• 4/18/2006
  • Charleston, SC
  • Holly Auer
  • Charleston,net

Oral cancer survivor’s cook book helps keep weight on with good food

George Chajewski is a man who lives for food. From European chocolate to tropical fruit to roasted game meats, fine cuisine is both his life’s work and his personal passion.

But when he was diagnosed with oral cancer last winter, the flavors died. After doctors removed a 16 mm tumor (almost the diameter of a penny) from Chajewski’s tongue, he was forced to trade his love for filet mignon for months of agony following surgery and radiation to his mouth.

As the head catering chef for the Medical University of South Carolina, cans of Ensure just wouldn’t do for Chajewski. He didn’t mind the butter pecan flavor, but it still wasn’t enough to keep meat on his bones. So he combined his skills in the kitchen with his newfound role as a cancer patient and created a cookbook that allows patients to eat well and stay healthy during treatment and recovery.

Because South Carolina has long suffered from high rates of head and neck cancer, Chajewski has a captive audience of readers. The Palmetto State ranks third in the nation for deaths from these cancers, which take the lives of 3.8 out of every 100,000 state residents. Just as smoking fuels many of the state’s other health woes – heart disease and diabetes among them – tobacco use is related to about 85 percent of head and neck cancers. Most often, the disease turns up in patients in their 50s and 60s.

But doctors also are troubled by the growing number of younger patients turning up with tongue and tonsil cancer who have never smoked, chewed tobacco or had significant alcohol exposure. It’s thought that the human papilloma virus, the same rampant sexually transmitted disease that causes cervical cancer, is to blame, said M. Boyd Gillespie, a head and neck surgeon at MUSC.

The U.S. Centers for Disease Control and Prevention estimates at least half of all sexually active men and women acquire the virus at some point, but a forthcoming HPV vaccine is expected to make a dent in that trend.

Unsafe sun exposure adds to the problem. Doctors are diagnosing more young people with advanced skin cancers that must be treated with the same punishing radiation therapy as oral cancer.

And although the treatment is tough to endure, head and neck cancers detected early – before moving to the lymph nodes in the neck – have at least a 90 percent cure rate. The mouth sores that often characterize the disease tend to appear early and persist for months, unlike a canker sore or gum irritation that heals in a few days or weeks.

After surgery, Chajewski underwent seven weeks of chemotherapy and radiation, which zapped his salivary glands and left his mouth and throat dry and inflamed. When his battered body needed high-calorie foods more than ever – cancer patients who drop too much weight are at increased risk of infection – eating had become torture.

“You just don’t want to eat,” Chajewski said. “You find excuses so you don’t have to.”

He dropped from 216 pounds to 167 in three months. There had to be a better way, he knew, to get through this disease.

His blender came to the rescue, coupled with a few modifications to his favorite recipes. Chajewski began with soups, like his favorite, one featuring mushrooms. Dicing the vegetables a little smaller than usual, then giving them a whirl in the blender after cooking, proved to be just the trick to help put his favorite flavors down his aching throat.

Chajewski also tweaked his chicken soup recipes, and though he normally discarded the skin and fat, his doctors told him to toss all that in the blender, too – that’s how badly he needed the calories. Heavy cream, too, became a standby thickener for soups.

In time, he’d assembled a passel of recipes that could carry oral cancer patients through their treatment and recovery without withering away, gagging on canned protein shakes or resorting to a feeding tube. It was a novel concept, one MUSC doctors say has potential to help thousands of patients a year.

Few studies have addressed how to provide better nutrition for head and neck cancer patients, Gillespie said.

“In the past, we have often taken the approach that we’ll just put a feeding tube in their stomach and they can stop eating and we’ll just pump food into them,” he said.

But that often creates more problems than it solves. Without eating, throat muscles weaken and bands of scar tissue form that can cause long-term swallowing difficulties. Plus, robbing patients of eating’s social and sensory pleasures stands to hurt their emotional state, making them less able to cope with the rigors of treatment and recovery.

“They know they would enjoy partaking, but they can’t, so it’s just very awkward,” Gillespie said. “They end up retreating from the table and the socialization. That’s an important aspect we’ve been ignoring.”

Chajewski’s recipes solve both the physical and social issues. The dynamic dishes, with flavorings borrowed from the Deep South to the Far East, are both soothing enough for the patient and tasty enough to leave their friends and families asking for seconds.

Bayou Duck Gumbo and African Potato Root Soup, for instance, are among the choices in the collection, which offers soups, sauces, pastas, meats and desserts.

Chajewski will prepare a selection of recipes from his cookbook today at a banquet for head and neck cancer survivors as part of Oral, Head and Neck Cancer Awareness Week, which doctors hope will draw at-risk South Carolinians in for free screenings.

BY Holly Auer
The Post and Courier