By Tim Graham
Jim Kelly announced today he has cancer in his upper-jaw bone and will have surgery Friday at Erie County Medical Center.
The Press Coverage blog reached out to specialists in the field for insight into the Hall of Fame quarterback's diagnosis (squamous-cell carcinoma) and potential issues.
Dr. Paul van der Sloot, specialist in head and neck surgery and microvascular reconstruction, Wilmot Cancer Center in Rochester:
"Squamous-cell carcinoma's the most common kind of cancer we see in the head and neck, and it comes from the lining of the mouth or the throat, that pink tissue you see within the mouth. This did not originate in the bone. It originates from the lining of the mouth.
"It's really hard to say specifically where it originated in this case. In most cases this would have arisen within the oral cavity or within the mouth. It's not completely without possibility this originated in the nose or the sinus. But it certainly sounds like it originated within the oral cavity.
"Because it's bone, treatment options for this are initially more limited than they would be for other squamous-cell carcinomas. Sometimes we treat these with radiation or a combination of radiation and chemotherapy, other times with surgery. In this case, surgery really is the best primary option if this is involving the bone in the vicinity.
"If all the margins [tissues around cancer] are negative there may discussion about whether or not he needs other therapy, radiation being the most likely. Radiation would be used after surgery rather than the primary treatment in this case."
Dr. Victor Cimino, chief of plastic and reconstructive surgery and chief of oral and maxillofacial surgery, Loyola University Health System (University at Buffalo School of Medicine graduate):
"It's unfortunate to hear about Jim Kelly. I remember he was a local hero. I lived there for all four Super Bowl losses. That was the era I was there, from 1989-96. It was a great time there. He's a good guy.
"Squamous-cell carcinoma is one of the common cancers that's seen intra-orally, unfortunately. Squamous-cell cancers are what you can get from smoking or drinking. But in younger folks, a lot of the spontaneous cases are happening now without any association from smoking or drinking and can be associated with the human papillomavirus.
"It's typically surgically treated with an incision in the affected area with a clean margin of normal tissue around it. Sometimes that's treated in conjunction with radiation therapy later on after the patient's healed to ensure they're cancer-free in the area.
"As far as reconstruction goes in the upper jaw, there are a lot of different options. Sometimes the upper jaw is a little more easily reconstructed because of the areas you can attach dental appliances to. You can also transfer bone to that area either in a vascularized fashion or a non-vascularized fashion to fill the defect, and with some conventional reconstruction from a surgical standpoint or an enamel/plastics standpoint, with dental implants or appliances or with a combination of his own tissues, the area can have a very satisfactory reconstruction.
"It all depends on how widely and aggressive the resection needs to be. If it remains all intra-oral, they heal up very well. With reconstruction options we have now, people can be brought back not only to a functional reconstruction, but also a very acceptable aesthetic reconstruction.
"All things considered, with the treatments we have now and with the surgical options in combination with radiation and the elaborate reconstructive things we can do, his rehabilitation should be reasonable."