Back in October 2010, after getting the news that "the margins were all good, and all the lymph nodes we scoped were clean" report, I blogged about that news here on the site.
I noted that I would not become "Cancer Guy," and can most definitely say I've lived up to that vow. There's typically no reason to ever bring it up, and other than a slight bit of facial asymmetry (there's a wee bit *more* of me on the left side b/c of the neck dissection), there's no noticeable difference I would need to explain, like when I couldn't pronounce certain letters for a while. When people see the massive scar on my arm (yes, an arm can become a tongue, just w/o the tastebuds), they probably assume it's military-related and too awkward to ask about. No one ever has.
But that's not about denial -- it's about putting something difficult in the rearview, and it's also about not driving other people nuts (the same reason I don't post FB statuses about what I'm eating or the run I just did...who, exactly, is supposed to care?)
I've never said "No" to Mass Eye and Ear for anything. To say that's the least I could would be a huge understatement. Annual brochure, awareness video, news clip for a syndicated medical segment? Yes, yes, and yes. Not everyone gets the best medical care in the world. I do. If I can help them raise awareness of something very serious that could help save someone's life, that's a no-brainer. If the story of diagnosis-treatment-successful deployment-successful follow-ups helps paint that narrative, all the better.
And the whole awareness thing is key because cancer survival has everything to do with detection. Catch it early enough, and it's surgery. Wait too long, and it's way more complicated. Radiation around the mouth can make it harder to produce saliva. Too little saliva could mean tooth decay. Tooth decay can create new problems. And so on.
In Michael Douglas' case, he did wait too long. Because "cancer" might not have been one of the originally-suggested reasons for the oral discomfort, it was somehow missed by his original medical team, despite the walnut-sized tumor developing on his tongue.
Anyway, Michael Douglas made waves this week by saying that his cancer was "caused" by all the oral sex he has performed over the years. While I won't doubt the lovemaking/lady-pleasing prowess of Michael Douglas, there is an important problem with the word "caused" there. And not in the stodgy, cranky grammarian way I try to correct misuse of words like "notoriety" or "humbled," but in a far more important sense that actually matters.
HPV-16 and HPV-18 are undeniably, unquestionably linked to certain cancers, including oral ones. So are smoking and drinking.
The drinking thing is of particular concern from those who are either born with, or develop, alcohol intolerance that prevents functioning of the enzyme needed to process alcohol into acetic acid. If you want to read all about the linkage between the single nucleotide polymorphism associated w/the onset of alcohol intolerance and the risks of squamous cell carcinoma, please feel free to click here. If you want to read about the highly carcinogenic properties of acetaldehyde, Google it.
That's all a huge mouthful of five-dollar words, so sometimes it's easier to say, "I'll have a scotch and soda, hold the scotch."
Anyway, back to Michael Douglas for a second. It's common folk wisdom, but not medically sound, to say a particular thing *caused* someone to get cancer. No M.D./Ph.D. is going to say you got cancer "because" you grew up near Pilgrim 1, or because you stood near a microwave. (Michael Douglas, btw, has a long and storied history of alcohol and tobacco use). The trouble with saying it is that it's a step away from starting to stigmatize those who suffer from poorly-differentiated cell division. (Note to anyone reading...if someone shares news of a cancer diagnosis w/you, there's one thing you should never say: "What did you do to get that?")
A growing percentage of oral cancer diagnoses involve HPV-positive patients. Keep mind that 80-90 percent of people eventually have some strand of HPV, which typically comes and goes within a two-year span. The vast majority of these strands do not have the cancer association. And just like not every lung cancer diagnosis involves smoking, not every oral cancer diagnosis involves HPV.
Trust me, I know.
In a way, it's a great thing that Michael Douglas is getting this into the news, because it's sparking the conversation that lets people jump in to help separate fact from fiction. Awareness is key. If you feel a persistent, extremely sharp pain on or around your tongue that feels like someone is driving a nail through one of the most sensitive parts of your body, have someone check it out. If the dentist sees a lesion, get a biopsy. The biopsy process will be physically painful in way that I won't even attempt to talk about in this protracted blog entry, but there's only one worse option.
And that option is simply unpalatable.
I noted that I would not become "Cancer Guy," and can most definitely say I've lived up to that vow. There's typically no reason to ever bring it up, and other than a slight bit of facial asymmetry (there's a wee bit *more* of me on the left side b/c of the neck dissection), there's no noticeable difference I would need to explain, like when I couldn't pronounce certain letters for a while. When people see the massive scar on my arm (yes, an arm can become a tongue, just w/o the tastebuds), they probably assume it's military-related and too awkward to ask about. No one ever has.
But that's not about denial -- it's about putting something difficult in the rearview, and it's also about not driving other people nuts (the same reason I don't post FB statuses about what I'm eating or the run I just did...who, exactly, is supposed to care?)
I've never said "No" to Mass Eye and Ear for anything. To say that's the least I could would be a huge understatement. Annual brochure, awareness video, news clip for a syndicated medical segment? Yes, yes, and yes. Not everyone gets the best medical care in the world. I do. If I can help them raise awareness of something very serious that could help save someone's life, that's a no-brainer. If the story of diagnosis-treatment-successful deployment-successful follow-ups helps paint that narrative, all the better.
And the whole awareness thing is key because cancer survival has everything to do with detection. Catch it early enough, and it's surgery. Wait too long, and it's way more complicated. Radiation around the mouth can make it harder to produce saliva. Too little saliva could mean tooth decay. Tooth decay can create new problems. And so on.
In Michael Douglas' case, he did wait too long. Because "cancer" might not have been one of the originally-suggested reasons for the oral discomfort, it was somehow missed by his original medical team, despite the walnut-sized tumor developing on his tongue.
Anyway, Michael Douglas made waves this week by saying that his cancer was "caused" by all the oral sex he has performed over the years. While I won't doubt the lovemaking/lady-pleasing prowess of Michael Douglas, there is an important problem with the word "caused" there. And not in the stodgy, cranky grammarian way I try to correct misuse of words like "notoriety" or "humbled," but in a far more important sense that actually matters.
HPV-16 and HPV-18 are undeniably, unquestionably linked to certain cancers, including oral ones. So are smoking and drinking.
The drinking thing is of particular concern from those who are either born with, or develop, alcohol intolerance that prevents functioning of the enzyme needed to process alcohol into acetic acid. If you want to read all about the linkage between the single nucleotide polymorphism associated w/the onset of alcohol intolerance and the risks of squamous cell carcinoma, please feel free to click here. If you want to read about the highly carcinogenic properties of acetaldehyde, Google it.
That's all a huge mouthful of five-dollar words, so sometimes it's easier to say, "I'll have a scotch and soda, hold the scotch."
Anyway, back to Michael Douglas for a second. It's common folk wisdom, but not medically sound, to say a particular thing *caused* someone to get cancer. No M.D./Ph.D. is going to say you got cancer "because" you grew up near Pilgrim 1, or because you stood near a microwave. (Michael Douglas, btw, has a long and storied history of alcohol and tobacco use). The trouble with saying it is that it's a step away from starting to stigmatize those who suffer from poorly-differentiated cell division. (Note to anyone reading...if someone shares news of a cancer diagnosis w/you, there's one thing you should never say: "What did you do to get that?")
A growing percentage of oral cancer diagnoses involve HPV-positive patients. Keep mind that 80-90 percent of people eventually have some strand of HPV, which typically comes and goes within a two-year span. The vast majority of these strands do not have the cancer association. And just like not every lung cancer diagnosis involves smoking, not every oral cancer diagnosis involves HPV.
Trust me, I know.
In a way, it's a great thing that Michael Douglas is getting this into the news, because it's sparking the conversation that lets people jump in to help separate fact from fiction. Awareness is key. If you feel a persistent, extremely sharp pain on or around your tongue that feels like someone is driving a nail through one of the most sensitive parts of your body, have someone check it out. If the dentist sees a lesion, get a biopsy. The biopsy process will be physically painful in way that I won't even attempt to talk about in this protracted blog entry, but there's only one worse option.
And that option is simply unpalatable.
Nicely played.
ReplyDeleteRegards — Cliff