A top Australian chef dedicated to his craft was forced to make the traumatic decision of choosing his ‘final meal’ – before having part of his mouth removed as doctors fought a to contain an two aggressive forms of cancer.
Brendan O’Keefe, from Adelaide, spent 15 years cooking and tasting food from the nation’s top kitchens. Then in 2021 he became irritated by what he thought was an infected tooth, after spotting a ‘small lump’ on his gum.
He thought little of it and didn’t even rush to see a doctor.
When he did, he was referred to a maxillofacial surgeon, who as a precaution decided to conduct a biopsy on his gum. But he told Brendan he was ‘99.9 per cent sure’ there was nothing sinister to uncover.
How wrong he was. The minor irritation was actually a sign he was suffering from two forms of rare and aggressive cancer in his head and mouth; spindle cell carcinoma and rhabdomyosarcoma (RMS).
Brendan O’Keefe, from Adelaide, was diagnosed with two different forms of cancer in one year: sarcomatoid spindle cell carcinoma of the sinus and rhabdomyosarcoma – a ‘rare’ type of sarcoma
The chef had been suffering from what he thought was an infected tooth after spotting a ‘small lump’ on his gum in 2021 so didn’t ‘rush’ to see a doctor
‘I had spent 15 years of my life eating at the best restaurants all around the country and I didn’t know if the way I taste and eat would ever be the same again. Turns out I was correct and food would change forever.
‘I was operated on under mild sedation and all was going well, until I very clearly heard the words “wow, this isn’t what I was expecting”. At that point my gut was starting to tell me that I’m in trouble,’ Brendan told FEMAIL.
‘He had to stop because I was in pain and he couldn’t find the end of the lesion because it went so deep.’
Brendan had to wait 20 days for the biopsy results and was eventually told the dreadful news over the phone.
‘My phone rang and my heart dropped. I knew this was it. The surgeon didn’t beat around the bush, just started to throw around lots of lengthy medical terms,’ he said.
‘I lay in bed thinking about how I was going to break this to my wife, Emily, and the rest of my family.’
When he spoke to her, the only two words he could muster were ‘it’s cancer’ and the pair cried for hours.
He chose Africola, a South African BBQ restaurant in Adelaide. for his last meal where he and Emily enjoyed wagyu sirloin steak pipis with pear couscous and beetroot labne and sprouted lentil salad
What are RMS and spindle cell cancers?
RMS – rhabdomyosarcoma – is a rare type of cancer that forms in soft tissue — usually in skeletal muscle tissue or organs such as the bladder or uterus. RMS can occur at any age, but it most often affects children.
RMS symptoms are usually first found in the head and neck area, the urinary or reproductive organs, or the arms and legs.
The signs and symptoms depend on where the cancer is found.
If the cancer is in the head or neck area, signs and symptoms may include: Headaches, bulging or swelling of the eyes, or nose, throat or ear bleeds.
What is Spindle Cell Carcinoma?
Often linked to smoking and drinking alcohol, and potentially radiation exposure.
It often appears as a lesion or as a flat tumor.
The cancer is found in the mouth, primarily on the tongue, frequently involved sites include the tongue, the cheeks, floor of the mouth, and lips. Patient tend to complain of swelling, pain, paresthesia, or bleeding. Because of its benign appearance., the tumor is often mistaken for another benign lesion.
Spindle cell carcinoma is worse than conventional cell carcinoma.
From that point everything was a ‘whirlwind’ for Brendan who had ongoing phone calls with doctors, appointments and scans while still working in hospitality.
Brendan decided to enjoy a ‘final meal’ before mouth surgery in case he lost his sense of taste forever.
He chose Africola, a South African BBQ restaurant in Adelaide with his wife Emily, enjoying a wagyu sirloin steak, pipis with pear couscous and beetroot labne and sprouted lentil salad.
‘I had spent 15 years of my life as a chef, eating at the best restaurants across the country, and I didn’t know if the way I taste and eat would ever be the same again.
‘Turns out I was correct and food and the way I knew it would change forever,’ he said.
Surgeons removed nearly two thirds of his top jaw, including the teeth, as well as lymph nodes in surrounding tissue
In January 2022 Brendan had his first major surgery and doctors found a tumour in his head that was 6cm long. A third extended into his mouth.
The remainder of the tumour was ‘hidden’ in his maxillary sinus – a hollow space in the bone beside the nose.
Surgeons removed nearly two thirds of his top jaw, including the teeth, as well as lymph nodes in surrounding tissue.
He then needed a second surgery the following month as his team of doctors ‘weren’t happy with the margin achieved’ and wanted to ensure no cancer was lingering.
To this day, doctors aren’t sure what caused the life-threatening cancer – and will likely never know.
From the ordeal, Brendan had been left unable to eat solid foods and his facial structure has completely changed. He also has difficulty speaking
‘I just wonder, why me? Have I really been this bad a person? What did I do in a previous life? Or maybe it’s just all random and I’m really, really unlucky,’ he said.
‘One of the hardest parts was not being able to get a specific prognosis. I was told that they don’t know, or that my specific cancer is so rare that there isn’t really enough date to say.’
‘They (doctors) just keep saying that I’m young and they need to do everything they can to make sure it doesn’t come back. The urgency and their aggressive approach said it all to me.’
Following surgery, he started six and a half weeks of intensive radiotherapy. During this time Brendan worked closely with a dental team to ensure the radiation wasn’t destroying his bones or remaining teeth.
From the ordeal, Brendan had been left unable to eat solid foods and his facial structure has completely changed. He also has difficulty speaking.
‘Until recently I was wearing a special denture called an obturator which was specially designed to seal the hole in my mouth. Without this, I struggled to speak, food and drink would go into my mouth and come straight back out of my nose,’ he said.
‘Swallowing food felt like razor blades. I was struggling to maintain weight and ended up on a liquid diet,’ he said
‘I can’t really drink through a straw anymore, can’t blow a candle out, and I have extensive numbness throughout the left-hand side of my face.
‘The way I look has changed as well, my facial structure has changed on one side, I have big scars, a large portion of my facial hair never grew back after radio therapy.’
Three weeks into treatment Brendan also lost his ability to taste and had chunks of hair falling out. His mouth stopped producing saliva and soon developed a candida infection.
That meant anything around his mouth burnt, with even drinking water feeling like his mouth was ‘on fire’.
‘Swallowing food felt like razor blades. I was struggling to maintain weight and ended up on a liquid diet,’ he said.
‘My team are scrambling to figure out what is going to work best for my next round of treatment, at this stage they’re unsure whether I should be treated for a carcinoma or a sarcoma, which significantly complicates things.’
‘I want to live’,’ he said
Last month he had an intense surgery to remove and reconstruct a portion of his lower jaw using a part of his fibula and ‘a very large skin graft’ from another part of his leg.
‘At the same time I had my neck cut open on both sides and another 80 to 100 lymph nodes removed for further examination,’ he said.
‘Speaking with my oncology team I was informed that they’re not sure what causes it and because of the rarity of this kind of tumour it would be unlikely I would ever find out the cause – it generally affects people in more advanced age, like over 70.’
All he can do at the moment is wait and hope.
In the meantime, he’s signed up for clinical trials in attempt to help find some answers on what to do next. And he’s still working as an assistant manager in a restaurant.
Two sentences from Brendan’s ‘amazing’ mum helped him push through some of his darkest days. She told him ‘Do you want to live? Or do you want to die’ and ‘take it one day at a time’.
‘I couldn’t have come this far without those words of wisdom,’ he said.
‘I want to live’.