Photo: Robert Hope following his revolutionary surgery
A Lancashire dad has had his jaw re-built after cancer with revolutionary surgery using bone from his leg and 3D computer planning.
Robert Hope, 52, who lives in Clayton-le-Moors near Accrington, has praised East Lancashire Hospitals NHS Trust for going over and beyond with his treatment and says he is amazed at the results.
Robert, who is married to Sally and has a son and daughter, was first diagnosed with cancer affecting his jaw over four years ago after his dentist was unhappy with white lesions in his mouth and referred him to specialists.
In 2013, Robert had a biopsy at Burnley General Teaching Hospital and was diagnosed with aggressive squamous cell sarcoma.
Robert, a self-employed joiner who used to have his own company making UPVC windows, had surgery to remove the tumour at Royal Blackburn Teaching Hospital and was back at work fitting windows just 11 days later with staples in his neck.
Robert recalls: “They removed the lesion and they took away my left upper jaw and I lost about five teeth and my gums.”
Robert had radiotherapy and a course of chemotherapy a few months later. After that, he had six-monthly check-ups to monitor his progress.
Life had got back to normal for Robert – but then four years later, the cancer returned.
Again, it was Robert’s dentist who spotted some lesions and his mouth so he took photos and sent them to East Lancashire Hospitals NHS Trust.
Robert went to see Naseem Ghazali, a consultant in oral and maxillofacial and head and neck oncology and a reconstruction surgeon.
Ms Ghazali has praised Robert’s dentist for being so on the ball as biopsies showed it was cancer.
She says: “The cancer was now affecting Robert’s lower jaw while before it was his upper jaw.
“As his first cancer was quite aggressive, he had needed radiation afterwards and all the area where the new cancer was had been previously radiated.
“This presented a problem as radiation causes a lot of scarring and this meant the tissue and blood supply would not be as good.
“So I knew treating the new cancer in the lower jaw would mean facing more difficulties and I needed to think about how to re-build Robert’s jaw.”
Ms Ghazali knew that the removal of the cancer would leave a large defect so she had to borrow bone from somewhere else in Robert’s body to re-build his jaw.
Ms Ghazali explains: “It was not just the bone that Robert was losing but the gum and a bit of the cheek so I needed bone and soft tissue.
“The only way I could do that was to use some of his leg bone and the skin next to it to re-build the jaw and I took a blood vessel too.
“I used the same technique as you would for an organ transplant but instead of borrowing an organ, I was borrowing bits of Robert’s own body to re-create and re-build the parts he had lost due to the cancer.”
The complicated aspect of Robert’s case was that Miss Ghazali knew she needed to very accurately fit Robert’s leg bone to his jaw so it would be an exact fit and not affect his jaw and teeth.
Ms Ghazali worked with a team of medical engineers to mastermind the surgery using 3D surgical technology planning.
Ms Ghazali says: “CT scans from Robert’s legs and jaw were uploaded on to software and we used that to virtually build on his jaw and we planned where we would put the bone.
“This allowed the medical engineers to customise the titanium plates we would use to fix the leg bone to the jaw.
“It also allowed us to customise the surgical cutting guides which tell me where I need to cut.
“I used similar cutting guides on the leg bones and detached the blood vessel and tissue and transplanted it to his jaw.
“The surgery took about 10 hours. But without the 3D planning, it would have taken an additional two to three hours.
“It went very well and the bone flap worked beautifully.”
Robert says he is delighted at how well the procedure went and is full of praise for the care and treatment he received at East Lancashire Hospitals NHS Trust.
He says: “They made me a new jaw using my leg bone. They used my fibula bone which does not actually do anything apart from support muscles.
“I lost my incisor teeth, my molars and wisdom teeth and all my jaw.
“I was worried about what my visual appearance would look like and whether I would be able to talk or eat after losing so much of my jaw.
“I was also concerned about whether I would be able to cycle as I am a keen cyclist and love taking off on my bike.
“But I didn’t want to die so I knew I had to go ahead with the operation.
“However, the end result is amazing and they have done a really good job.
“I can talk and eat and ride my bike and live life as normal.
“I look a bit different but nothing startling or noticeable. I wasn’t expecting to look this good!
“Ms Ghazali is wonderful and so dedicated and caring. She is the perfect surgeon.
“It is incredible what they can do and the surgery I had was quite ground-breaking. I never expected the NHS to go to such great lengths.
“You would have thought you’d have to pay privately for such amazing surgery.
“I was only in hospital for seven days and my recovery has been fine.
“Everybody at East Lancashire Hospitals has been so caring, respectful, kind and considerate.
“I am really pleased with the end result of my surgery and I am happy as I can still do everything in life that I want to do.”