WARNING GRAPHIC IMAGES: Women who lost nose after mouth cancer gets £900k payout

Andrea McNicholas, 49, was diagnosed with the disease – by then in its latest stage – in July 2011 after complaining of symptoms including having a hole in her palate which wouldn’t heal for more than a year.

In November of the same year, she underwent a gruelling 20-hour operation, in which her neck was dissected, and her nose and part of her jaw were removed.

In the wake of the surgery, Mrs McNicholas, of Wigan, has been left with irreparable damage to her face.

She’s likely to be fed through a tube for the rest of her life, has difficulty breathing and swallowing, and her self-esteem is so shattered that she barely leaves the house.

Now, following a four year investigation, she has been awarded £900,000 in an out-of-court settlement after Wrightington, Wigan and Leigh NHS Foundation Trust admitted liability.

“This has had a dramatic affect on my mental health, as I’m constantly stuck indoors and feel as though I am unable to live my life,” said Mrs McNicholas.

“I don’t leave the house unless it is for appointments as I get tired very quickly. I am also extremely paranoid about the way I look. I feel as though everyone stares at me, regardless as to whether I wear big glasses or cover the majority of my face.

“I’m not the person I once was, in respect of my appearance or my personality.

“I sometimes think, ‘What’s the point in actually being here, when I cannot do normal, every day things, which most people take for granted?’ I just long to be normal - and I am unsure if I will ever reach that point again.”

Mrs McNicholas was referred to the Royal Albert Edward Infirmary, Wigan, in June 2010 for an MRI scan after she raised concerns about a small hole in her mouth that was not healing.

There, it was recommended a biopsy be taken – but when she returned two weeks later, she was not told the results, and was instead prescribed a course of antibiotics.

Over the next year, her symptoms worsened until she began experiencing painful pins and needles, which would shoot down her right cheek and across her upper lip.

Even though her dentist continued to refer her back to the hospital, a further biopsy wasn’t taken until July 2011 – more than a year on.

Tragically, by then it was too late, and the results revealed that Mrs McNicholas had stage four cancer of the mouth.

“I was told it was a very advanced form of cancer which I now know to be squamous cell carninoma,” she said.

Mrs McNicholas’ test results showed that the cancer, which had started in the roof of her mouth, had eaten away at her top gum line, cheek bone and nose, and was spreading toward her eye socket and tear duct.

It was also present in her upper lip and both glands either side of her neck.

She continued: “The diagnosis was absolutely heartbreaking. I couldn’t believe it.”

Before she could undergo surgery, Mrs McNicholas had three courses of chemotherapy to shrink the tumours that were ravaging her face.

Following the November 2011 operation – which she said “severely disfigured” her face – she has been left a shell of her former self.

She had to go through post-operative chemotherapy and radiotherapy, and even suffered a cardiac arrest due to complications in her treatment, which set back her recovery.

Though she has undergone a string of painful reconstructive surgeries, they have done little to change her appearance, due to the amount of bone and tissue removed in the original operation.

To this day, Mrs McNicholas has no nose and must wear a prosthesis, has no teeth and so cannot eat, relying instead on a tube to be fed and cannot close her left eye, meaning she has to tape it down at night time in order to be able to sleep.

She now requires hearing aids in both ears, and since having grafts taken from her back in an effort to rebuild the inside of her mouth, she has suffered mobility problems with her left arm.

But even more profound than her physical scars and her psychological ones.

Too self-conscious to leave her house, she is unable to work or socialise.

Her only potential chance to return a shred of normality to her life is a facial transplant, which are currently only available in the USA .

However, as she has previously suffered cancer the anti-rejection medication she would be required to take following such surgery may significantly reduce her life expectancy.

“I never imagined I would look like what I did after surgery,” she said. “Not to blow my own trumpet, but prior to being diagnosed I was a petite, good-looking lady, and what I became was unbelievable.

“Whilst in hospital I wouldn’t go near a mirror. I didn’t want to look at myself.

“But after a few weeks, I went to the toilet and accidently caught a glimpse of myself. It broke my heart, and I will never ever forget that moment.

“I knew my life had changed forever.”

A spokesperson from Stephensons Solicitors LLP, who handled the case, said: “If diagnosed in time Mrs McNicholas would have undergone a left neck dissection with removal of some of her upper jaw and septum, but not her nose.

“Reconstructive surgery would have been carried out at the same time to repair this with implants being later inserted in place of the removed teeth. Chemotherapy or radiotherapy would not have been required and she would have been able to eat, work and essentially lead a normal life without any impact on her sight, hearing or mobility and having avoided a cardiac arrest.”

A spokeswoman from Wrightington, Wigan and Leigh NHS Foundation Trust said: “The trust deeply regrets the shortcomings identified in the care provided and accepted full responsibility for the delay in diagnosis of cancer and expressed its unreserved apologies to Ms McNicholas.

“Legal representatives for Ms McNicholas and the trust have worked to agree an appropriate settlement to provide for Ms McNicholas’ needs now and into the future. The trust appreciates that money can never fully compensate for the pain and suffering Ms McNicholas has had to endure and would like to pay tribute to the strength she has shown throughout such difficult times.

“Steps have been taken to implement changes aimed at preventing this from happening again.”