Cancer Care
Cancer care includes a variety of treatments, systematic therapies, surgery and clinical trials.
By Emma Avila, epackard1@iuhealth.org, writer for IU Health’s Indianapolis Suburban Region
A nickel-sized cancerous tumor on Melissa Vincent’s tongue changed her life. After surgery at the IU Health Schwarz Cancer Center, she is using her voice to help others.
For Melissa Vincent, a simple trip to the dentist changed her life. When she went for a routine visit in late 2019, the dental team noticed a few faint gray lines under her tongue, which can be indicative of cancer.
Over the next few months, an oral surgeon performed a biopsy and diagnosed her with moderate dysplasia, which is a precancerous condition. In early 2020, Vincent’s oral surgeon closed his clinic for two months due to the COVID-19 pandemic. By the time she returned in May, her tongue was visibly worse, and she was referred to Indiana University Health.
She connected with Dr. Michael Sim, a surgeon specializing in head and neck oncology and microvascular reconstruction at the IU Health Joe & Shelly Schwarz Cancer Center in Carmel.
Sim took a biopsy of Vincent’s tongue. It confirmed her precancerous condition had worsened to cancer. The diagnosis was stage one squamous cell carcinoma.
Sim ordered a positron emission tomography (PET) scan, which uses a radioactive substance called a tracer to look for disease in the body. It showed Vincent had a tumor, about the size of a nickel, in the left side of her tongue. The best option to treat it would be through surgery.
“It is the most common type of oral cancer we see, arising from the tissue that forms the mucosa, or outer lining, of the mouth, including the tongue,” Sim explained. “It is standard of care to treat oral cancers with surgery first to provide the best outcomes possible.”
Preparing for surgery
For Vincent’s case, Sim performed a glossectomy, a surgical procedure in which the affected portion of the tongue is removed. It was scheduled for June 26, 2020.
“Hearing Dr. Sim explain how he would reconstruct my tongue, using my own wrist tissue and an artery from my left arm, sounded crazy in the moment. But it was also comforting. I trusted Dr. Sim implicitly and felt grateful he had a plan that would remove the tumor from my tongue,” she said
Part of the procedure included skin from her leg grafted onto her wrist to help cover the area where the tissue and artery were taken. Also, lymph nodes from her neck were removed for testing to assure that the cancer hadn’t spread anyplace else in her head or body.
When Vincent woke up after surgery, she was happy to learn Dr. Sim had removed the tumor successfully and that her lymph nodes showed her body was free of the cancer.
“The surgery went as perfect as we can ask for, and she recovered well after surgery without any complications,” Sim said.
“I knew in my soul I would be okay, and that God was using Dr. Sim to help heal me,” Vincent shared. “I know the Lord was sanctifying my life through cancer for new purposes.” She added, “I’d be remiss though if I didn’t say what a huge blessing it was that neither chemotherapy or radiation were required as part of my postoperative care.”
The road to recovery
Vincent remembers how intensive the first month of recovery was, something Sim had told her to expect. She followed a strict regimen of cleaning and caring for the areas affected during surgery.
Seven days after the procedure, the staples in her neck where the lymph nodes had been taken were removed. The stitches in her arm dissolved and her wrist had accepted the skin from her leg that was grafted onto it.
Though everything else was progressing smoothly, Vincent was still getting used to the feeling of the changes in her mouth.
“The side of my tongue that was replaced by my wrist felt heavy and dependent on the non-affected side to move it,” she recalled.
Her speech was difficult at first, but it came back within a week.
“Dr. Sim encouraged me to talk,” she said. “I’ve always been a talker. I have a Bachelor of Arts in Communication and my career choices have always required that I rely heavily on my ability to speak.”
Vincent returned to IU Health University Hospital every six months for imaging to confirm the cancer had not returned. By September 2022, all the images showed that there were no signs of cancer, and she was released from Sim’s care.
The toll cancer takes on mental health
Though Vincent healed physically from the surgery to remove her cancerous tumor, she did not expect the affect her journey would have on her mental health.
“Honestly, the easiest part of my cancer journey was having the surgery,” she explained. “The hardest part has been the head game that’s followed. Even as a person with a deep Christian faith, I recognize that my brain needs the same care my body received after the glossectomy.”
Vincent and her husband documented every part of her cancer journey, which she shares through her blog and an outreach ministry they call Simply Spoken Life, which was named to give a nod to Sim and the successful glossectomy that has her speaking again. Through her work, Vincent enjoys sharing what a successful journey through oral cancer can look like, and she also says it has been therapeutic.
Now, almost three years post-surgery, Vincent regularly attends two IU Health cancer support groups, one held virtually through IU Health West and another at the IU Health Schwarz Cancer Center.
“I knew, in my spirit, that I needed to be with people who have walked my same path,” she said. “So, when I learned IU Health and the Schwarz Center Cancer offer support services for cancer patients, I was confident I’d receive even more great care, and maybe also make some new friends.”
Finding support among other cancer survivors
Michelle Hoy, an oncology social worker at IU Health West, hosts Virtual Cancer Support Group. The group started during the COVID-19 pandemic and is open to anyone with any type of cancer being treated at any hospital.
“We have people attend from as far as Canada and North Carolina, as well as many locations across Indiana,” Hoy said. “Emotional support is key when dealing with a cancer diagnosis. Some days will be harder than others. Knowing where to find support on the days you need it can be very beneficial in coping with your illness. Some people find support from family, friends, neighbors and coworkers. Many find support groups can be helpful in a different way than family and friends. Talking with others who have had cancer, even if it is a different cancer from yours, can help you feel less isolated, better understood, and even learn about resources that have helped others in a similar situation.”
Erin Kollada, a speech-language pathologist at the IU Health Schwarz Cancer Center, with the help of a few others, runs a support group called Community & Connection. It is for people with oral, head and neck cancer.
“The goal of this group is to provide an opportunity for community, connection, education and support for patients, families, friends and caregivers who have experienced the impact of head and neck cancer and its treatment,” Kollada explained. “I want patients to know there are several resources available for social and emotional support, both within the medical community and outside of it. Working with a behavioral health provider who specializes in the oncology population is ideal, but everyone has different needs which are met in various forms.”
Both support groups meet monthly, and Vincent has found both beneficial.
“We lament a little bit,” she said with a bit of a laugh. “After cancer you manage these, sort of, new emotions. It’s just like anything hard in life, every now and then, the teapot has to let the steam out, so to speak.”
Vincent added, “Both Michelle and Erin do a phenomenal job of guiding these important conversations. It’s been a blessing to hold space with people who understand my feelings. We also celebrate each other’s successes, the hurdles we’ve cleared and the people who’ve helped keep us alive.”
The goal is education and awareness
Through sharing her story, Vincent hopes to offer encouragement to other cancer survivors and their loved ones.
“I have, very literally, grown to love my scars. They’re my storybook. I use them as a platform to share my faith in Jesus. I’m overwhelmed with joy about my surgery outcomes and how great my care at IU Health has been.”
Through her openness and vulnerability, she has even made an impact on her care team.
“Ms. Vincent is an amazing human being,” Sim said. “She is a true warrior and an inspiration.”
Now, Vincent hopes to use her journey to spread awareness.
“I want other cancer patients and their families to see that you can get better physically. And mentally, which I’m learning is a huge component of cancer care, you can also feel healthy and whole.”
Cancer care includes a variety of treatments, systematic therapies, surgery and clinical trials.
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