A top Australian chef dedicated to his craft was forced to make the traumatic decision of choosing his ‘last meal’ – before having part of his mouth removed as doctors battled to contain two aggressive cancers.
Brendan O’Keefe, from Adelaide, has spent 15 years cooking and tasting the best kitchens in the country. Then in 2021, he became annoyed with what he thought was an infected tooth, after seeing a ‘little lump’ on his gums.
He thought little about it and did not even hurry to see a doctor.
When he did, he was referred to a maxillofacial surgeon, who decided to perform a biopsy on his gums as a precaution. But he told Brendan he was “99.9 percent sure” there was nothing sinister to discover.
How wrong he was. The minor irritation was actually a sign that 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 cancers in one year: sarcomatoid spindle cell carcinoma of the sinus and rhabdomyosarcoma – a ‘rare’ type of sarcoma
The chef was suffering from what he thought was an inflamed tooth after seeing a ‘little lump’ on his gums in 2021, so he didn’t ‘hurry’ to see a doctor
“I had spent 15 years of my life 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 right and that food would change forever.
‘I was operated on under light anesthesia and everything went well until I heard very clearly the words ‘wow, I didn’t expect this’. That’s when my gut started telling me I was 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 results of the biopsy and finally got the terrible news over the phone.
My phone rang and my heart was pounding. I knew this was it. The surgeon didn’t beat around the bush, just started using a lot of long medical terms,” he said.
“I lay in bed thinking about how I was going to tell 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 couple cried for hours.
He chose Africala, a South African BBQ restaurant in Adelaide. for his last meal where he and Emily enjoyed wagyu sirloin pipis with pear couscous and beetroot labne and sprouted lentil salad
From then on everything was a ‘whirlwind’ for Brendan who had constant phone calls with doctors, appointments and scans while still working in the hospitality industry.
Brendan decided to enjoy a “last meal” before the 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 and eaten in the best restaurants in the country, and I didn’t know if the way I taste and eat would ever be the same again.
“Apparently I was right and food and the way I knew it was going to change forever,” he said.
Surgeons removed nearly two-thirds of his upper jaw, including the teeth, as well as lymph nodes in the surrounding tissue
In January 2022, Brendan underwent his first major surgery and doctors found a tumor in his head that was 6 cm long. A third stretched into his mouth.
The rest of the tumor was “hidden” in his maxillary sinus – a hollow space in the bone next to the nose.
Surgeons removed nearly two-thirds of his upper jaw, including the teeth, as well as lymph nodes in the surrounding tissue.
He then had to have a second surgery the following month because his team of doctors were “not happy with the margin achieved” and wanted to make sure no cancer persisted.
To this day, doctors aren’t sure what caused the life-threatening cancer — and probably never will.
The ordeal left Brendan unable to eat solid food and his facial structure has completely changed. He also has trouble speaking
‘I just wonder, why me? Have I really been such a bad person? What did I do in a past life? Or maybe it’s 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 they don’t know, or that my particular cancer is so rare there isn’t really enough date to say.”
“They (doctors) keep saying I’m young and they have to do everything they can to make sure it doesn’t come back. The urgency and their aggressive approach spoke for me.’
After surgery, he began intensive radiotherapy for six and a half weeks. During this time, Brendan worked closely with a dental team to ensure that the radiation did not destroy his bones or remaining teeth.
The ordeal left Brendan unable to eat solid food and his facial structure has completely changed. He also has trouble speaking.
“Until recently, I wore a special prosthesis called an obturator that was specially designed to seal the hole in my mouth. Without this I would have difficulty speaking, food and drink would go into my mouth and come right out of my nose,” he said.
“Swallowing food felt like razor blades. I struggled to maintain my weight and ended up on a liquid diet,” he said
“I can’t really drink through a straw anymore, can’t blow out a candle and have numbness on the left side of my face.
“My appearance has also changed, my facial structure has changed on one side, I have large scars, a large part of my facial hair has never grown back after radiation.”
After three weeks of treatment, Brendan also lost his sense of taste and chunks of hair fell out. His mouth stopped producing saliva and soon developed a candida infection.
That meant everything around his mouth was burning, with even drinking water feeling like his mouth was ‘on fire’.
“Swallowing food felt like razor blades. I struggled to maintain my weight and ended up on a liquid diet,” he said.
“My team is struggling to figure out what will work best for my next round of treatment. At this stage they’re not sure if I should be treated for a carcinoma or a sarcoma, which complicates things considerably.”
“I want to live,” he said
Last month, he underwent intensive surgery to remove part of his lower jaw and reconstruct it using part of his fibula and “a very large skin graft” from another part of his leg.
“At the same time, my neck was cut open on both sides and another 80 to 100 lymph nodes were removed for further examination,” he said.
“Speaking to my oncology team I was told they are not sure what causes it and because of the rarity of these types of tumors it’s unlikely I’ll ever pinpoint the cause – it generally affects older people, like over 70.”
All he can do at this point is wait and hope.
In the meantime, he’s signed up for clinical trials in an effort to find answers about what to do next. And he still works as an assistant manager in a restaurant.
Two sentences from Brendan’s “amazing” mom helped him get through some of his darkest days. She said to him, ‘Do you want to live? Or do you want to die’ and ‘take it one day at a time’.
“I couldn’t have gotten this far without those wise words,” he said.
‘I want to live’.