Andrew is a head and neck patient at Cromwell Hospital who had a cyst removed from his throat using transoral robotic surgery (TORS). Andrew’s wife shared with us his journey, from diagnosis to post surgery.
Andrew is 41 years old, and in August 2021, he wasn’t really feeling like himself. There was nothing specific he could put his finger on, just generally low levels of energy and sometimes a feeling that he wasn’t really ‘present’. We have private BUPA medical care through our employers and were due our two-yearly medical health check, and so had a health assessment at Nuffield Health, Romford (Essex).
The GP that Andrew saw as part of this assessment was great – she really listened and took on board how he had been feeling (albeit he couldn’t exactly pinpoint ‘what’ the problem was). She referred him to a cardiologist and a neurologist for further investigations.
By November 2021, he had undergone a number of tests such as an ECG, an EEG, a heart monitor for one week, an MRI scan, etc. The cardio results all came back clear. However, on his brain scan, there was an incidental finding on the periphery of the scan area. It was not within the area of the brain that they were specifically scanning, but on the outlying edge. The consultant said that it appeared to be a cyst – it was regular in shape, with a defined edge, and may possibly have always been there. To get further imaging however, Andrew had a follow-up MRI scan, which provided better visibility of the area in question.
By spring, Andrew had been referred to a consultant in a private hospital in London. Further imaging scans showed that the ‘cyst’ had grown. A fine needle biopsy was performed, but the results were inconclusive – which was largely put down to the ‘cyst’ being difficult to access (as it was reached through the hard palate of the mouth) and multiple cell types in this area often providing inaccurate results. The consultant advised that this needed to be removed surgically; as whether it was a cyst, or a benign or malignant tumour, it really should not be there! He referred us to Mr Asit Arora at Cromwell Hospital, given his experience in operating on these types of growths – but also the fact that it could potentially be suitable for TORS (which would prove to be far less invasive than traditional surgical methods, which would have required access either via the neck, or more intrusively through breaking the jaw).
Upon meeting with Mr Arora, both Andrew and myself were immediately put at ease. He was confident that Andrew was a suitable candidate for TORS, and that the benefits of this versus traditional surgery were substantial – both in terms of minimising risks as part of the surgery, but also in terms of post-operative recovery. He explained everything in a way that we fully understood, was happy to take the time to answer our many questions, and at no point did we feel pressured or uncomfortable. We felt confident in Mr Arora, and we were clear that TORS for the removal of the growth was the correct path to follow.
Andrew’s surgery went ahead on the 4th of August 2022 at Cromwell Hospital. The care that he received there was outstanding. As somebody who doesn’t like operations at the best of times, Andrew was understandably anxious. The team were considerate; taking the time to ensure he understood what the procedure would entail, the post-op recovery plan, and what to expect from the coming days and weeks. Thankfully, the surgery went as well as we could have hoped for, and four to five hours after going down to surgery, he was back in his room.
The next few days Andrew remained in hospital – gradually upping his fluid and food intake. Whilst he started to reintroduce foods slowly to begin with (such as clear broths, clear teas and water), we were both astounded that less than 12 hours after his operation he was able to (very carefully) eat omelette, mash potato, and ice cream! Andrew was discharged on the evening of Saturday 6th of August – although there was no pressure for him to leave, and should he have felt the need then he would have been able to stay a further night. Upon being discharged, all the medication, sprays, gargles etc were explained in detail – with phone numbers provided in the event that we were at all concerned about Andrew’s recovery and needed to speak with a member of the medical team.
The TORS approach meant that aside from limited jaw mobility, to look at Andrew you would not have known that he had undergone surgery. There are no visible scars, and within six to eight weeks his jaw movement returned to normal (once all internal bruising had subsided). Fortunately, by adhering to the regime advised by Mr Arora, Andrew recovered well from his surgery. Most medications were completed within two weeks of surgery, and at his post-op consultation with Mr Arora a couple of weeks later, he was pleased at how well Andrew was doing.
Even at the point of Andrew’s operation, we still did not know exactly what it was that was being removed. It was at his post-Operative consultation that Mr Arora shared with us that the histology had confirmed it was in fact a carcinoma ex-PA i.e., a malignant tumour that had developed within a previously benign tumour. The tumour removed was approx. 5 to 6cm, and as you can imagine this is never something that you want to hear. Mr Arora was, as always, incredibly caring, and considerate in his approach though and provided us with a welcome balance of support, information, and recommendations of what’s next.
Overall, Andrew’s recovery has been good. Understandably, his cancer diagnosis was a shock, and something that is still taking time to process. The support of the team at Cromwell though, has been remarkable – and this is underpinned by the care we have received from Mr Arora, who we would not hesitate to recommend. His patience, his empathy, and the time he takes to ensure you are completely comfortable in understanding what is happening makes such a difference. His expertise in this field, and his ability to perform TORS gives patients a welcome alternative to traditional, invasive, surgical options. I think it is fair to say that Andrew’s recovery was significantly benefited by the fact that it was carried out via TORS. Although it has been a challenging time, we are in no doubt that this has been made easier by being in the care of Mr Arora, and we are incredibly grateful for all that he has done for Andrew.