Eric Bowles was 16 when he noticed what he thought was a canker sore on the side of his tongue. Over the next month the sore gradually grew, but only bothered him if directly touched. During routine x-rays at the dentist’s office, Eric asked them to be careful since he had a spot on his tongue that was sensitive. The dentist took one look and called an oral surgeon who met with Eric the next day and performed a biopsy of the lesion. Everyone was shocked when the diagnosis came back as squamous cell carcinoma of the tongue.
Classified as a cancer of the head and neck, squamous cell carcinoma of the tongue is not an uncommon diagnosis, but is usually found in older adults with a long history of tobacco and alcohol use. Eric, a junior in high school at the time, did not fit the criteria. He had just started singing lessons to train to become a classical singer, and did not foresee cancer as a part of that future. “I don’t remember being particularly afraid when I heard the diagnosis,” Eric said, now 21. “At that age I don’t think I could have fathomed it being something life-threatening. I just wanted to get done what needed to be done and move on with my life and my singing lessons.”
After seeing an ENT doctor, Eric was referred to Clarence Sasaki, MD, The Charles W. Ohse Professor of Surgery (Otolaryngology) at Yale School of Medicine. Along with his parents, Eric attended a Tumor Board where his case was presented and a treatment plan outlined. Everyone involved knew that Eric was planning on being a singer and they assured him that they would do everything they could to spare his voice, while still removing all of the cancer. Because the tumor was more than 5 mm thick, a neck dissection was performed to capture possible spread to lymph nodes. Thankfully no nodes were found to be positive, but it left Eric with a small scar. They then removed thin slices of his tongue until no cancer cells were seen, and after a week in the hospital, Eric was released and began his radiation treatments.
“Eric’s case is remarkable not only because of his young age and lack of risk factors, in 30 years of practice Eric is one of only two cases that I can recall, but also because of his bravery through a physically and emotionally challenging treatment process,” said Dr. Sasaki. “It comes as no surprise that many of my patients are the bravest people I have come to know.”
Eric was diagnosed in March of 2009, and received his last radiation treatment on August 20th of the same year. He remarked that the entire process went by quickly, which he said helped both emotionally and mentally. During the week he spent in the hospital before and after his surgery, Eric had his music with him on his iPod, but couldn’t bring himself to listen to it and risk associating music with what he was going through. Eric first knew he wanted to pursue a career in music during an 8th grade field trip to see Phantom of the Opera. He has since been part of the Eastern Connecticut Symphony Choir and the Opera Theater of Connecticut. He will also be joining the chorus of The Yale Graduate Voice Program for their performance of La Boheme.
Immediately following his last radiation treatment, Eric was back with his singing instructor. “My tongue was stiff, which made it hard to sing, so I had to learn exercises to help compensate for that. I was not only starting all over again, but had to learn new techniques,” Eric explained. Searching for a reason as to why this cancer, so rare in young adults, decided to strike him, Eric underwent blood tests and genetic testing, but they revealed no explanation. For Eric this was the most frustrating part of the experience, not knowing what caused it.
According to Dr. Sasaki, cancers of the mouth are typically associated with tobacco abuse in 75% of afflicted patients in their 50’s and 70’s; alcoholism increases this risk by 15 times. Whereas the human papillomavirus, type 16, 18, 31 or 45, is often found in patients age 40-50 with cancers involving deeper structures of the tonsils or base of tongue. Eric did not fit either of these profiles.
“Without the comfort and care Yale gave to my family and me, this would have been a completely different experience,” Eric said. “They made sure to explain everything to us before anything was done, and walked us through every procedure. It was important for me to be involved in the process, but I think even more so for my parents. ”
Except for a scar that runs from Eric’s ear to the middle of his neck, he feels as though he is back to where he would be had he not been diagnosed and is currently researching music schools to attend. Because radiation therapy may affect thyroid function later in life, Eric may require thyroid replacement therapy at some point, but his future is bright. Eric learned a lesson early on in life, that cancer can easily break down barriers such as age, but that we too can break the barriers of cancer through new treatments, a positive attitude, and high-quality care.