My lost summer
I hear that April is oral cancer awareness month — everything gets its month or week or day of recognition now.
Five years ago, I barely knew oral cancer existed, but I was about to become keenly aware.
In mid-March 2010, I noticed a lump on the right side of my neck — a swollen lymph node. I was scheduled to run an early season 5K that’s part of Detroit’s St. Patrick’s Day celebration, and my big concern about the lump was that I might be coming down with a cold that would hamper my running. It turned out that I ran decently and didn’t get a cold — but the lump didn’t go away.
I have a lipoma — a fatty lump — on the back of my head (yes, I’m a fathead), and I thought the lump probably was another of those. But I had turned 50 a couple of years before and hadn’t gotten a physical as guys of that age are supposed to do, so I scheduled one.
At my physical, somewhere between “cough” and “bend over,” I asked the doc, a Syrian resident at Henry Ford Hospital, about the lump.
He felt it and, without hesitation, said, “I’m going to send you to an ear, nose and throat doctor to rule out cancer.”
He had to be wrong. I quit smoking in 1992 after quitting drinking in ’90. I ran. I biked. I wasn’t obese.
Cancer just didn’t care about any of that. I had Stage IV head and neck cancer.
It completely wrecked the summer, with random oral biopsies and a double tonsillectomy in June seeking the source of the cancer, and 35 radiation treatments from late July through just after Labor Day. The treatment made my mouth a war zone, destroying my sense of taste for a few months and creating radiation sores inside and out.
Perhaps, though, I can help raise awareness about oral cancer.
Oral cancer is something of a nonspecific term that covers cancers of the tongue, roof of the mouth or farther back in the throat. The primary way to detect the cancer before it spreads to lymph nodes is for your dentist to carefully look for trouble spots in your mouth. All dentists should routinely do this now.
That’s not foolproof; the cancer can be invisible. In my case, the source was inside my right tonsil, found only by a microscopic exam of a slice of tissue removed during my oral biopsies. It was important to find the source so the radiation could be targeted and be a bit less unpleasant.
I was lucky, too, that a young doc in training at an inner-city hospital knew what to do with me. I heard and read many stories later about people given antibiotics for six months before someone realized what was going on.
It’s a cancer that is on the rise, even though its longtime primary cause, smoking, is in decline. An increasingly common cause is the human papillomavirus, specifically HPV-16. HPV is implicated in almost all cervical cancers, and, according to the Oral Cancer Foundation, “the fastest-growing segment of oral cancer patients is young, healthy, nonsmoking individuals due to the connection to the HPV virus.”
The Centers for Disease Control and Prevention website says this: “Anyone who is sexually active can get HPV, even if you have had sex with only one person. You also can develop symptoms years after you have sex with someone who is infected, making it hard to know when you first became infected.” Most people, though exposed, never develop symptoms associated with HPV.
My cancer was HPV-positive, and today’s standard treatment is more effective against this strain than cancers not linked to HPV.
An HPV vaccination is now available, and the CDC recommends it for girls and boys now by age 12.
Oh, yes, this is one of those recommendations that makes some parents and moralists uncomfortable because it suggests that children might have sex by their mid-teens. It’s certainly better if they don’t, but it’s also certainly better if they don’t get cancer 10, 20 or 30 years later. Piety and wishful thinking just don’t ward off cancer. (Or babies, but that’s an entirely different column.)
The Oral Cancer Foundation says, “125 people in the U.S. every day will be newly diagnosed with an oral cancer, and one person every hour of the day, 24/7/365 will die from it.”
I didn’t. My favorite doctor through the treatment was the radiation oncologist, Avraham Eisbruch. He told me the first time I met him, “Oh, we cure 90 percent of these cancers now. Of course you only care about your case, which is either zero or 100 percent.” He always forgot, too, that I’d smoked until 1992, which added some uncertainty to my probable cure rate.
But Eisbruch told me many times that this cancer never comes back after three years. “After three years, you are out ov zee voods,” he would say in his German accent. Five years after my diagnosis, that’s music in my memory.
Some people will say, and mean it, that they wouldn’t trade their cancer experience. They learned about themselves, they learned about the kindness of others and they made new friends. All of those things in fact happened in my case, but if I could go back, I still would rather not have had cancer.
And I’m pretty sure you don’t want your kid to go through it.
Randy Essex is editor of the Post Independent.