Face off with cancer

It's simple. Cut the face out, remove the tumour, and put the face back on. Surgeons are doing it in Hong Ko

Published: Thursday 15 October 1998

-- A RADICAL form of "face off surgery, being used at Queen Mary Hospital in Hong Kong, aims to rid patients of recurring nasopharyngeal cancer, a deadly cancerous tumour which forms in the centre of the head behind the nose and found mostly in southern China. To cut out the tumour, surgeon William Wei of the University of Hong Kong uses a small chainsaw to slice away half the patient's face, swing it open and pluck the tumour out. To reassemble the patient's face, he then uses miniature metal plates and screws.

"We pioneered this," Wei said, speaking on this novel method of surgery, reminiscent of the recent Hollywood blockbuster film Face Off directed by Hong Kong-based director John Woo. It showed patients having their faces removed and then swapped. "This sort of tumour is very common in here. Treatment of the disease is by radiotherapy and when it recurs, there's been nothing we could do."

Queen Mary surgeons had been discussing a case of cheek cancer, in which a patient's cheekbone was removed, when they hit on the idea of using a similar operation to open the cheek like a door and carve out tumours behind the face. Once surgeons sawed along the cheekbone beneath the eye, down along the nose and through the upper jaw, the face swung open and gave wide exposure to the site of the tumours. The team has performed the six-hour operation on about 60 patients so far. "I don't show the patients the chainsaw, of course," Professor Wei said. "I tell them the bone has to be broken."

Cancer patient Kwan, a bank worker who requested his full name be withheld, said he approached the operation with trepidation, after radiotherapy failed to cure his tumour. "Before the operation, I was scared - the skull had to be cut and opened," the 38-year-old man said. "But I had no other choice. If 1 didn't accept the operation, the cancer would have spread." It took Kwan a little more than two months to recover, with minimal side effects. "My mouth cannot open wide because some muscles have been cut inside, and my hearing on the side of the operation is not good because the duct between the nose, ear and throat was cut," he said. Professor Wei said the surgery was suitable only for certain patients - those who had tried radiotherapy and had early detection of a relapse. "If the tumour is too big, you can't do it," he said. "And if you can't take all the tumour out, it's no use going in."

Of patients whose tumours are completely removed, 42 per cent survive at least another five years. Without the chainsaw intervention, they would have died, Wei said.

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