Grand Forks man celebrates surviving rare cancer

When Dwight Dinkel lost hearing in his left ear five years ago, he had no idea it would lead to a journey through cancer treatment.

The hearing loss was gradual, said Dinkel, 65, of Grand Forks. It started out as ringing in his ears and progressed until it was gone altogether.

At LM Glasfiber in Grand Forks, where he worked at the time, employees were given routine hearing tests as a safety precaution.

"You had to have good hearing to know a forklift was coming," he said.

The doctor who examined him thought he had water on the eardrum and referred him to an ear, nose and throat specialist, who ordered a magnetic resonance imaging, or MRI, scan.

The ENT doctor also removed a tissue sample, called a biopsy, through the nose for analysis.

"They found a tumor," said Dinkel. "I was told I had cancer."

In December 2009, he was diagnosed with nasopharynx carcinoma, he said. It was the first time he'd been diagnosed with cancer.

A small tumor, growing behind the nose where the nasal passages and auditory tubes join, caused the hearing loss.

He decided to seek treatment at the Cancer Treatment Centers of America in Zion, Ill., he said. He made the decision after talking with an acquaintance who had been a patient there and "was five years cancer-free," and after learning more about the hospital online.

The CTCA at Midwestern Regional Medical Center is a 73-bed specialty hospital dedicated to treating patients who are battling complex cancer. It is one of several such affiliated facilities throughout the country.

Pin-point radiation

The tumor's size and location near the brain demanded precise, pin-point accuracy in radiation treatment-something that, at the time, was unavailable in Grand Forks, but is today, he said.

When he went for his first appointment at the CTCA, "the first question the doctor asked me was, was I a smoker," he said. "I had been, but I had quit many years earlier, long before I got the cancer."

He had started smoking in the military and continued for "not more than 10 years," he estimated. He smoked about three packs a day.

At CTCA, Dinkel learned that nasopharynx cancer is rare.

"The doctor said I was the second case at that hospital," he said.

Beginning in January 2010, Dinkel received 35 radiation treatments-one each weekday for seven weeks-and four chemotherapy treatments in the final two weeks.

During radiation treatment, "they put a mask over my face to keep my head still. I figured I was safe."

The only side effects of treatment were temporary loss of taste and the ability to produce saliva, he said.

"After three treatments of radiation, I got my hearing back."

Each radiation treatment was brief, "five, 10 minutes-15 at the most," he said. "I didn't feel anything. It took longer to put my mask on."

Dinkel needed no surgeries for the cancer, he said. "They never put a knife in that area at all."

As a patient, he lived in CTCA "guest quarters" with other patients who were dealing with a variety of cancers.

"We played cards and dice. We ate together," he said. "You become one big family."

For some of those patients, the CTCA was their last resort. The doctors they had previously seen had no more treatment options to offer.

"They had basically been told to go home and get your affairs in order," he said.

Five-year survivor

After his initial seven weeks of treatment, he returned to the CTCA for check-ups every three months for the first two years and, after that, every six months.

"Now I go there once a year," he said.

Dinkel has confidence in the quality of care provided there because treating cancer patients "is all they do."

His wife, also a former CTCA patient, has been cancer-free for two-and-a-half years, he said. "It's an amazing place. It's been a godsend for us."

In June, Dinkel, along with 115 other survivors, returned to officially mark five years of being free of cancer during the annual "Celebration of Life" ceremony.

With other former patients, he walked down a red carpet lined with hundreds of family, friends and health-care providers. He took part in a commemorative tree-planting ceremony.

A gold leaf, engraved with his name and hometown, has been added to a "Trees of Life" wall display inside the hospital.

Rare cancer type

The type of cancer Dinkel had is "somewhat rare," said Dr. Grant Seeger, a cancer specialist with Altru Health System in Grand Forks. "About 2,000 people are diagnosed in the United States each year-or less."

There may be no signs of the cancer in its early stages, but signs and symptoms may appear as the tumor grows.

Some people may notice a blockage on one side of the nasal passage, Seeger said.
"The patient feels like they can't breathe through that side of the nose. It can be a benign polyp and develop into cancer, or it can start out as cancer."

Symptoms may also include spontaneous nose bleeds, having "a copious amount of discharge" from the nose, or the bulging of one eye, he said.

These tumors are more common with age, with about four out of five cases occurring in people who are at least 55 years old, according to the American Cancer Society. They can grow and spread into nearby areas and then may spread to nearby lymph nodes, which are bean-sized collections of immune cells scattered throughout the head and neck, and the rest of the body.

Cancer cells from nasal tumors can also travel to regional lymph nodes or through the bloodstream to the lung or bones, Seeger said.

"There are a lot of potential ways to get (nasal cancer), including exposure to toxins," he said. People who smoke or work in factories where they inhale chemicals or toxic fumes may be at risk.

"Anytime you're breathing in chemicals on a daily basis, those are factors that are most notorious for causing those types of cancer."

"(Use of) alcohol alone is not a risk factor specifically linked to nasal cancer, but alcohol and tobacco together can enhance risk," he said, noting that genetics can also play a role in one's risk for subcategories of this type of cancer.

There are several types of nasal cancer but, in general, the survival rate at stage one is 65 percent, stage two is 60 percent, stage three is 50 percent, and stage four is 35 percent, Seeger said. "That's a global ballpark estimate."

Staging is a process that tells the doctor how widespread a cancer may be; it will show if the cancer has spread and how far.

Because of the location of these tumors in the nasal cavity area, "right between the eyes and in front of the brain, (radiation) needs to be very accurately targeted."

Altru uses high-end technical equipment to treat cancer patients with "intensity modulated radiation therapy," he said.

Through a formal association Altru has with Mayo Clinic, Altru physicians may consult, by electronic secured format, with specialists there to help determine the stage of the cancer and a treatment plan, he said.