Like many cancer survivors, actor Val Kilmer, 60, is thinking of others as he rides out the coronavirus outbreak: “Hope everyone is continuing to stay strong and safe,” he wrote on Instagram, sharing a drive-by photo of “beautiful Laura, daughter of my dear friend Lisa Little Chief Bryan,” holding a copy of Kilmer’s just-released memoir, “I’m Your Huckleberry.”
Known for roles in “Top Gun,” “Batman Forever,” and “The Doors,” Kilmer opens up about his throat cancer in the book, calling it, “one of my most personal projects.” Kilmer also was brave enough to share that the battle so tough, that he thought about wanting to not continue .
Read More“I Prayed Immediately”
His good friend, Cher, supported him during the dark days following his diagnosis, inviting him to stay in her guest house as his health declined.
“One night I suddenly awoke vomiting blood that covered the bed like a scene out of The Godfather. I prayed immediately, then called 911,” writes Kilmer who adds that, “Cher stepped in and stepped up.”
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"And yet even in my grave condition, I saw her scanning the paramedic, who was Gregory Peck drop-dead handsome. Only in Hollywood, right? Despite the fact that I was covered in blood,” he recalls, “here we were, joking about beauty and desire … while my life seemed to be in mortal danger.”
Impact on Speech
Kilmer underwent a tracheotomy, chemotherapy, and radiation. He turned to his Christian Science faith and prayed for healing. Today, he says, “I’ve been healed of cancer for over four years now, and there’s never been any recurrence. I am so grateful.” Although his speech has been greatly affected, he says he continues to do voice exercises every day.
"The fact that my impeded speech could spell the end of my career only served to motivate me," he writes. Kilmer reprised his Iceman role in the sequel, “Top Gun: Maverick,” now scheduled for release on December 23rd.
Types of Throat Cancer
Throat cancer has also impacted Megadeth’s Dave Mustaine, rocker Eddie Van Halen, and Beth Chapman, wife of Duane ‘Dog’ Chapman, who succumbed to the disease in 2019 after it spread. We don't know the details of Kilmer's case, but we do know that some forms of throat cancer are quite curable.
"Hopefully, [the cancer is] just involved in the neck and in the lymph nodes," Dr. Jessica Geiger, a medical oncologist specializing in head and neck cancer at Cleveland Clinic Cancer Center, told SurvivorNet.
"If the PET scan shows that the cancer has moved to the lungs or the liver, then our approach would not be to cure cancer but to treat it and to keep it under control."
Staging Throat Cancer
"It's really complicated because there are three stage 4s. It's not like breast cancer where once you're stage 4, you're incurable," Dr. Geiger continues.
“There are no screening guidelines to screen for throat cancer, unlike cervical cancer with pap smears,” says Dr. Jessica Geiger, a medical oncologist at Cleveland Clinic Cancer Center.
"In early-stage throat cancer, the cancer is confined to the primary tumor. That's often treated with surgery alone or sometimes even just radiation alone."
"In more advanced throat cancer cases, the lymph nodes of the neck are involved,” she says. When the disease spreads into the lungs or liver, “we call that distant metastatic disease and by definition those patients are considered incurable," she continues.
"So our treatment would be focused on palliative therapy, controlling the disease but, unfortunately, not curing it."
Causes and Symptoms
Often, throat cancer is caused by HPV, or human papillomavirus. "The most common type of head and neck cancer patients that we see are patients who have HPV-related throat cancer. So this is cancer that starts in the back of the throat such as in the tonsils or the base of the tongue," says Dr. Geiger.
"They often don't present with symptoms until lymph nodes in the neck are involved. Sometimes they have a sore throat, but sometimes all they have is a painless neck mass that the patient may just feel when they're shaving or washing their face,” says Dr. Geiger.
"Typically, a patient who develops a sore on the tongue or a lesion in the inside of the mouth that doesn't heal,” she explains. A dentist or primary doctor will refer them to an ear, nose and throat surgeon or an oral surgeon who will order an ultrasound of the neck or a CAT scan. “Then, we set the patients up with a biopsy to confirm cancer or to show something else and we proceed from there."
A New Approach to Treatment
According to Dr. Geiger, "The treatment for throat cancer, causes a lot of longterm side effects. Difficulty swallowing, neck fibrosis or scar tissue so it makes it difficult for the patients to turn their head.”
"A lot of our clinical trials, now, are looking at what we call de-intensifying therapy. Reducing the amount of radiation that patients receive, leaving out chemotherapy or substituting another agent such as immunotherapy in place of chemotherapy," she said.
“These are questions that are being asked in clinical trial format and over the next several years we hope to answer whether or not patients with HPV-related throat disease actually need the full course of treatment that tobacco-related cancers need."
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