For Scott Goodman, halfway is never enough. His intensity bursts through into everything he does -- his way of speaking, his job, his love of life and family -- even his exercise regimen.
So, when he was diagnosed with squamous cell cancer of the ear canal, Goodman knew he wanted his treatment to be as aggressive as possible.
Squamous cell cancer that begins inside the ear is extremely rare. So rare, in fact, that it's not clear how many cases occur each year. However, Paul Gidley, M.D., associate professor in MD Anderson's departments of Head and Neck Surgery and Neurosurgery, estimates that only some 300 cases are diagnosed every year in the United States.
One day in 2007, as Goodman stood in front of the bathroom mirror preparing for work, he did something your mother and doctors probably have told you a million times not to do. He put a Q-tip in his ear.
"When I took the Q-tip out of my left ear, there was blood on it," he says. "That's not what you expect to see, and I knew it wasn't normal."
Goodman, who describes himself as "49 years young," is a consultant who helps start, develop and grow surgical device companies. He is on friendly terms with many doctors, and he made an appointment as soon as possible with an ENT (ear, nose and throat) doctor (also known as an otolaryngologist).
The doctor saw a growth in Goodman's ear and removed tissue from it for a biopsy. The result stumped him; he never had seen or even heard of the type of cancer cells. He referred Goodman to a specialist at a cancer center close to where Goodman lives in Louisville, Ky.
"The specialist said he had heard of the cancer and believed he had the skill set to treat it -- but he never had," Goodman says. "That's when I knew I really was in trouble."
Aggressive treatment carried risks
When Goodman found he had ear cancer, he got to work searching for the best place to be treated.
"Everyone wanted to do partial this and partial that," he says. "The doctors at MD Anderson wanted to be more aggressive -- and I did, too."
This meant surgical removal of the eardrum and canal, temporal bone, parotid gland and several lymph nodes in his neck. Gidley and Erich Sturgis, M.D., associate professor in the departments of Head and Neck Surgery and Epidemiology at MD Anderson, warned Goodman of possible side effects and a long, arduous recovery.
Although he knew the road back to "normal" would be a challenge, Goodman was confident he had the mental and physical stamina to handle whatever the surgery threw at him.
"I have a large support group of family and friends, and I've always been a healthy man," he says. "I'm very active and had even ridden in four 500-mile bike marathons. The month before the surgery, I worked out twice a day so I could be as strong as possible."
Recovery was extensive
The eight-hour procedure was a success. Since a wide margin of tissue around the tumor was removed, Goodman was able to avoid radiation and chemotherapy.
"Sturgis was such a good surgeon that he was able to put me back together without the need for reconstruction," Goodman says. "He formed skin flaps to cover the orifice where my ear used to be."
True to the doctors' predictions, recovery was a challenge, and almost four years later Goodman feels that he still is healing.
"I couldn't blink for about three months because my facial nerves just wouldn't work," he says. "It took about a year to feel halfway normal, and even now I'm getting better every day."
Intensity is channeled into inspiring others
Goodman's facial function is normal now, though he copes with occasional eye fatigue and ear pain. He says he sometimes feels like cement has been poured into his ear. But that doesn't stop him from what he considers his new life mission: reaching out to other cancer patients.
"When I come back to MD Anderson, my personal goal is to talk to everyone in the ENT clinic, especially young people," he says. "My calling is to uplift, encourage and give them strength. I let them know there is hope."
Back to intense workouts and enjoying life full throttle, Goodman sees his glass as not only half full, but brimming over.
"Every day I put my best foot forward and do the best I can," he says. "I'm healthy, whole and well. I can hear, I'm alive, and I'm cancer-free."
Q&A: Ear and Temporal Bone Cancers
Cancer of the ear and temporal bone are rare, and they can be difficult to diagnose and challenging to treat. Yet, progress is being made in finding out what drives these diseases and how to approach them more successfully.