“When I got the results, you really could have knocked me over with a feather,” 58-year-old Roberto Johnson said concerning his diagnosis of adenoid cystic carcinoma. Johnson was never a smoker or a drinker — he never any used tobacco products.
In July 2014, a mundane task became a life-altering experience. Johnson was brushing his teeth when he came across a lump on his upper right jaw. Since there was no pain, he ignored the growth.
After a few weeks, Johnson began to notice some discomfort and scheduled an appointment with his dentist, who recommended a root canal. Unfortunately, that didn’t resolve Johnson’s pain.
“A couple of weeks after the root canal, I discovered I still had the same symptoms and the lump on my gums,” Johnson explained. 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 the lab, where it was biopsied.
On Oct. 22, 2014, Johnson learned that the tissue was positive for adenoid cystic carcinoma. Immediately, he was referred to Rui P. Fernandes, MD, 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. 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 explained.
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.”
Fernandes explained that Johnson presented with a diagnosis of an adenoid cystic carcinoma affecting his upper jaw and needed surgery as well as post-operative radiation therapy. 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 explained.
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. When Johnson heard that news, he was very emotional. “It was pretty much tears of joy,” he said.
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. “Although I did have some side effects, I think my side effects, because I had the proton therapy, were far less than I might have had if I had conventional radiation,” Johnson said. “Going through the radiation with the proton, I never had a need for a feeding tube, and I never had any issues with swallowing.”
Fernandes is pleased with Johnson’s recovery. “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.
“Anywhere I went, I kept coming back to UF Health and Dr. Fernandes,” Johnson said. “No matter what turn I made, no matter who I spoke to over the phone, no matter what website I went to, no matter what research I did, I ended up coming back to UF Health. I realized that in God’s providence, he had me sent to the right person at the right time right from day one.”
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.”
An oral cancer survivor’s story – Roberto Johnson
Rui P. Fernandes, MD, DMD, FACS, FRCS
Associate Chair, Department of Oral and Maxillofacial Surgery; Chief, Division of Head and Neck Surgery; Program Director, Head and Neck Oncologic Surgery and Microvascular Fellowship; Director, UF Center for Reconstructive Surgery; Co-Director, UF Health Skull Base Team