When 55-year-old Todd Stokes of Warren, Michigan, noticed a small canker sore in his mouth, he never expected the news that would soon follow.
While eating pizza in October 2019, the canker sore that had been there for a week was causing him so much pain that he could barely eat. He decided to go to the store to get some topical over-the-counter medication.
Two days passed and the treatment wasn’t helping, so Stokes called his primary care physician, who prescribed a round of antibiotics and quickly referred him to an oral surgeon to take a closer look and biopsy the canker sore.
Within two days, Stokes was called back to the oral surgeon’s office and was given the diagnosis of squamous cell carcinoma of the floor of the mouth -- a cancer arising in the lining of the mouth.
He said he was in shock, especially after everything he had been through in his life up until that point (we’ll get back to that shortly).
“I began to cry -- the tears were for my mother,” Stokes said. “I didn’t know how I was going to tell my family this news; I had finally rebuilt my life and was thriving.”
A challenging past
Stokes had spent years as a recovering alcoholic and former smoker. He had been sober for 14 years prior to his diagnosis and had experienced other health emergencies throughout the years.
He suffered from esophageal varices -- abnormal, enlarged veins in the tube that connects the throat and stomach -- in 2004 and again in 2006. Each time, he went into a coma-like state and almost didn’t survive.
Stokes’ sobriety began in 2006 when he decided to seek help through a 12-step recovery program following his second health emergency. The strong fellowship formed through that program, and support from his family, played a big role in his life getting back on track.
“I had rebuilt my life from being almost homeless with no job, to becoming sober and dedicating my life to helping others through recovery fellowship. Now I had to tell my family I have cancer,” Stokes said. “Even though my heart hurt for my family and what they were about to go through with me, the years spent in the recovery program had taught me to take things one day at a time. I knew this would help my cancer journey. I couldn’t change the fact that I had cancer, but I could accept it and move forward with a positive approach.”
Next steps lead to fast action
After receiving his cancer diagnosis, Stokes’ oral surgeon sent him directly to Henry Ford to meet with Dr. Tamer Ghanem, the head and neck cancer and microvascular surgery director with the Department of Otolaryngology, to prepare for next steps.
Stokes’ case was presented to the Head and Neck Tumor Board and his best option for a cure involved surgery with the possibility of additional radiation and/or chemotherapy afterward.
Reconstructive surgery
“Todd’s cancer was unique because he was a fairly young patient who was very active and full of life,” Ghanem said. “It is a very serious, life-threatening diagnosis with a tough recovery.”
A stage 3 squamous cell carcinoma in the floor of mouth, like Stokes’ tumor, is a serious cancer diagnosis, with a 60% to 70% survival rate at five years. The surgery that was needed to remove Stokes’ cancer also included extensive reconstruction of the floor of mouth and tongue, because removing it would affect his speech and his ability to eat.
“Our goal was to not only beat the cancer, but to give him the best shot at a functional quality of life following the surgery,” Ghanem said.
“They didn’t waste any time,” Stokes said. “The team was so caring and sincere, they explained everything about what the surgery would entail and what my options were. I never felt afraid, and I knew I was in the best hands.”
Preparing for surgery
Stokes’ surgery was scheduled for Nov. 12 at Henry Ford Detroit. Prior to going into surgery, the Henry Ford team gathered his family to explain what to expect along with follow-up care.
“Everyone from every area of the hospital came in and shared what their role would be during the procedure with all my loved ones,” Stokes said. “That made a lasting impression. I never felt like a patient. I felt like (my) family and I instantly knew everything was going to be alright.”
The surgery went better than expected. Dr. Vivian Wu, Stokes’ cancer surgeon, and Ghanem, his reconstructive surgeon, were removed all the cancer and reconstructed the floor of his mouth and tongue with vascularized tissue from his forearm skin, eliminating the need to remove his jaw.
Stokes went through six weeks of radiation therapy after the procedure and some speech therapy to help with recovery. He is currently doing well and has limited speech impairment.
“I owe my life to Dr. Ghanem, Dr. Wu -- everyone I encountered at Henry Ford was truly exceptional. It wasn’t just one person -- they all stood out,” Stokes said. “It was a true team approach.”
A new outlook on life
Stokes is living life to the fullest these days and enjoys spending time with his family. He still struggles with some difficulties from the surgery, including sore teeth and the loss of feeling in half of his tongue, but he continues to share the positive impact the diagnosis had on his life and spreads the spirit of hope and faith to everyone he meets.
“My outlook on everything has changed,” he said. “Things like cancer can cause you to think of only you, but you have to understand that you can be the light and give hope to others through the process.”