The Princess Margaret Cancer Foundation | UHN

Jennifer Cicci: “That robot saved my life!”

Jennifer Cicci gets teary when she thinks about the donors who helped to buy the surgical robot for Princess Margaret Cancer Centre.

“I’m just so thankful. They gave me my life,” she says, emotion constricting her voice. “Actually, I feel overwhelmed by their kindness.”

In 2008, donations to The Princess Margaret Cancer Foundation enabled the purchase of the Cancer Centre’s first and only surgical robot. 

The da Vinci system enables surgeons to perform minimally invasive surgery through a few small incisions, using tiny instruments. The robotic arms can articulate in ways that the human hand cannot, with tiny high-definition cameras that can see inside a patient much better than a surgeon’s eyes can. As a result, surgeons can reach places in the body previously inoperable, and cut with greater precision. 

Research at The Princess Margaret has proven that patients who undergo robotic surgery have a faster recovery time, experience less pain and need fewer transfusions.

Jennifer, a dental hygienist, first noticed something odd in her neck in September 2013. “I knew right away that I had cause for concern. It was completely painless, but my heart sank,” she says. “You know that little voice we all have inside of us? Mine was telling me that this wasn’t good!”

Unfortunately, Jennifer had to self-advocate her way through a series of specialists before she was able to get a proper diagnosis of HPV-related tonsil cancer. 

“Historically, tonsil cancer is seen in men, 50-60 years old, who are heavy smokers and heavy drinkers. That’s partly why it took so long for me to be diagnosed, because every specialist who looked down my throat said, ‘This doesn’t look like cancer.’ They thought that because I didn’t present any of the traditional risk factors, it wasn’t cancer,” says Jennifer. 

The incidence of throat cancer is rapidly rising in Canada due to an epidemic of the Human Papilloma Virus (HPV). HPV-positive throat cancer is considered highly curable, with a disease-free survival rate of 80% or more over five years. This is in contrast to excessive smokers and drinkers with advanced throat cancer who have a five-year survival rate of only 50%.

Jennifer was thrilled to have the option of robotic surgery for her tonsil cancer, over standard chemotherapy treatment. 

“The chemotherapy they would have used for my cancer presents a 25% increased risk of developing a secondary cancer down the road and I felt that was too high,” says Jennifer. “Plus, I have a lot of drug and medication allergies. I was terrified that the chemotherapy that was trying to save my life would in fact end it. I believe that robot saved my life!”

Thanks to robot-assisted surgery, Jennifer was able to avoid massively invasive, jaw-splitting surgery that would have cost her the ability to speak and swallow. 

Jennifer with her sons (left to right), Jordan, Nicolas, Christian, and Mackenzie

Dr. John de Almeida, a surgeon specializing in Head & Neck cancer at The Princess Margaret, performed a complex, five-hour surgery on Jennifer using the da Vinci robot. He removed a baseball-sized mass of tissue from the right side of her throat, including a part of the back of her tongue, along with 26 lymph nodes.

“Within about a month of surgery, I started to feel much better,” she says. “I was able to swallow most foods and still had most of my saliva glands.”

As Jennifer was preparing for follow-up radiation treatments at The Princess Margaret, a CT scan revealed a few more enlarged lymph nodes. Dr. de Almeida performed another quick operation on her neck. He removed four more lymph nodes, two of which tested positive for cancer, and a salivary gland.

“Dr. de Almeida took such good care of me the entire way through,” Jennifer says. “He knew from my first surgery that I was pretty nervous going under the anesthetic. So before my second surgery, while the anesthetist was preparing to put me to sleep, Dr. de Almeida stood by my bed and held up his phone, scrolling through pictures of his little baby boy for me to look at. I felt so peaceful.”

Fortunately, Jennifer’s cancer was contained to her throat. A year after receiving follow-up radiation treatments, Jennifer appears to be cancer free, and is coping with side effects that include weight loss, a lack of saliva and the extra effort required to eat.

“I tell everyone about Dr. de Almeida and robotic surgery, because they have been the most important factors in my recovery,” she says. “Together, they saved my life.”