Posted on Monday 23 November 2020
Annabel Lovick with her sons Harvey (left) and Harrison (right).
A mother of two who was diagnosed with tongue cancer has made a full recovery following extensive surgery which included a tongue reconstruction.
Annabel Lovick, 48, from Bromley in south-east London, was shocked to be told she had grade 2 tongue cancer earlier this year, especially as she did not fit the usual profile of someone with the disease. Mouth cancer affects around 8,300 people every year in the UK.
In February she underwent a complex operation at Guy’s Hospital, which is one of the country’s leading centres for head and neck cancer management, to remove the cancer and reconstruct a large part of her tongue which needed to be taken away. She has since made a good recovery and is now keen to raise awareness of the condition, particularly among younger people.
Annabel, a life coach, discovered a lesion on her tongue around a year ago. She said: “I didn’t think much of it at first and tongue cancer never crossed my mind. I heard that it was Mouth Cancer Action Month in November and even though it hadn’t changed, it prompted me to see my GP. Because I was fairly young, female, a non-smoker and I don’t drink, she said not to worry about it.”
But by the New Year it had started to change so Annabel saw her dentist who advised her to have it checked at Guy’s Hospital. At her appointment in February, Annabel was given an MRI scan and had a biopsy a few days later. She was stunned to be told she had tongue cancer.
Annabel, who has two teenage sons, said: “I was told that I needed to have a big operation because the lesion was changing quickly and was the size of a small grape. I would need around a third of my tongue removed through an incision in the neck, lymph nodes in my neck taken away, teeth removed and a tongue reconstruction using tissue from the back of my leg.
“I couldn’t believe I needed so much surgery for something so small. It was a lot to get my head around but I focused on staying positive and had to practice what I preached as a life coach. I had the operation less than three weeks after being diagnosed.”
The 10-hour surgery was led by Mr Georgios Orfaniotis, a plastic surgeon, and Mr Richard Oakley, a head and neck cancer surgeon and clinical lead for head and neck surgical oncology at Guy’s and St Thomas’ NHS Foundation Trust.
Annabel stayed in hospital for two weeks and needed a tracheostomy (a small plastic tube in the windpipe that forms an artificial airway) for eight days.
She said: “The tracheostomy was very unpleasant because I had no swallow mechanism and couldn’t feel my tongue. It was removed once I could breathe through my mouth and it was like I had to learn to breathe again.
“At that point I could eat and drink, starting with yoghurt and mushed up food. I needed a mirror as I couldn’t feel my mouth or tongue, so I had no concept of how close to my mouth the spoon was. It felt like a foreign object in my mouth.
“People were surprised my voice still sounded the same, it was a bit like speaking with a big sweet in my mouth. Eventually as time went on it felt as though it got smaller and smaller.
“Overall the recovery was better than I thought it would be. I remember feeling fine around three or four months afterwards as I wasn’t tired and could eat anything.”
Annabel was delighted with her treatment at Guy’s Hospital. She said: “I was massively pleased with my care, the team was amazing. Every day a consultant or surgeon saw me which was more attentive than I expected. It’s unbelievable that such technical surgery can be done. They were brilliant.”
Mr Orfaniotis said: “Annabel has done amazingly well. To see her talking you wouldn’t notice anything has been done. Even with the tissue being taken from her calf, she was running again two months after surgery.
“Annabel’s tumour has been completely removed and we will monitor her closely for five years. Her early diagnosis means she has a very good chance of being cured. Seeing patients like her do so well makes the job very rewarding – it’s why we do what we do.
“At Guy’s and St Thomas’ it’s a real team effort. We work with a massive team of specialists including specialist cancer nurses, psychologists, speech therapists, physiotherapists, intensive care nurses and specialist ward nurses.”
He says the approach to treating mouth cancer is very effective at Guy’s Hospital, which treats patients from across south London. Mr Orfaniotis explains: “We have all the required specialities on site and deal with larger numbers than most centres. We make sure it’s a quick process to get patients to the right path, so we have the best chance of getting rid of the cancer.
“If a mouth lesion is cancerous you might be inclined to just remove it but ideally you need an appropriate clear margin around the cancer to be sure it’s all gone. Without this there is a chance the cancer can come back, and that patients may need additional radiotherapy treatment. Radiotherapy may cause a dry mouth, reduced sense of taste, further scarring inside the mouth and problems with speech and swallowing.
“You only have one good chance to remove the cancer and reconstruct the tongue well. Our tongue reconstruction success rates are now nearly 100%.”
At Guy’s Hospital a pioneering method is used where tissue from the calf is taken for the reconstruction, rather than the traditional method of taking it from the forearm – which leaves a noticeable scar and can affect the mobility of the hand – or from the thigh, which does not match the thickness of the tongue. This has the best results in terms of quality of the reconstruction and also the healing of the donor site.
Annabel is now keen to raise awareness of tongue cancer among young people. She said: “Check your tongue for any new lesions. Tongue cancer doesn’t only affect older people who smoke and drink and there needs to be more awareness of it.”
Mr Orfaniotis said: “We are seeing more and more cases of tongue cancer in young people and have operated on patients as young as 19. Some oral cancers are associated with the human papillomavirus (HPV) and conditions where the immune system is suppressed.
“It is worrying because young people need to be aware of it and look for any unusual signs and symptoms. This type of cancer spreads quickly so an early diagnosis is vital. Any lesion on the tongue or oral cavity should be checked by a dentist, GP or oral surgeon if it is there for more than a week.”
Annabel says having cancer has helped to reinforce her positive outlook. She adds: “My message to others is don’t try to change the things you have no control over, focus on the things you can control and react in a positive way. A positive mindset gets you through so much.”
Annabel has documented her journey from diagnosis to six months after her surgery to help other people with the condition. Watch Annabel's videos.