Mr. Rajput who is courier man by profession had developed swelling on the right side of his lower jaw and pain, 2 months ago. He consulted local and many big hospitals but nothing helped him subside his pain or swelling. With time, he started having difficulty in chewing food, due to falling of lower and upper jaw teeth also difficulty in open his mouth. Since the patient's health continued to deteriorate; he was referred to Wockhardt Hospital, Mira Road wherein he was able to get rid of the tumor.

Dr Atul Narayankar, Consultant Medical Oncologist, Wockhardt Hospital, Mira Road, highlighted, "The patient presented with swelling and pain in the lower right jaw for two months. CT scan and biopsy confirmed that he was suffering from stage IV head and neck cancer (that includes cancers in the buccal mucosa throat, lips, mouth, nose, and salivary gland). Tobacco use, heavy alcohol use, and infection with human papillomavirus (HPV) increase the risk of head and neck cancers. The primary growth of the tumor was large and it has spread to the nodes in the neck."

Dr. Narayankar added, "As the tumor was locally advanced, upfront surgery was difficult. Hence, it was planned to shrink down the tumor with chemotherapy, and the patient was counseled. He received two cycles of chemotherapy (3 drug regimen) before surgery. The patient had an excellent clinical response to chemotherapy cycles and was then operated by Dr. Sheetal Radia and team."

Dr. Sheetal Radia, Head and neck cancer Surgeon, Wockhardt Hospital, Mira Road "The patient encountered right lower jaw pain and swelling and ulcer on the right side of mandible so more than half mandible becomes nacrose up to the condyle and opposite incisor teeth. Enlarge lymph node involved till behind the neck. After completing chemo sessions, in the month of April and May., the patient was scheduled to undergo Composite bite resection with Bilateral neck dissection to remove the tumor. Also, flap reconstruction that was done by Dr. Akshay Deshpande. The size of the tumor was 9.5cm, maxilla 4cm."

The more than half lower jaw cut with the cancerous lymph nodes in the neck were removed along with the upper alveolus bone, buccal mucosa muscle, and the skin, and it was replaced with the flap from thigh muscle (anterolateral thigh flap). It is a versatile flap that may be used for any defect in the body that requires soft tissue reconstruction with skin.

Dr. Radia said the procedure lasted for 5 hours and he was discharged after 7 days after surgery. He can eat, swallow, and speak properly now. The pain and swelling have disappeared and have got a near-normal face. Head and neck cancers are one of the most common cancers in India due to the extensive use of tobacco products. If a patient diagnosed at an early stage then surgery with proper management (chemotherapy/surgery/Radiotherapy) these patients can be cured and can live a good quality of life. Also, ongoing COVID-19 pandemic has affected cancer patient management to a large extent all over the world. Delaying treatment worsens the outcome of the disease."