Cancer treatment and compassion in equal measures
25 July 2018
Even with the best treatment, half of all head and neck cancer patients die of the disease. Dr Satyesh “Sat” Parmar compassionately accompanies them on their treatment journeys.
With the "World Head and Neck Cancer Day 2018" approaching on July 27, Sat discussed his experience as a consultant surgeon specializing in oral and maxillofacial, head and neck, and reconstructive surgery at the University Hospital of Birmingham (GB).
“Our patients tend to be slightly older because head and neck cancer is extremely rare in children. The patients come from all walks of life,” he explains at the end of a 12-hour day of surgery. His voice brightens as he discusses his patients: “We get to know our patients and their families very well and—hopefully—take them through the most difficult journey of their lives.”
Honesty as a foundationIn preparing his patients for that journey, Sat combines a gentle demeanor with complete honesty.
“I’m always really honest, even if it’s not what the patients want to hear. I’ve found that if you’re totally honest, the patients can accept almost everything. As the relationships evolves from the first consultation, I get to know everything about them: what they do for a living, how they spend their time, their hopes and plans for their lives, the details of their living situations,” he said. “I really feel for the patient and that’s absolutely critical. When they come back to the clinic for post-treatment follow-up, it’s like seeing an old friend. With most patients, these are relationships I’ll have for the rest of my life.”
Most patients, he said, are profoundly grateful for more than the treatment delivered by the team in Birmingham. They are also grateful to have expert caregivers who respect their personal cancer journeys.
“Head and neck cancer deals with your appearance, your identity, the way you speak, whether you can eat. Our aim in reconstructive surgery is to get our patients looking, eating and speaking normally,” says Sat, who—in addition to his work as consultant surgeon—has become a prominent figure in AO CMF as a member and AO CMF Master Course Chair. “The social function of one’s appearance and ability to eat and speak normally is enormous. And the satisfaction of being able to help patients in this way is enormous, too. For me, it’s a privilege.”
Sat is all too aware that the odds of his patients completely beating cancer aren’t particularly promising. Medical training does not fully prepare a surgeon for the death of a patient.
“There are some who say we shouldn’t get attached to our patients, but for me, that is not an option,” Sat says, quick to explain that even after 15 years in practice, he still takes patient setbacks, including deaths, hard. “If I weren’t upset, I think there would be a problem with me.”
“I really feel for the patient and that’s absolutely critical. When they come back to the clinic for post-treatment follow-up, it’s like seeing an old friend. With most patients, these are relationships I’ll have for the rest of my life.”
Honored by long patient relationships
He feels honored that patients and their families continue to include him—and often his team—in their lives long after the treatment journey has ended.
“One patient—a woman in her mid-40s—had her cancer return a second and third time. She said, ‘I’ll only let you operate if you’ll come clubbing with me,’” he recalled. “So, our secretary, nurses and I went to a club with her. It was a bit of both fun and sadness.”
In another case, Sat and his team successfully operated on a 31-year-old man, but the patient suddenly bled to death on the day he was to be discharged.
“Everything had gone to plan, and I took his death quite hard,” Sat said. “A year later, his wife rang me up to meet with the children and her. At that meeting, they asked me every possible question: Was it my fault? Why hadn’t I stopped the bleeding? It was a hard meeting. The family later raised £8,000 for a head and neck cancer charity at my hospital.”
In cases where Sat and his team can save a life, they often make a friend for life. Early in his career, he operated on a six-year-old cancer patient; every Christmas following that successful intervention, the patient’s mother sent Sat a photo of her daughter.
“The patient is now 19 years old and just got into the police academy,” he says, adding that he recently met up with the family for a meal.
Tim Martin (top photo, left) and Prav Praveen are his consultant colleagues and Sat is quick to point out that such success stories are only possible in a cohesive, like minded team.
The head and neck team is supported in Birmingham by great anesthetists, operating room teams, intensive care, ward and outpatient staff as well as head and neck specialist nurses.
“The way we work as a team allows us to carry out more complex surgical procedures and our results have been good,” he said. “It’s easy to be pleased when an operation goes well, but we always remember the patients for whom treatment didn’t go as well.”
To learn more about World Head and Neck Cancer Day (#WHNCD2018)
Get to meet and learn from Sat Parmar at the next AO CMF Course—Advances in Congenital or Acquired Deformities
22-24 November 2018 in Hannover, Germany