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Fighting and surviving oral cancer

David Hastings really wants to talk to Michael Douglas. The Gulfport man needs just a few minutes to tell the actor what he's in for.

Douglas, 65, announced last week that he has oral cancer, at the base of his tongue. Hastings was diagnosed with cancer in the same location in 2006.

"He needs someone like me to talk to who can tell him, 'This is what you need to know, this is what helps, don't try this, this is going to happen to you and this is normal,' " Hastings said.

"His wife (actor Catherine Zeta-Jones) is going to need help, too."

During an interview on David Letterman's Late Show last week, Douglas said he did two things wrong: He smoked and he drank alcohol. Eight in 10 people with oral cancer use tobacco, according to the American Cancer Society. The longer you smoke or chew tobacco, the greater your risk.

Heavy drinkers are also at risk. How much does it take to cause trouble? Not as much as you might think.

"Smoking a half pack of cigarettes a day for at least 15 years or drinking several alcoholic drinks a day for 10 years or longer increases your risk,'' said Dr. Tapan Padhya, director of the Division of Head and Neck Oncology at Moffitt Cancer Center in Tampa.

"Put smoking and alcohol use together and your cancer risk is significantly higher."

The cancer society estimates that 25,800 new cases of oral cancer will be diagnosed this year; more than half will be men.

Younger folks at risk

Hastings, 62, didn't fit the typical patient profile. In fact, he describes himself as "a health nut who didn't smoke, didn't drink much, exercised for my whole life and did everything you can think of to avoid getting cancer."

But like Douglas, Hastings admits he ignored a warning sign for weeks. Douglas says his was a persistent sore throat. For Hastings it was a lump he noticed while shaving, on the left side of his neck.

"I didn't say anything to my wife. I thought it would go away. But a month later it was still there," he says. (See sidebar for more warning signs.)

Padhya says oral cancer patients whose cancer is on the base of the tongue or on the tonsils tend to have the best prognosis.

So does the growing group of younger patients whose cancer is linked not to smoking and alcohol but to HPV, the human papillomavirus, which causes cervical cancer in women. The typical head and neck cancer patient used to be a longtime drinking, smoking man in his 60s.

"In the last 10 years, we've seen a whole new group who are 10 years younger and have little or no alcohol or smoking history. Research shows HPV may be the leading cause in that subgroup," says Padhya.

Hastings is part of that group. He has worked tirelessly to get the word out about this sexually transmitted disease, its link to oral cancer and the need for girls and boys to receive the vaccination against HPV before they become sexually active.

He went before the Florida House to advocate for making the HPV vaccination mandatory for ninth-grade girls and spoke before a Centers for Disease Control and Prevention panel in favor of vaccinating middle school-aged boys.

Life after treatment

Hastings and Padhya also say that while Douglas' diagnosis of Stage IV oral cancer sounds bad, it isn't necessarily a death sentence.

Much depends on whether the disease has spread; Douglas told Letterman that his doctors have given him an 80 percent chance of surviving.

Padhya also points out that not every patient will need disfiguring surgery to get rid of the cancer. Surgery is often reserved for cancer that returns after radiation and chemotherapy, the treatments that Douglas told Letterman he is now undergoing.

Hastings had seven weeks of the combination treatment. "It's brutal," he says. "They kill the cells, good and bad, in that area with the maximum amount of radiation that you can absorb." He likens the effects to having a severe, blistering sunburn in the throat.

"You can't taste, make saliva or swallow. You're on high doses of painkillers, you can't work. I'm a very fit guy and I lost 30 percent of my body weight. There's no way around it," he says.

Hastings, who owns a CPA business, spends about two to three hours a day encouraging and advising others through the Oral Cancer Foundation website. He says his physical recovery took two years; treatment left him with a damaged thyroid and partial hearing loss. And a touch of anxiety. Now, even the mildest sore throat makes him wonder if the cancer has come back.

Irene Maher can be reached at imaher@sptimes.com.

fast facts

Symptoms of oral cancer

If you experience any of these symptoms for more than two weeks, go to your doctor or dentist for an evaluation:

• A sore in the mouth that doesn't heal

• Mouth or throat pain that doesn't go away

• A white or red patch on the gums, tonsils or tongue

• A lump or thickening in the cheek or neck

• A persistent feeling that something is caught in the throat

• Difficulty swallowing

• Ear pain (actually pain from the base of the tongue referred to the ear)

• Bleeding in the mouth or throat

• Hoarseness

Fighting and surviving oral cancer 09/08/10 [Last modified: Wednesday, September 8, 2010 9:41pm]
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