The surgeon, and the entire Providence Cancer Center medical team treating Roth, should have remembered that the Sherwood mom was different from the start.
Roth is 49. She has never smoked and is not much of a drinker. She had no reason to suspect she had oral cancer, the disease that eventually led to her leg surgery.
The 40,000 people diagnosed annually with oral cancer traditionally have been older men with a history of smoking and heavy drinking, said Dr. Bryan Bell, director of Providence's new multidisciplinary oral, head and neck cancer treatment center in Northeast Portland.
The new treatment center, which opened in December, is unusual for the Northwest in that it brings all the players on the oral cancer treatment team in one room, increases access to clinical trials and puts clinicians next door to researchers to promote collaboration between scientists and physicians in the search for a cure, Bell said.
It comes as more cases of oral cancer are being reported among people ages 35 to 55. Some oral cancer cases are linked to the human papillomavirus, or HPV, a sexually transmitted virus. About 7 percent of oral cancer patients have no apparent risk factors, like Roth.
A special education instruction assistant who works with autistic children, she was having her teeth cleaned seven years ago when the dentist found a spot on her tongue. The bump was biopsied and found to be leukoplakia, which can be a precursor to oral cancer.
Bell removed it three times over the next five years, always in the same spot.
The fourth time Roth detected the bump, her mouth hurt and she bled when she brushed. It was 2010 and she was visiting her husband, Chris, in Boston soon after he'd taken a new IT job. The family was thinking about relocating.
When she returned to Oregon, she went back to see Bell.
"I knew from the look on his face it was not something we'd dealt with before," Roth said.
What Bell found -- in a different spot than the first bumps -- turned out to be cancer. Surgeons removed a golf ball-sized tumor, two teeth, and a portion of her tongue and jaw.Nine months later, the cancer appeared in a different spot and she had to endure four more surgeries -- within a week -- and then more than six weeks of chemotherapy and radiation.
Roth lost much of her teeth and jaw. To reconstruct her face, surgeons used a titanium plate and part of the fibula bones, as well as some tissue and veins, in both of her legs.
Running again didn't seem likely.
Roth started getting exercise by "riding" her daughter's bike around her neighborhood near Sherwood High School, holding her feet down instead of pedaling -- kind of walking without completely putting her weight on her feet.
A month after her last chemo treatment, she went for her first "wog," as she calls it. Walk a little, jog a little. She worked up from there, adding distance and time. Soon she was running 5K and 10K races. A year after her last surgery, she ran a half-marathon in the best time of her life, 1 hour and 51 minutes, beating her personal best from 20 years ago.
People say her physical fitness probably explains how she has endured such difficult treatment and such an aggressive cancer. Bell said oral cancer can be especially debilitating since the treatment affects chewing, talking, hearing and how a patient looks.
Roth's fitness may have helped but she believes it's her attitude that has made the most difference.
?
"They say one out of four people will be diagnosed with cancer," she said. "I look at my family. There are four of us. If I can be the one and do that and have them not to have to go through it, I'll do it every time."
Running didn't hurt as much as she expected. More difficult was learning to talk again. Speech therapy has helped her use what tongue she has left, but some people have had trouble understanding her, and many stared.
Except the autistic children she works with. "They have a sense they're a little different," she said, "and they have more compassion for people who are a little different."
When Roth told her school principal that people;s stares upset her, he told her, "At least you're here to stare at."
The remark resonated. Of the 40,000 new cases a year, Bell said 50 percent will be alive in five years.
"I continue to be amazed by patients' courage," Bell said. "And Becky leads the heap. Nobody crystallizes hope and courage like that brave woman."
"I have a new motto," Roth said. "Say I won't and I will."
Bell said the chance for a recurrence is highest in the first two years. Roth's been clean for 16 months, including her most recent scan in December.
She said she tries not to think about the odds as she goes about her daily routine as a working mom of two active teenagers. But when she schedules her quarterly CAT scan, she cannot help but worry all the time, she said.
She does her best to keep a positive attitude. She thinks of her son, Christopher, who is a high school senior; and her daughter, Kelly, who's a freshman; and her husband.
"I want to be here for them," she said. "I don't feel like I did anymore than anyone would do in my situation. I have reasons I want to be here. I'm not giving up."
And every other day, because she can, she goes running.
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-- Larry Bingham?
Source: http://www.oregonlive.com/portland/index.ssf/2013/01/becky_routh_49-year-old_oral_c.html
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