Prosthodontics lab technicians play key role in cancer treatment

Tucked away in our Head and Neck Center are three artists. But instead of choosing the perfect color for a painting, they select the perfect tooth from tray after tray of various artificial ones – about 1,000 in all. While not traditional works of art, the custom prosthetics created by these prosthodontic lab technicians are invaluable masterpieces for our patients. “Each person’s mouth is unique, similar to a fingerprint,” says Cong Nguyen, lead dental laboratory technician. “So everything we create is customized to perfectly match each individual patient.” The lab technicians partner with our oncology and maxillofacial prosthodontic doctors, who care for patients with some of the most complex cases of oral loss and reconstruction. Restoring what’s lost due to cancer and cancer treatments often goes well beyond implants done at a local dentist office. Many times, the prosthetics made here include structures such as the roof or floor of the mouth. These sophisticated implants, called obturators, help restore proper air flow and enhance patients’ abilities to eat, drink and speak. The intricacies involved in this work require specialized training. It’s a career that runs in William Graham’s family. “My dad did this in Mississippi, and I started working with him when I was 18,” says Graham, who joined MD Anderson in December 2015 as a prosthodontic lab technician. Teeth as art Our dental artists make about 20 custom obturators each week. Following surgery, a u-shaped tray filled with a thick liquid is pressed into the patient’s mouth to create an impression of the remaining teeth and tissues. The technicians create an exact replica of the patient’s mouth by...

Lymphoma treatment teaches survivor to prioritize health

As an attorney, Corey Ellis has endured strict deadlines and harsh hours. All of that, though, pales in comparison to the stress he experienced when he was diagnosed with stage IE extranodal N/K T-cell lymphoma, a rare cancer that was in his nasal passage. “There’s been no more stressful episode in my life,” he says. “The sort of cancer that I had, statistically, never happens in the United States. There’s almost no information available for it.” Seeking extranodal N/K T-cell lymphoma treatment Corey received his lymphoma diagnosis in July 2013, while living in eastern Tennessee. “I will never forget the doctor’s words: ‘I’m so sorry Mr. Ellis, but I have some bad news. You need to get your affairs in order,’” Corey recalls. “I was completely defeated temporarily by those words.” Hoping for better news, he went to a hospital in Nashville. When he found out that they’d never treated his diagnosis, he turned to the internet to search for experts. He found one — a researcher in Japan. That researcher connected him with his protégé, Yasuhiro Oki, M.D., here at MD Anderson. In early September, Corey flew to Houston to meet with Dr. Oki and was struck by how quickly Oki looped radiation oncologist Bouthaina Dabaja, M.D., into their meeting, even though he didn’t have an appointment with her. “Unlike the other physicians I talked to, they immediately had a treatment plan in mind, and they were obviously well-coordinated,” he says. “I made the decision then and there that I was going to receive my lymphoma treatment at MD Anderson.” Dabaja and Oki’s plan included 30 rounds of...

Pediatric cancer patients connect through a robot

Ava can’t take her eyes off the laptop screen. But it’s not a game or a movie that has so fully captured the 7-year-old’s attention. It’s her friends. Although Ava is confined to her hospital room, she’s able to talk with her friends in another part of the hospital. She’s even able to travel with them and participate in their activities. Ava’s able to virtually break through her hospital walls using a 4-foot VGo robot. “Ava’s face lit up when they brought in the robot,” says her grandmother, Elvia Tobias. “She was so disappointed when she had to be admitted to the hospital and wouldn’t be able to attend the rest of the special camp. She’s used the robot all day, which allowed her to focus on happy things rather than missing out and being sick.” VGo robots put pediatric cancer patients in control Imagine video chat interactions combined with Segway mobility, and you’ve got a good picture of the VGo. The patient sees through the robot’s camera and a screen shows the patient’s face. Everything’s controlled by the patient through software loaded on a laptop. “The kids quickly learn how to use the controls. They’re usually better than I am at driving it around,” says Adrian Jackson, who has supported the VGo project for two years as a support services analyst in Pediatrics. MD Anderson has two VGo robots that are used in a variety of ways to help keep our childhood cancer patients connected and involved in school and life while they’re being treated. The primary goal is education, according to Daniel Smith, manager, Pediatric Education and...

Cancer treatment side effect: Neutropenia

Neutrophils are a type of white blood cell that helps your body fight infection. A condition called neutropenia occurs when the number of the neutrophils in your bloodstream is lower than normal, putting you at risk for illness or infection. If you receive chemotherapy or radiation therapy, you may develop neutropenia because the cancer treatment prevents the production of neutrophils. Patients who have cancers that affect bone marrow, such as leukemia, lymphoma and myeloma, also may become neutropenic. To understand more about neutropenia, we spoke with Carmen Escalante, M.D., professor and chair of our General Internal Medicine department. What are common symptoms of neutropenia? Neutropenia may not cause symptoms and is most often diagnosed by a blood test. Some patients may be asked to take their temperature regularly throughout the day to monitor for infection. Signs of infection include a temperature of 100.4 or greater for more than one hour. What does it mean if my doctor says I have febrile neutropenia? It means that you have both a fever and a low white blood cell count. When this happens, you are often advised to see your doctor right away or go to the emergency center. Your doctor will perform a careful evaluation to look for a source of the fever and prescribe antibiotics. Sometimes, the source of the fever can’t be identified, and this is called a fever of unknown origin (FUO). Antibiotics are still prescribed in this situation, and often the fever resolves as the neutrophils increase. What are the signs of infection caused by neutropenia? Typical signs of infection include: Fever of 100.4 or higher for...

My journey to overcome three cancer diagnoses

Everyone’s cancer journey is unique, and mine has certainly been more unusual than most. It began in August 2005, when I was diagnosed with two different breast cancers — one in each breast. Then, just four months later, I was diagnosed with stage II colorectal cancer after noticing intermittent bleeding in my stool. Having lived in the Houston area my entire life, I felt that there was only one place to go — MD Anderson. I had my first appointment with my breast surgeon, Rosa Hwang, M.D., in August 2005. Coordinating my breast and colorectal cancer treatment Dr. Hwang performed a double segmental mastectomy to begin my breast cancer treatment. In October, I started chemotherapy, but that was put on hold once my colorectal cancer was diagnosed. My care team did an amazing job coordinating treatments for each cancer. My radiation oncologist, Thomas Buchholz, M.D., recommended we first shrink the colorectal tumor with radiation, so I had daily colorectal and breast radiation for seven weeks. I also had concurrent chemotherapy during this time, under the care of Cathy Eng, M.D., for my colorectal cancer. In April 2006, Miguel Rodriguez-Bigas, M.D., performed surgery to remove the colorectal tumor, at which point I was declared cancer-free! However, I still had six months of chemotherapy after surgery. The treatments were exhausting, especially as I continued to work as a third grade teacher and as a mom to my three kids, then ranging from middle school to college. However, all of their activities gave me a sense of purpose, and I wouldn’t have made it through without the support of my family and...