Source: www.mdanderson.org
Author: Valerie Jones

A routine dentist visit prompted a series of tests that led to Jay Rusovich’s squamous cell carcinoma diagnosis in early 2023.

“My dentist was cleaning my teeth when he saw something in my throat,” says Jay. “He told me to get it checked out.”

Jay visited his primary care doctor and took a multi-cancer early detection blood test. While awaiting the results, Jay visited an ear, nose and throat (ENT) specialist. The ENT didn’t find anything, but Jay’s primary care doctor called him with the results of his blood test.

“He said the test showed that there was cancer in my bloodstream coming from my throat,” says Jay, who was 67 at the time. He went back to his ENT and had a biopsy. It showed Jay had HPV-related squamous cell carcinoma. It was early-stage and located on his left tonsil.

Jay hadn’t had any symptoms before his diagnosis. He had been going to the gym six days a week and eating organic foods. He didn’t drink or smoke.

After the initial shock of his cancer diagnosis, Jay focused on getting treated. He lived in Houston and knew of MD Anderson’s reputation as a leader in cancer care. So, he requested an appointment.

Determined to find the best squamous cell carcinoma treatment
Jay first visited MD Anderson West Houston to learn about treatment options. After hearing about traditional radiation therapy and chemotherapy, Jay was hesitant about the possible side effects.

After speaking to oral oncologist Mark Chambers, D.M.D., about proton therapy and researching the treatment online, Jay requested an appointment with radiation oncologist Steven Frank, M.D., who specializes in treating head and neck cancer patients with proton therapy. From Jay’s research, he’d learned that this advanced type of radiation would minimize the impact of radiation on the areas surrounding his tonsil.

Jay’s proton therapy treatment
Jay is glad he weighed his treatment options and chose proton therapy.

“As you enter MD Anderson’s Proton Therapy Center, you walk into a beautiful lobby where you’re greeted kindly and offered water or coffee,” says Jay. “Dr. Frank introduced me to his whole team. They were all great.”

This set a positive tone and helped ease Jay’s nerves.

“Dr. Frank was wonderful and had a great bedside manner,” says Jay. “He didn’t think I needed chemotherapy. Since the cancer was early-stage, he said I was a good candidate for proton therapy.”

In October 2023, Jay began pencil beam proton therapy treatment. He received 34 treatments over six weeks.

“They place the immobilization mask over my face. I’m strapped in. My eyes are closed. I steady my breathing. They put a warm towel over me. After they have the proton beam targeting the correct area, the radiation starts, but I don’t feel anything,” Jay recalls. “Out of 34 sessions, I only had one time where it felt like I was choking. One of the nurses came over and held my hand. That calmed me down.”

For the first two weeks, Jay received treatment Monday through Friday. He opted to do his treatments at night because he worked during the day.

Managing side effects from proton therapy
Jay began experiencing side effects from proton therapy treatment after the first two weeks. It started with a sore throat. Then he got mucositis and lost his sense of taste. The radiation also damaged his salivary glands and caused severe neck burns on both sides of his face.

“It was rough,” recalls Jay. “I was in such bad shape right before my last treatment that I had to go to MD Anderson to get fluids.”

Jay developed sores in his mouth, so he used baking soda rinses. He sings in a band, and he had to get right on top of the mic to sing because it hurt so bad, he recalls.

For two months, Jay couldn’t go to the gym, and he was on a liquid diet. He didn’t have an appetite. He lost more than 10 pounds.

“I was drinking six to eight shakes a day to get the calories in, whether I could taste them or not,” he says.

He also became fatigued and depressed.

Jay leaned on his close friends and his faith in God during the rough times undergoing treatment. He and a friend who’d just undergone cancer treatment leaned on each other.

“I don’t know where I would have been without my support system,” he says.

After he finished treatment, he banged the gong at the Proton Therapy Center and went home to start trying to heal.

Healing after proton therapy
Jay is now getting back to his old self. At his three-month checkup at MD Anderson, he learned that he is cancer-free. His mouth sores have healed, and his sense of taste is starting to come back. He goes to the gym regularly, doing everything from cardio to weightlifting.

“I would get a little tired at first, but now my energy is back to normal,” he says. “Exercise has played a massive role in my recovery. My state of mind has improved tremendously.”

As for the neck burns, Jay says his neck is still a little sensitive, but his skin is smooth.

“It’s actually better than it was before,” he says. “I think the radiation gave me a bit of a lift and a youthful enhancement.”

Blood work showed that the proton therapy impacted Jay’s thyroid function, so his care team gave him medication to boost his hormone levels. That’s been working well.

He has a few lingering side effects, like dry mouth and ear pain on the left side. He still feels like he made the right decision.

“My care team saved my life and helped me maintain my quality of life,” he says. “That’s as important as the treatment itself.”

Jay will return to MD Anderson every three months for checkups for the first year. After that, he won’t have to come as often.

“You have to come to a place of acceptance,” Jay says of his treatment and recovery. “There are side effects, but they’re going away,” he says. “Dr. Frank and his team are amazing. The treatment was five-star. They couldn’t have been more professional.”