'A great chance to be on the right side of history'
April 02, 2018
Survivor: Dr. Stephen Lucas not only survived prostate cancer but also HPV-related oropharyngeal cancer. He is an advocate for the HPV vaccine. The Chesterton, Ind., dentist poses here with wife, Mary.
. — After five days in an intensive care unit with a breathing tube, Dr. Stephen Lucas felt a calling.
He would use whatever voice and strength he came away with to help prevent others from enduring the same suffering he did after major surgery following his diagnosis of HPV-related oropharyngeal cancer.
"There's got to be some reason I'm alive," Dr. Lucas told the ADA News. "Maybe I could do something to help somebody out."
Today, Dr. Lucas, 63, is going on four years free of cancer, and he is an advocate among his patients for the HPV vaccine.
HPV is thought to cause 70 percent of oropharyngeal cancers in the U.S., according to the Centers for Disease Control and Prevention.
While HPV can be easily transmitted sexually, it can spread through any intimate skin contact or through body fluids.
Already a survivor of prostate cancer, Dr. Lucas sought medical insight right away in 2014 when he noticed a swollen lymph node in his neck. After the team he knew at the the Mayo Clinic from his previous cancer suggested a biopsy, he visited his ear, nose and throat physician to get it done.
"I knew there was a problem when I had an appointment for a week out and he called two days later and said 'We need to talk,'" Dr. Lucas said.
He had orophayrngeal cancer associated with the human papilloma virus strain 16.
Immediately, treatment decisions had to be made, Dr. Lucas recalls. He found doctors at Mayo Clinic and Northwestern Medicine in Chicago who specialized in the disease. The recommendation was intensive surgery along with a month of radiation.
In the summer of 2014, surgeons removed part of his oral pharynx, tongue and soft palate. The sore throat and inability to eat following that were nearly unbearable.
"It's the most painful thing I ever had in my life, and I had prostate surgery," he said.
Days later, he faced a setback when his surgery site started bleeding after he went for a run.
"I know that sounds nutty, but I had to do something," he said. "The more you lie around, the more you feel sorry for yourself."
It was after the bleeding that he was intubated in intensive care for nearly a week to fully heal. Weeks later, he gained back enough strength to begin radiation treatments about every other day for a month.
During this time, he worked several hours a week at his practice, sometimes driving to his radiation treatment on his lunch break.
"I felt like I could do it, so I did," he said of working through treatment. "You can either sit at home and feel sorry for yourself or go out and try and beat the thing. I imagine most dentists would have that particular attitude."
In the end, he did beat the thing. His final radiation treatment was in October 2014. Staff at the Mayo Clinic suggested he throw himself a big party last year when he hit the three-year cancer-free mark.
He's back to running and his normal routine. "I do everything I did before — probably more of it," he said.
The experience, he said, gave him more empathy toward his patients and emphasized his role as a screener of oral cancers.
He regularly discusses the HPV vaccine with parents of young patients. Some may not be eager to discuss it, he said, but he emphasizes that "here you have one particular kind of cancer that you can actually do something about," he said. "We can mitigate this if we get people to get the vaccine."
The CDC recommends that 11- to 12-year-old boys and girls get two doses of the vaccine six to 12 months apart. The CDC also recommends that girls and women through age 26 years and boys and men through age 21 years get the vaccine if they were not vaccinated when they were younger. Men who are 22 through 26 years old also may be vaccinated. The number of recommended doses depends on the age at vaccination.
The ADA is part of the National HPV Vaccination Roundtable, a coalition of public, private and voluntary organizations with expertise relevant to increasing HPV vaccination coverage in the U.S. For more information on this roundtable, including resources for clinicians, visit HPVroundtable.org
. To download or review an action guide for dental health care providers related to cancer prevention through HPV vaccination, visit EBD.ADA.org
The ADA also offers a brochure, "Get The Facts About Mouth and Throat Cancer
," that discusses HPV. Readers can save 15 percent on all ADA Catalog products with promo code 18122 until May 31. To order, visit ADAcatalog.org
or call 1-800-947-4746.
A head and neck cancer track at ADA 2018 – America's Dental Meeting offers dental professionals ways to learn about their role in cancer screening, biopsy and management. It includes the course Following the Path of Oral Cancer Diagnosis and Treatment (7822), where dental professionals will learn the basics of an oral cancer screening exam and examine the specialist's viewpoint of staging and treatment for defined cancer lesions. To register for this course or the meeting, visit ADA.org/meeting
Dr. Lucas said he would like to see organized dentistry do more to advocate for the HPV vaccine, such as launch a national advertising campaign, to urge dentists to educate patients about the vaccine.
"We have a great chance to be on the right side of history," he said.