March 4, 2022
by Dr. Parul Dua Makkar; Dr. Sanjukta Mohanta
When you see you it, you don’t forget it. Cancer. It’s as scary to look at as it is to tell a patient that they have something suspicious in their mouth – something that may be oral cancer. What if you saw the lesion in your own mouth? Would you say, “It can’t be cancer. I don’t have any risk factors. I am too young.” Well, that is exactly what 33-year-old Calgary dentist, Manu Dua, said to his sister, Parul, in July 2019. He showed his sister, a dentist in New York, a photo of the sore on the side of his tongue. “What do you think this is?” he asked. She pleaded with him to get it biopsied. It was large and ulcerated. It had been there for weeks and was becoming more painful. Manu shrugged. “The oral surgeon thinks it’s lichen planus. Don’t worry.”
One month later, Manu was learning to talk, chew and swallow again. He had half of his tongue resected and then reconstructed using the skin from his left arm and the radial artery from his left hand. The lymph nodes from the left side of his neck were removed and his arm was repaired with skin from his leg. Manu had treatment for stage 2 squamous cell carcinoma of the left side of his tongue.
It wasn’t an easy recovery. He developed a severe facial infection and a respiratory tract infection from the tracheotomy. He couldn’t speak for days and he had to learn how to use his left hand again. Those dark days made him focus on his second chance in life. He said, “You shouldn’t have to face death to understand the meaning of life.”
Manu celebrated his recovery by visiting Parul and his nephews in New York. He then returned to work at the practice he started just 3 years earlier. He bounced back quickly, only taking six weeks off of work. While his hand and tongue regained strength, his mind was in anguish. Manu said, “This trauma was unjust. I know the risk factors for oral cancer and I avoided them. A dentist getting oral cancer is like a shoemaker whose own shoe is broken.”
Just five months after returning to work, the pandemic hit. Manu had to shutdown his office and figure out what to do with his staff and patients. Then another shock. The left side of his neck
swelled up. A CT scan and biopsy confirmed it on April Fool’s Day. The cancer was back.
A cancerous lymph node was left behind from the first surgery. Manu had to have another surgery and go through 33 treatments of chemotherapy and radiation. As hard as this sounds, it was even harder going through this during COVID. Manu went through the consultations and treatments alone.
Alone to suffer with the mental and physical anguish, he sold his practice himself while going through treatment. Remarkably, the sale didn’t cause him to lose his sense of purpose. Instead, he felt free of responsibility. He started writing a book about his insights on life, called Life Interrupted, Dr Dua’s Survival Guide. He bought a Porsche and a puppy. He was living with gratitude. He found peace.
His time to enjoy life was short. A few months later, a follow-up scan showed that the cancerous lesion in his lung had quadrupled in size. There were several metastases. The cancer was inoperable. Manu was devastated, but ready to fight his third round of cancer.
He had more chemotherapy and immunotherapy, but it was futile. Manu struggled to breathe and was getting weaker. He was dying and Parul was trying to cross the border during a lockdown to visit her younger brother. While she frantically tried to get a COVID test and authorization to fly to Calgary from New York, Manu passed away on March 14, 2021, with his parents by his side. He was 34-years-old.
When it happens, you don’t forget it and nothing prepares you for it. Death. The day a loved one passes away and you are left alone. What do you say to someone who just lost a brother? What do you say to parents carrying the ashes of their son? You say, “We can make a difference. We can prevent this from happening again.”
As dentists, we can prevent some oral cancers and find oral cancer in the early stages. We can educate our patients about the risk factors and encourage the HPV vaccine. We can do thorough oral cancer screenings on each patient regularly. We can refer patients with suspicious lesions to an oral pathologist. We can promote oral cancer awareness and self-assessments so patients visit their dentist when they suspect something unusual. Together we can decrease oral cancer and oral cancer mortality.
In his book, Manu said, “After suffering more physical and emotional pain than most human beings should ever endure, it occurred to me that the only thing that saved me was hope.”
There is hope that no one else has to suffer like Manu and his family. We can all do our part to make hope into reality. As Manu wrote in his book, “We are more powerful than we can ever imagine.”
*Life Interrupted, Dr. Dua’s Survival Guide is available on Amazon. A percentage of proceeds of the book sales will be donated to the Oral Cancer Foundation.
About the Authors
Dr. Parul Dua Makkar obtained her DDS from University of Oklahoma in 2003 and has a GPR training from Staten Island University Hospital. Currently she works as a general dentist in NY. She Parul_dua@yahoo.com, instagram: @pdmfamilydenta
Dr. Sanjukta Mohanta is a general dentist practising at a publicly funded clinic in Brampton, ON. She graduated from the University of Toronto in 1999. firstname.lastname@example.org, Instagram: @drsanjmohanta