Michael Douglas cancer diagnosis: What did the 'Basic Instinct' star think caused the cancer and what it actually was
In 2010, Hollywood icon
Michael Douglas
publicly revealed he was battling stage IV throat cancer. He initially thought stress, years of smoking, and heavy drinking might have played a role.
However, as facts emerged, it became clear the cancer was linked to a different culprit altogether.
What was it?
What did Michael Douglas think caused his cancer (and what it really was)
When diagnosed in August 2010, Douglas publicly suggested that long-term alcohol and tobacco use, along with stress, might have contributed to his cancer. He admitted that stress, especially relating to his son's incarceration at the time, also weighed on his mind. Later, in a candid 2013 interview, the American actor and producer mentioned human papillomavirus (HPV) tied to oral sex as a possible cause.
In a quite uncanny manner, parallels were drawn between him starring in films like 'Basic Instinct', 'Fatal Attraction', and so on.
His initial symptoms, like persistent throat or ear pain, were misdiagnosed as infection, until a physician in Montreal peered deep into his throat and a tumor was spotted at the base of his tongue. A biopsy confirmed stage IV squamous cell carcinoma of the tongue, an advanced form of oral cancer, prompting immediate treatment with chemotherapy and radiation.
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The real culprit: HPV, not habits
In 2013, Douglas made headlines when he suggested his cancer was caused by HPV, a sexually transmitted virus, possibly contracted through oral sex. He remarked: 'this particular cancer is caused by HPV … which actually comes about from cunnilingus.'
However, his representatives clarified he was speaking broadly about HPV-linked cancers, not necessarily his own case. They added that he did not definitively state that oral sex caused his personal cancer, and emphasized that HPV is a known risk factor for oropharyngeal cancers, but not necessarily the direct cause in every case.
What is HPV and why does it matter in oral cancer
HPV, or Human Papillomavirus, is a common viral infection that can cause various health problems. It is primarily transmitted through sexual contact and affects the skin and mucous membranes, with over 200 identified types. While many HPV infections are harmless and resolve on their own, some types can lead to serious complications like genital warts and certain cancers.
HPV is categorized into low-risk and high-risk types.
Low-risk HPV:
These types can cause genital warts but are not typically associated with cancer.
High-risk HPV:
These types can lead to various cancers, including cervical, vaginal, penile, anal, and throat cancers.
HPV is now recognized as a major risk factor for this type of cancer, particularly in the back of the throat, tonsils, and base of the tongue. While HPV infection is common, it usually clears up on its own.
However, in some cases, it can persist and lead to the development of cancer years later.
HPV-related throat cancers are becoming increasingly common. In fact, HPV now accounts for a majority of oropharyngeal cancer cases, especially among men. These cancers often strike adults who are non-smokers and non-heavy drinkers.
What is squamous cell carcinoma?
Squamous cell carcinoma (SCC) is a type of cancer that develops from squamous cells, which are flat, scale-like cells found in the skin and other tissues.
It's the second most common type of skin cancer, after basal cell carcinoma, and can also occur in other areas like the lungs, head and neck, and cervix. SCC is often caused by prolonged exposure to ultraviolet (UV) radiation from the sun or tanning beds.
Squamous cells are a type of epithelial cell, meaning they form the lining of surfaces throughout the body, including the skin, respiratory tract, and digestive tract.
They are flat and scale-like, resembling fish scales under a microscope.
While SCC is commonly found on sun-exposed areas of the skin like the face, scalp, and hands, it can also develop in other locations, including:
Skin:
This is the most common site.
Lungs:
Lung cancer can sometimes be of the squamous cell type.
Head and neck:
This includes cancers of the mouth, throat, and voice box.
Cervix:
Cervical cancer can also be squamous cell carcinoma.
Other locations:
SCC can also occur in the nasal cavity, sinuses, and tear ducts.
Can HPV cause SCC?
Some types of Human Papillomavirus (HPV) can cause squamous cell carcinoma (SCC). Specifically, high-risk HPV types, like HPV-16 and HPV-18, are strongly linked to the development of certain squamous cell carcinomas, particularly in the oropharynx (the middle part of the throat). HPV infection is a significant risk factor for oropharyngeal squamous cell carcinoma (OPSCC).
Risk factors
SCC risk factors include excessive sun exposure, fair skin, a history of sunburns, older age, male gender, immunosuppression, and certain genetic syndromes apart from those stemming from HPV. Lifestyle factors like smoking and heavy alcohol consumption also increase the risk. Additionally, chronic wounds, exposure to radiation or arsenic, and a history of other skin cancers can be contributing factors.
Let's take a detailed look:
Ultraviolet (UV) radiation exposure:
Sun exposure is the most significant risk factor, particularly for cutaneous squamous cell carcinoma (cSCC).
Cumulative sun damage over time, especially during youth, increases the risk.
Fair skin:
Individuals with fair skin (Fitzpatrick skin types I-III) are more susceptible due to lower melanin levels, which offer less protection against UV radiation.
Age:
The incidence of SCC rises with age, with most cases occurring in individuals over 50.
Gender:
Males are generally at a higher risk of developing SCC compared to females.
Immunosuppression:
Weakened immune systems, often due to medications or organ transplants, make individuals more vulnerable to SCC.
Genetic predisposition:
Certain inherited conditions and genetic mutations (like TP53, CDKN2A, Ras, and NOTCH1) can increase susceptibility to SCC.
Smoking and alcohol consumption:
Heavy smoking and excessive alcohol intake are strongly linked to SCC, particularly in the oral cavity and esophagus.
Chronic wounds and scarring:
Persistent wounds, burns, or scars can create an environment where SCC can develop.
Arsenic exposure:
Long-term exposure to arsenic, through drinking water or occupational settings, can increase the risk of SCC.
Actinic keratosis:
These are precancerous skin lesions caused by sun damage and are a significant risk factor for cSCC.
Oral hygiene:
Poor oral hygiene and dental problems can contribute to oral SCC.
Family history:
A family history of skin cancer can increase an individual's risk of developing SCC.
Prevention and treatment
To prevent squamous cell carcinoma (SCC) of the skin, it's crucial to minimize sun exposure and avoid tanning beds. Regularly using sunscreen with at least SPF 30, seeking shade during peak sun hours, and wearing protective clothing like hats and long sleeves are essential steps. Annual skin exams, especially for those with risk factors like a history of sun exposure or family history of skin cancer, are also recommended.
Squamous cell skin cancer treatment options include surgery (excision, Mohs surgery), radiation therapy, and topical or systemic medications, depending on the cancer's size, location, and stage. For early-stage, small cancers, less invasive procedures like curettage and electrodesiccation, cryosurgery, or photodynamic therapy might be sufficient. For advanced cases, or when surgery is not an option, radiation therapy or medications like imiquimod or 5-fluorouracil may be used.
In the case of Douglas, the actor underwent aggressive chemotherapy and radiation treatments and has been cancer-free since 2011, though he continues with regular check-ups.
Sanjay Dutt on his battle with cancer: 'It all comes down to willpower and keeping the faith'
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