Giving Voice to Tongue Cancer

It was in October 2008 when Leo "Jojo" Flores, a manager in a multinational semiconductor company for 25 years,felt a singaw (canker sore) in his tongue. He thought he could get rid of it with a strong mouth wash or with home remedies and over-the-counter products.

"After a month or so, the singaw was still there and it was  becoming not just uncomfortable but painful as well," said Jojo

He kept on delaying his checkup due to the numerous holidays during the month of December that year. By the first week of January 2009, Jojo had to fly to the United States for a three-week business trip. He was only able to see his doctor again around the second week of February 2009.

"My doctor ordered a biopsy and after a week’s time, it was confirmed. I had cancer of the tongue. (squamous cell carcinoma).I would later learn that it was Stage IV," related Jojo.

After seeking different opinions, Jojo eventually came under the care of Dr. Daniel Alonzo, who at the time headed the Department of Otolaryngology of The Medical City (TMC) in Pasig (Dr. Alonzo is currently the head of TMC’s Cancer Center). He scheduled Jojo for an operation right away, following a month-long series of pre-operation tests which Dr Alonzo also required him to take.

The operation schedule coincided with a number of significant events – the 16^th birthday of Jojo;s daughter, his son’s graduation from elementary school and a major project for Jojo’s company. SoJojoappealed to Dr. Alonzo if the operation can be moved to a later date.

"I distinctly remember Dr. Alonzo replying that it was  up to me: ‘You can choose between your career and your obligations, or the risk to your life.’ It was a tough decision considering these significant once-in-a-lifetime family events, never mind the work issues, but I eventually chose the latter and proceeded with the surgery on March 2, 2009,"said Jojo.

The procedure took all of 19 hours which involved a lateral dissection of his front throat; tongue removal; harvesting a flap from the left front thigh to be sutured permanently in the mouth to cover the void from removing the cancer-stricken tongue; inserting a tracheostomy tube to temporarily assist in breathing, and inserting a temporary feeding tube (PEG) in the stomach area for food intake. After the operation, Jojo spent about 36 hours in intensive care, then two more weeks in the recovery room before finally being discharged. Jojo went home with 90 percent of his tongue removed, radically altering his ability to speak and to ingest food.

His cancer treatments was far from over, though. He was on medical leave from work for five months. For the entire month of June, he underwent daily radiation therapy concurrent with six chemotherapy sessions. And for the first three years after surgery, he visited Dr. Alonzo for regular checkups every three months.

"When I went back to work five months after the operation, I was no longer the same Jojo my officemates knew. The cancer which hit me has greatly affected my social skills. Obviously, I no longer speak and sound the same.Needless to say, my food intake is forever changed."

"Colleagues would come visit me at my office to say ‘hi’ to me, check on how I was doing, give their sympathies and congratulatory remarks for being back at work, etc. I usually have answers for them for anything that they would ask about my condition, what I went through.

But I won’t forget this one employee who came to my office and, in the course of our chat, asked me, "Sir, bakitganun, kung ano pa yung best asset ninyoyun pa ang'kinuha Niya?"

“As a manager in the company, I am used to conducting and facilitating meetings, video- or phone-conferences, giving training sessions, making presentations, talking to an audience, etc.  Heck, I was even fairly good at karaoke sessions – ballads, pop rock and all!

“To say that I was totally unprepared for that question is an understatement. I certainly pondered on the question and couldn’t help but share the same with very few people close to me, but who similarly didn’t quite have the answer.

“Until a relative told me: Well, perhaps God wants you to excel in other areas,” shared Jojo.

Eight years to-date, Jojo continues to be virtually cancer-free and is reintegrating himself as a productive member of society, albeit the many challenges he faces from his disability and likewise brought about by his age.Jojo left the corporate world in 2011 and has since been involved in project-based assignments. He is, however, a regular invitee to various sessions in TMC and in the Ateneo School of Medicine and Public Health (ASMPH) regarding cancer-related and Patient Partner programs.

A wide reader of various topics ranging from technical (usually electronics, computer-related), to medical (cancer-related), to nutritional, to current events, to spiritual, to daily Bible reading, Jojo adds, “I am quite introspective of the articles or topics I read. For me, it is more than just absorbing knowledge or having the desire to do so.”

To keep fit, Jojo does light exercises and lifts light weights once in a while.

Jojo’s regular diet is normally plant-based, getting the nutritional balance from a combination of fruits, vegetables, legumes, and whole grains; usually blanched or boiled, uncooked at times. But all these (including cooked meats added occasionally) will have to go through a blender, and must achieve the right consistency for proper ingestion and to appreciate taste – not too thick, not too thin.

“To Dr. Alonzo and his team whom I’ve had a reason to meet eight years ago: my heartfelt ‘Thank You!’This may not suffice to convey the real worth of this phrase, knowing that I am but one among a multitude of patients’ voices who already mentioned this;for making me whole again to the best of your and your team’s abilities.From the time I first sought treatment with you to post-surgery up to the present, as I have openly shared in many speaking opportunities, I never felt that I was ‘just another task’ out of the many routinesthat you all had to perform, given your collective gifts. So then may this article be a lasting testament as to how our merciful and just the Creator chooses His instruments tasked to fulfill His plan, to work for the good of all those who love Him.”

For those who wish to contact Jojo for anything, you may do so through the Center for Patient Partner of The Medical City.