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Michael Douglas and Throat Cancer FAQ

Michael Douglas Has Stage IV Throat Cancer; Experts Weigh In
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What are the symptoms of throat cancer? continued...

Any of these symptoms may signal throat cancer.

"I want people, especially smokers, who have what appear to be simple, stupid symptoms to see an ear, nose, and throat doctor," Har-El says. "All of us have hoarseness at end of the day, but if it persists over three weeks, see the doctor."

Har-El says that patients with ear pain often go to their doctor, who looks in their ear and tells them nothing is wrong.

"If you go to your doctor with ear pain and he says your ear is fine and unrelated to any other problem, go see an ear, nose, and throat doctor," he says.

What is the treatment for throat cancer? What are the side effects?

Treatment for early stage oropharyngeal cancer has traditionally been radiation, usually along with chemotherapy. But Har-El says surgery is becoming more and more popular, because small throat tumors can be removed with minimally invasive surgery or even with robotic surgery.

"This spares the patient radiation therapy, which is quite taxing to the patient," Har-El says.

Advanced tumors present more of a challenge.

"One is to do very, very big surgery. This removes the base of the tongue but sometimes also the voice box, because the base of the tongue prevents food from going through the voice box into the windpipe," Har-El says.

However, Teknos notes that reconstructive surgery can use tissues from other parts of the body to repair the base of the tongue. This technique makes it unnecessary for the surgeon to remove the voice box.

The other option for late stage oropharyngeal cancer is radiation and chemotherapy, which Douglas began three weeks ago. Surgery would be necessary only if this treatment fails.

While avoiding surgery, the side effects of radiation and chemotherapy are severe.

"The first few weeks are no big problem, but then patients often have significant difficulty with swallowing," Har-El says. "In most cancer centers -- and we certainly do it with advanced base-of-the-tongue tumors -- they insert a feeding tube right into the stomach through the belly. Mostly we try to do it ahead of time, before problems start, because if you do it later you have to interrupt treatment."

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