Two-time cancer survivor grateful for a second opinion and MD Anderson

In the fall of 2020, Bill Middelthon felt something like a canker sore in his mouth. Normally, canker sores heal on their own in about 2 to 3 weeks. So, when the sore in his mouth persisted, he made an appointment with a local periodontist in his hometown of Miami, Florida. His doctor recommended a biopsy. The results showed a type of  head and neck cancer called squamous cell carcinoma of the oral tongue. 

After the tumor was removed surgically, he did two things: quit smoking cigars and made an appointment at MD Anderson. 

“My local oncologist wanted me to start radiation therapy,” Bill says. 

Bill was concerned about the potential side effects of having radiation on his mouth. His son, Matthew, had a friend who had minimal side effects after receiving proton therapy for a similar diagnosis at MD Andersons. So, Bill decided to make an appointment at MD Anderson. 

A life-changing second opinion for head and neck cancer

Bill remembers the ease he felt when setting up his first appointment at MD Anderson. “Shonie Pickron in Business Services led me through the appointment process and helped me prepare,” says Bill.

In January 2021, Bill made the trip to Houston to meet head and neck surgeon Carol Lewis, M.D.,  and radiation oncologist Steven Frank, M.D. They determined that he did not require radiation treatment. Instead, they recommended he undergo monitoring every three months. 

 “If it wasn’t for MD Anderson, I would have received unnecessary radiation to my mouth,” Bill says. Relieved, he returned home to Florida.

Facing a second cancer diagnosis

During a routine checkup that August, bloodwork showed that Bill’s prostate-specific antigen (PSA) levels were elevated. His local urologist put him on  active surveillance, also known as “watchful waiting.” A month later when his levels increased, it was time for a biopsy.

By January 2022, Bill was diagnosed with prostate cancer. The biopsy showed four spots in his prostate where the cancer was present. “There was no doubt in my mind that I wanted to get back to MD Anderson as soon as I could,” says Bill. 

Prostate cancer treatment: proton therapy and the NOVA fiducial marker 

On June 28, Bill returned to MD Anderson to see Dr. Frank. This time, Bill’s care team recommended he receive NOVA fiducial markers followed by proton therapy.

The NOVA technique, pioneered at MD Anderson, uses a positive MRI signal to provide more precise planning and localization of the tumor in the prostate. This pinpoints the exact location of the tumor before a patient receives radiation.

“The NOVA fiducial marker creates a precise guide from an MRI or CT scan to help physicians guide proton therapy. Without the fiducial marker, the tumor is harder to see, making treatment more difficult,” says Frank. “This allows patients to be treated with the maximum radiation dosage and reduces exposure to nearby healthy tissue.”

On July 8, Bill was ready to start seven weeks of proton therapy. Midway through treatment, the side effects he felt from proton therapy were fatigue and increased urination. 

Bill credits his many radiation therapists at MD Anderson Proton Therapy Center and nurse practitioner Ian Moore for helping him through treatment. “They were very professional and answered all my questions,” Bill says.

Advice for other cancer patients

After a two-month stay in Houston, Bill returned home to Florida. He returns to Houston for follow-up appointments with Dr. Lewis every three months and with Dr. Frank every six months. 

Bill encourages other men to keep a watch on their prostate-specific antigen (PSA) levels and to get a second opinion if they have doubts about their diagnosis or treatment plan. 

“Local doctors can get you to a certain point, but when your PSA goes up and they say surgery, get to MD Anderson,” Bill says. “I was blessed to be treated by doctors and medical staff who are experts in their area of care.”

Disclosure: Steven Frank, M.D., and MD Anderson Cancer Center  licensed IP related to NOVA fiducial markers to C4 Imaging, LLC, and Dr. Frank holds equity in the company.

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