Michael Douglas survived his brush with squamous cell carcinoma.
Erin Moran wasn’t as fortunate.
When the 56-year-old former “Happy Days” and “Joanie Loves Chachi” star succumbed to complications from the disease on April 22, it came just four months after her December diagnosis, according to an open letter her widower, Steven Fleischmann, wrote last week.
“The coroner told me it was really, really bad,” he wrote. “The coroner said even if she was in the hospital being pumped full of antibiotics she still would not of made it. He said it was the best that she was with me and went in her sleep.”
When we South Floridians hear the term “squamous cell carcinoma,” we usually associate it with skin cancer – one of two eminently curable kinds (along with basal cell carcinoma).
(Melanoma, on the other hand, is a far more serious, and often fatal, form of skin cancer.)
But what many of us may not realize is that virtually all head, neck and oral cancers – including the throat cancer that Douglas and Moran had – are squamous cell carcinomas.
“The entire inner lining of your mouth and throat – including your tongue, tonsils and voice box – are comprised of squamous cells,” said Cleveland Clinic Florida head and neck surgeon Dr. Michael Medina. “When cancers in these areas are detected early, they’re usually curable – either with surgery or some combination of radiation and chemotherapy.”
However, because there are no early screening tests for oral cancers, it’s vital that folks not ignore certain symptoms.
“Any persistent scratchiness in your voice or throat should be checked out immediately,” said Jupiter Medical Center radiation oncologist Dr. Nathan Tennyson. “The same goes for any sore in your mouth that just won’t seem to heal.”
Medina added that an often-ignored symptom of throat cancer is a minor pain or strange sensation in the ears that won’t go away. “It can seem very innocuous at first,” he noted.
In some cases, though, throat cancer can develop asymptomatically – as it appears to have done with Moran.
According to Fleischmann’s account, the southern Indiana couple didn’t know anything was wrong with Moran until she “woke up and had about a dime-size blood stain on her pillowcase.”
They thought maybe she’d bitten her tongue in her sleep. When they discovered a bigger spot of blood a few days later, they went straight to an otolaryngologist – who took a biopsy and later gave them the unfortunate diagnosis.
“At this point, her doctors would have given her a metastatic workup to see if the cancer had spread,” said Tennyson.
With her starting a regimen of five days a week of radiation and one day a week of chemo, this indicates to Medina that they likely considered the cancer still Stage I or Stage II (meaning it wasn’t in the lymph nodes or any other organs).
However, wrote Fleishmann, “It got so bad so fast. By the middle of February, Erin could no longer speak or eat or drink.”
Fleishmann’s letter also said that the coroner told him that the autopsy revealed that the disease had spread to Moran’s spleen, lungs and brain.
With Moran’s death, and the death of director Jonathan Demme at 73 of esophageal cancer, they become the latest high-profile examples of a cancer that is on the rise.
Around 50,000 Americans are diagnosed annually with oropharyngeal cancer and the National Cancer Institute says that around 70 percent of the cases are related to high-risk strains of human papillomavirus (HPV).
“Smoking used to be No. 1 risk factor for oropharyngeal cancers, but now it’s HPV,” said Tennyson.
Dr. Ted Teknos, chair of head and neck surgery at the Ohio State University Comprehensive Cancer Center, told SELF magazine last week, “We’re at the tip of a big epidemic of HPV-related malignancies. To put it in perspective, since the 1980s to the 2010s, (throat cancer) has increased by 228 percent, primarily because of the HPV virus.”
And potentially even more troubling, noted Teknos, is that despite the virus remaining dormant in folks for decades, “We’re now seeing a lot of throat cancer patients who are in their 40s and 50s … but soon we'll see people who were infected with HPV 50 years ago who, as they reach their 70s, will have a much higher rate of throat cancer.”
Signs/symptoms of oropharyngeal cancer
A sore throat that does not go away.
Pain when swallowing.
A lump or mass in the neck (due to spread of the cancer to nearby lymph nodes).
Source: American Cancer Society