A compass for cancer treatment
All roads led oral cancer patient to UF Health Jacksonville
By Kristin Sibbitt
In July 2014, Roberto Johnson was brushing his teeth.
Never a smoker or a drinker — he never any used tobacco products — Johnson, 58, felt a lump on his upper right jaw. But because there was no pain, he ignored the growth.
Soon, Johnson began to notice some discomfort. He scheduled an appointment with his dentist, who recommended a root canal.
“A couple of weeks after the root canal, I discovered I still had the same symptoms and the lump on my gums,” Johnson said.
After a second root canal and a few more weeks of pain, Johnson’s dentist referred him to an oral surgeon, who removed the lump and sent the tissue to a lab, where it was biopsied.
On Oct. 22, 2014, Johnson learned that the tissue was positive for adenoid cystic carcinoma.
“When I got the results, you really could have knocked me over with a feather,” Johnson said.
Immediately, he was referred to Rui P. Fernandes, M.D., chief of head and neck surgery at UF Health Jacksonville. Johnson was diagnosed on a Wednesday and seen by Fernandes that Friday.
Johnson was unsure of what the road ahead would look like, but when Fernandes explained the details of the surgery Johnson’s anxiety was eased.
“He told me that it would be a major surgery, require the loss of a few teeth, bone and part of my palette,” Johnson said. “He took the time to show me a skeletal model of where I would be losing my teeth and bone.”
Working as a sergeant for the Jacksonville Sheriff’s Office, Johnson was familiar with UF Health Jacksonville.
“As a first responder, I knew that UF Health had an excellent reputation as a trauma center, but I didn’t know they were also known for cancer treatment,” Johnson said.
Because it was a major surgery, Johnson asked Fernandes about seeking a second opinion. Fernandes encouraged Johnson to speak with other physicians so he would feel more comfortable about the operation and gave him the names of doctors in Miami, Tampa and Gainesville. Johnson scheduled a meeting with a physician in Gainesville who told him, “it’s not the building that matters, it’s the doctor.”
After hearing those words, Johnson felt positive that moving forward with Fernandes was the right choice. Johnson then met with Fernandes to schedule the surgery and was even more certain of his decision.
“In my lifetime, I have never ever had a doctor give me their personal cell phone number,” Johnson said. “When I was given Dr. Fernandes’ cell phone and told that I could call him any time, I knew then that he was the right person for me to do my surgery with.”
Johnson’s adenoid cystic carcinoma affected his upper jaw and needed surgery as well as postoperative radiation therapy, Fernandes said. Johnson’s surgery would entail the removal of a significant part of his upper jaw and possibly immediate reconstruction with a transplant from his lower leg.
“Given his profession as a police officer, which is not only physically demanding but also requires continuous interaction with the public, it was paramount that we maintained his facial form and ability to do the required physical activities of his job,” Fernandes said.
Fernandes discussed several options with Johnson before the surgery and decided the end goal was to eliminate the cancer but also maintain a normal facial appearance. Fernandes was able to accomplish those goals without the need to perform the transplantation.
“It was pretty much tears of joy,” said Johnson, of hearing the news.
Johnson remained in the recovery unit at UF Health Jacksonville for two and a half days following his surgery.
“The whole time I was there, the staff was very nice. I couldn’t have asked for a kinder group of people to take care of me,” Johnson said.
With the surgery complete, Johnson was referred to the University of Florida Proton Therapy Institute for radiation therapy to ensure the cancer was eradicated from his body.
“Roberto has now completed his radiation therapy and is back to work as a police officer without any external evidence of his surgery or radiation,” Fernandes said. “The future is bright for him.”
Johnson is extremely grateful to Fernandes and the staff for keeping him alive and well.
“I was sent to the right person from the beginning,” Johnson said. “I was referred to UF Health and Dr. Fernandes the day that I was diagnosed. On my own I considered other people, went to Gainesville and called other local hospitals just trying to find out if I was heading in the right direction.”
Johnson conducted extensive research on his own to make sure surgery was the correct course of treatment. Everything he read directed him back to UF Health and Fernandes. He learned that he needed a head and neck surgical oncologist who also specialized in oral and maxillofacial surgery. Again, all signs pointed to Fernandes, who has the recommended credentials.
Johnson recommends UF Health and Fernandes to anyone he meets.
“He’s passionate about what he does. His staff is tremendous and he’s a down-to-earth person,” he said. “I thank him from the bottom of my heart for everything he’s done for me. I really feel that the doctors here at UF Health definitely saved my life.”