Richard’s Story – Basal Cell Carcinoma

Basal Cell Carcinoma Patient Story

Testimonial: Basal Cell Carcinoma Head and Neck Surgery at UCLA

“I know that I made the right choice putting my health (and my life) in Dr. St John’s hands, and that I’ve got the best team of doctors and nurses for what cancer throws at me next” —Richard

In July 2019, I got the message no one wants to hear, “Mr. Nolan, I’m afraid you have Stage 4 cancer.” A common skin cancer (Basal cell carcinoma) had metastasized to my saliva glands and involved my facial nerves. My world turned to black. Test results showed cancer moving along my nerves towards my spinal column, greater auricular nerve and brain stem. After a medical review board review of treatments was inconclusive, Dr. Maie St John stepped in and changed my life trajectory forever. Here is why I think I made the right choice in putting my life in her hands, and why I think she’s the best: 

  • Dr. St John provides a superior plan, team and experience.  Dr. St John has put together teams of personally vetted, highly trained health care specialists that handle a high volume of cancer patients and are intricately interconnected. My fight against head and neck cancer required separate otolaryngology, facial reconstruction, dermatology, radiation, hematology, hearing and lymphedema specialists. Dr. St John provided like-minded professionals that are the best in their specialties (since I don’t work in the healthcare industry, I probably would have been forced to settle for the first available doctor). My 7 hour surgery consisted of a team of three head and neck surgeons:  Dr. St John (lead surgeon), Dr. Ishiyama (ear specialist and surgeon), and Dr. Blackwell (reconstruction surgeon). They have been working together for years and conducted hundreds (if not thousands) of surgeries together. They have separate but connected areas of expertise, work like a well-coordinated team, and have shared but varied experiences. Follow on treatments with Dr. Chin (radiation) and Dr. Chi-Ho (hematology) were similarly as impressive and just as interconnected with Dr. St John. My “post treatment and follow-up” team consists of Dr. Soriano (dermatology) for treatment of various skin cancer surgeries, rehabilitation services (swallowing tests, hearing tests, and lymphedema therapy) and revolving checkups with Dr. St John, Dr. Ishiyama, Dr. Blackwell and Dr. Chin… again, all orchestrated/communicated through Dr. St John.
  • There is a sense of urgency (if you need it).  After surgery was chosen as the first line of treatment, the original surgery date provided was two months in the future. Knowing the cancer was moving throughout my nervous system, every day I waited increased my stress level. Dr. St John intervened, and within two weeks I was being rolled into surgery. This involved her and her team of surgeons coming in on their “off day” to do the surgery.  
  • UCLA has incredible new advances in technology and procedures.  I was really impressed by the state of the art radiation equipment and the latest techniques which radiated my head and neck surgical areas and nerve pathways. Dr. Chi-Ho (hematology) and the nurses during my chemotherapy were outstanding. Although I came close but never got a chance to try it, it was fascinating to learn what UCLA is doing in the field of immunotherapy sessions. And since I have two cousins with similar head and neck cancers, I am planning on working with Dr. Chi-Ho to see if genetic research can offer insights on why I got this rare cancer and what it might mean for my three teenage sons.
  • Dr. St John (and her assembled teams) have a wonderful bedside manner and care deeply for their patients.  I still remember in one of my pre-surgery meetings, Dr. St John closed our session by telling me that she would care for me as if I were her brother. That touched me. As someone who served in the U.S. military (USAF) for 25 years, one of my favorite core values is “Service Before Self.”  It’s embedded in my DNA to look out for and care for my family and military “brothers” and “sisters” no matter what harm might come to me. I found comfort in having a doctor with a similar ethos. In the medical profession perhaps that is “self-sacrifice” or “empathy”… whatever it is, it was clear after my first meeting with Dr. St John that she is principally guided by doing what’s right for her patients. Throughout my life I have met a great many doctors, surgeons, and health care professionals who “do their jobs” (and do them well), but I have a very short list of people who provide health care at the next level… meaning they are willing to go above and beyond their roles and responsibilities and are emotionally invested in their patients outcome. I could feel it. And it’s not just Dr. St John… it is the whole team she surrounds herself with. Prior to surgery, my initial PET CT scan didn’t show any nerve involvement, but looking at my symptoms and using his vast experience, Dr. Chin (radiation) immediately ordered an MRI which showed that cancer was spreading along my nerves. My wife and I often comment that Dr. Chin’s astuteness probably saved my life. And while undergoing these daily radiation treatments, I met with Dr. Chin once a week to talk about how the radiation was affecting me and methods for easing the effects of radiation. Since recovering from surgery/chemo and radiation, Dr. Soriano (dermatology) has continuously performed MOHS surgeries to remove skin cancers before they have an opportunity to metastasize. She is one the nicest, engaging and caring doctors a patient could ask for.

I’ll admit that when I originally researched Dr. St John, I was awe-struck by her diplomas and credentials and that everyone spoke so highly of her within the UCLA system. Having gone through this process and gotten to know Dr. St John and members of her team personally, there’s a lot more than what you see on paper… there’s caring, coordination, communication and a wonderful optimism that permeates every visit to UCLA. Look, cancer is a monster, and I have encountered some soul crushing stories in this battle… but having just hit my one year mark since beating my head and neck cancer and continuing to receive numerous skin cancer and other treatments, I remain optimistic. Throughout this process a lot of people have told me that I could beat cancer. While I always appreciate the thought behind their good cheer, I know that it’s really good doctors, good medicine, good science, and the latest cancer fighting techniques and technologies that will beat cancer. My fight is not done... I will continue to get skin cancers for the rest of my life and pray that they don’t metastasize again. I know that I made the right choice putting my health (and my life) in Dr. St John’s hands, and that I’ve got the best team of doctors and nurses for what cancer throws at me next.


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