phone number to you

Wayne

Wayne....a question that is bothering me, concerning the grafting of the fibula. I will be faced with a decision regarding this surgery for reconstruction of my maxilla. How is the grafted bone attatched and made to grow into the existing bone in your mouth?

Of course, your huge surgery was all done at one time, so you didn't heal and then have to make a new surgical bed.

I am hesitant to interfere with my excellent healing...but I am oh, so tempted to have this surgery. I don't have to decide now, but I am not getting any younger, and at nearly 64, I'll need to decide soon, before they think I am too old to do it.

In my case, before removing the cancerous portion, they anchored the chin and the hinge on the left side together with a titanium strap.

On an xray, it looks a bit like a bicycle chain; full of holes. the reason for doing that is allignment; if they removed the canerous portion first, the muscles in the face and jaw would torque everything off to the side, and they couldn't re-align things properly.

Once the bad stuff was removed, they sculpted pieces of bone, and placed them behind the titanium. Initially they were held in place with staples (internally...they are still there) but they collect bone dust from the fibula removal, and pack it in, and around the titanium plate.

Over time, the bone (which also had tissue and blood supply brought along) actually grows and migrates into the openings in the titanium, making the two elements effectively one.

I had a panographic xray done a few months ago, and it's pretty cool to see what they did. Everything has healed up very well. YOu really wouldn't know I had that much done if I didn't point out the scars to you.

It is very strong, even right after surgery. My mouth was never wired, or retained. I woke up able to talk , and had food orally within a week.
Wayne