In early 2023, life shifted dramatically for Richard, a 52-year-old husband, father of two daughters, and seasoned investment banking professional in the life sciences sector. After decades spent advising biotechnology, specialty pharmaceutical, medical device and diagnostic companies around the globe, Richard suddenly found himself navigating a far more personal medical challenge. In late March, he was diagnosed with Stage 4a squamous carcinoma of the right mandible; a diagnosis that would set in motion a physically and emotionally demanding chapter of his life.
In early April 2023, within three weeks of diagnosis, Richard underwent major surgery at Memorial Sloan Kettering Cancer Center (MSKCC). This initial procedure was extensive; a 14-hour operation involving the removal of the right half of his jaw, a neck dissection extracting over 65 lymph nodes, and a fibula free flap jaw reconstruction using a large amount of tissue and bone from his left lower leg.
The recovery proved even more complex than expected. Within two and a half weeks, he had three additional surgeries to address venous congestion complications. What had been planned as a 10-day hospital stay stretched into weeks; Richard spent two weeks in the ICU alone and remained hospitalized until May 10th.
Throughout that time, he relied on a variety of essential, but cumbersome, uncomfortable, and motion-limiting medical devices including a feeding tube, a tracheotomy, multiple drains, and a vacuum-assisted closure system on his leg in addition to a large number of medications delivered via IV — all supporting him through an intense phase of recovery.
As the days stretched on, Richard tried to remain positive by joking with his care team, getting out of his bed and sitting upright in a chair for as long as he could each day, and walking up to two miles a day around the head and neck ward (28 laps of the floor) by the end of his hospital stay.
The transition home was very welcome but not easy, requiring a good deal of support and help from multiple family members and friends. The summer also brought an unexpected and unwelcome challenge. By mid-July, a Signatera blood test, additional PET, CT and MRI scans, and a new biopsy revealed the rapid recurrence of cancer — a 4 cm tumor adjacent to the graft site in Richard’s reconstructed jaw.
Treatment shifted quickly. In addition to surgery and radiation as standard of care, chemotherapy was added to his treatment plan. Richard underwent two weeks of induction chemotherapy with a triplet of agents followed by a full course of high-dose cisplatin over six weeks, all while completing 35 sessions of proton radiation therapy at The New York Proton Center. His active treatment concluded in September 2023.
Since the end of active treatment almost two years ago, Richard’s recovery has been ongoing and multifaceted. Richard has been working through a variety of common long-term side effects including trismus, osteoradionecrosis, fibrosis, lymphedema, fatigue, and brain fog. He is currently considering a dental prosthetic to replace the seven teeth that were removed during his lower jaw reconstruction and now wears a beard to help partially conceal surgical and radiation-related changes to his appearance around his right jaw and neck.
Throughout this journey, Richard credits much of his progress to the exceptional care and expertise of his medical teams. I am deeply grateful to all of my physicians at MSKCC, most notably Drs. Nancy Lee (Radiation Oncology), Jonas Nelson (Plastic Surgery), and Jay Boyle (Head & Neck Surgery – retired), as well as to the team at The New York Proton Center for delivering advanced proton radiation therapy, said Rich. My physical therapists at MSKCC and the Hunterdon Medical Center in Flemington, NJ, played a vital role and supported my rehabilitation every step of the way. Acupuncture at MSKCC also proved to be a highly impactful part of my treatment, helping me manage a range of chemotherapy-related side effects.
Most of all, Richard acknowledges the unwavering love and support of his family and friends. His wife, Priya Mahale, has been and continues to be a constant source of strength. He is especially thankful to his sister-in-law Dr. Rekha Mahale, his older sister Dr. Charlotte Wills, and his identical twin brother Mark Page for their help and companionship throughout countless appointments and procedures. Chad and Sheila Mahale and Tammy Ianelli also stepped in with unconditional kindness, caring for Richard’s and Priya’s daughters, Aasha and Anya, for the best part of the Spring, Summer, and Fall of 2023.
Richard’s journey has been shaped by medical complexity, but also by connection, expertise, and care. It continues on with resilience and with deep appreciation for everyone who has been a direct participant in his treatment or supported his journey along the way with their well wishes.
