Thursday, April 11, 2013

Reasons to Smile

Surgery, extensive therapy and dental reconstruction give cancer patient his life back

Robert Cierkes can now fully
enjoy playing guitar, one of
his favorite pastimes, with a
smile on his face. 

Robert Cierkes recalls the day in 2008 that his primary care physician noticed a lump under his tongue during a routine exam. The last thing Mr. Cierkes thought it could be was cancer, but that’s exactly what it was.

Upon confirmation that he had Stage II oral cancer, Mr. Cierkes was immediately referred to John R. Saunders, Jr., MD, FACS, GBMC’s Chief Medical Officer, surgeon with Johns Hopkins Head and Neck Surgery at GBMC and former Medical Director of the Milton J. Dance, Jr. Head and Neck Center at GBMC. He was quickly scheduled for surgery, which included removal of the lump under his tongue, nine of his bottom teeth, part of his jaw and his left neck lymph nodes. Although the surgery successfully removed all of the cancer, Mr. Cierkes needed extensive reconstructive surgery and rehabilitation. To make matters worse, he also suffered from a mini-stroke during the surgery, making recovery that much more of a challenge.

Following a 10-day stay at GBMC, Mr. Cierkes received home care for a month and a half. “I had a feeding tube in for six months, so the dietitian visited a few times a week to help me learn how to feed myself and care for the tube,” he says. In addition, Mr. Cierkes made regular visits to the Dance Center for dietary and speech therapy services. He had to re-learn how and what to eat in order to maintain proper nutrition and also needed assistance with verbal communication.

In October 2009, after several months of recovery, Mr. Cierkes started the next phase of the process—reconstructive surgery. He sought the services of Dr. Ghassan Sinada, a maxillofacial prosthodontist. In addition to operating his own practice, Maryland Prosthodontic Associates, located on GBMC’s campus, Dr. Sinada routinely collaborates with GBMC to ensure that head and neck cancer patients receive the comprehensive care they need. The first order of business was for Dr. Sinada to construct a dental implant that would replace the teeth and segment of jaw removed during surgery. This was followed by the placement of dental implants into the jaw.

“In cases like Mr. Cierkes’, oral reconstruction takes a lot of time and planning,” says Dr. Sinada. “We use advanced scanning and three-dimensional models to give patients the best results possible. Titanium implants are often placed in one visit, but several months are needed for proper healing before we can proceed to the next step.” It’s worth the wait. Accurate placement of the dental implants followed by careful fitting restores the ability to bite and chew in addition to supporting the patient’s lips and cheeks, giving a natural look and feel.

“Although the visits were long and not always pain-free, Dr. Sinada had an excellent, reassuring bedside manner,” says Mr. Cierkes. “He even gave me his personal cell phone number in case I had any questions.”

Now, Robert Cierkes is cancer-free thanks to Dr. Saunders and Johns Hopkins Head and Neck Surgery, rehabilitated thanks to the Dance Center team and sporting a beautiful smile thanks to Dr. Sinada.

For additional information on GBMC’s head and neck cancer services, call 443-849-GBMC (4262). To learn about Johns Hopkins Head and Neck Surgery at GBMC, visit For more on the Milton J. Dance, Jr. Head and Neck Center at GBMC, visit To inquire about Dr. Sinada’s services at Maryland Prosthodontic Associates, call 443-519-5293.

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