Medical student Carissa Watt was bracing herself for big dental bills when she began suffering a toothache during her paediatric rotation.
Two months, one ‘horrendous’ biopsy and a succession of confused dentists and specialists later, the outcome was much worse – Carissa received a diagnosis of a high-grade osteoblastic osteosarcoma, an aggressive malignant bone cancer in the right side of her jawbone.
Within a day of finding out this news, Carissa had an appointment with head and neck cancer surgeon Jonathan Clark. Within a fortnight, her medical oncologist had developed a chemotherapy plan, and her medical team had collected and frozen some of her eggs, a detail Carissa remains grateful for.
“I was 23 – I’d never thought about my fertility or future family,” she said, “but someone else had and they’d put measures in place to make sure that I wasn’t going to be affected by this later.”
Carissa went through ten weeks of chemotherapy at Chris O’Brien Lifehouse, followed by an 11-hour surgery to remove and reconstruct of part of her jaw, with the insertion of three dental implants. The surgery, which Carissa remembers as the ’11-hour nap’, was the most terrifying part of her treatment. Fortunately, Jonathan and his team managed to alleviate some of the fear.
“They gave us a detailed description of what the surgery would entail. They took us through every single drain that was going to be inside me when I came out of surgery and told me that I would be in ICU for two days afterwards, surrounded by beating machines. They involved me in the discussion of one big surgery versus two little surgeries, when they would happen and how healthy I was going to feel.”
Carissa spent ten days in recovery before returning home. On day sixteen, she was finally able to recognise her face in the mirror.
“I can’t emphasise how big that was,” she said. “I hadn’t been able to recognise my face in such a long time.”
Around four weeks later, Carissa was recovering well from surgery when she was called back to Chris O’Brien Lifehouse for more treatment. It was then that she received some complicated news: although her cancer had been successfully resected, the chemotherapy, rather than having the 90% cure rate that was hoped, had less than 20%.
It was a moment Carissa describes as ‘bittersweet’.
“I’d lost my safety net of chemotherapy and I was devastated,” she said. “But my radiation oncologist, Professor Milross, sat down with me and had a long chat about radiation therapy. He involved me in the discussion about side effects and long-term implications. I was walked through, and had my hand held. I was involved in the decision about my future treatment – that made everything a whole lot better.”
Carissa underwent six weeks of radiation therapy, becoming a self-described ‘angry red ball of frustration’, as she endured oesophagitis, dermatitis and ulceration.
In October 2017, her treatment was finally over. But complications arose six months later when Carissa developed a large, infected abscess in her jaw.
“I called my Clinical Nurse Consultant, Cate, from the emergency department. It was a Sunday, and she was gardening. But within five minutes she had organised intravenous antibiotics and admission into Lifehouse.”
Carissa then had to undergo surgery to have her facial implant removed.
“It was pretty hard on me. I felt guilty because I wasn’t fighting for my life against cancer, but the impacts were still affecting me.
“Cate came in after surgery and said, ‘I’m really sorry this has happened to you.’ And in that one moment, she acknowledged and validated how I was feeling. The validation alone helped me move on.
Being a survivor of head and neck cancer, Carissa says, is complex and difficult.
“It’s not always going to be a good outcome. And even if you’re not fighting the cancer, the other complications you’re fighting against can be just as heartbreaking.”
At 26 years old, Carissa is now 18 months post-treatment. Her PET scan shows no evidence of the cancer. Carissa is grateful – not only for her survival, but for the quality of life she now enjoys.
“The fact that I finished my final medical school exams, I’m moving onto an internship and going on dates where people are telling me I have a nice smile – that’s all that matters to me. That’s a testament to the legacy that Chris O’Brien left here. It’s a testament to everything that he’s worked for.”
Pictured above left to right are Justine Oates (head and neck cancer nurse practitioner), Prof Patrick Gullane (head and neck cancer surgeon, University of Toronto), Carissa Watt and Cate Froggatt (head and neck cancer clinical nurse consultant).