Curt Schilling Blames Smokeless Tobacco for His Oral Cancer

For years, even as tobacco use began to decline and disappear in most settings, professional baseball seemed one of the few exceptions. Now, the tide is finally turning. Recently, the legendary right-hand pitcher Curt Schilling revealed that he had been treated for oral cancer — and said that his chewing tobacco habit was to blame. “I’ll go to my grave believing that was why I got [cancer],” Schilling told the Boston Globe.

Schilling isn’t the only former player whose oral cancer is blamed on smokeless tobacco. Tony Gwynn, Hall of Famer and beloved coach, recently passed away from oral cancer at the age of 54. His death led to players pledging to give up the habit. But many still use “dip” or “snuff,” thinking perhaps it’s not so bad after all.

In fact, nothing could be further from the truth. With nicotine as its active ingredient, chewing tobacco can be just as addictive as cigarettes. Not only is nicotine addictive, it also increases heart rate and blood pressure, constricts the arteries, and affects the body in other ways. In addition to nicotine, chewing tobacco contains about 30 other chemicals known to cause cancer.

Tobacco use of any kind is a major risk factor for oral cancer. While it isn’t as well-known as some other types of cancer, oral cancer can be just as deadly. About 43,000 people in the U.S. are diagnosed with it each year — and the 5-year survival rate is just 57%. One reason for the relatively low survival rate is that oral cancer isn’t usually detected until it has reached a later stage, when it’s much harder to treat.

What can you do to reduce your risk for oral cancer? Clearly, you should stop using tobacco products of any kind. Moderating your intake of alcohol, and eating more plant foods and less red meat can also have an impact. And don’t forget to have regular dental checkups: cancer’s warning signs can often be recognized in an oral examination — and early detection can boost survival rates to 80-90 percent.

How does Schilling feel about chewing tobacco now? “I lost my sense of smell, my taste buds for the most part. I had gum issues, they bled, all this other stuff,” he told the Globe. “I wish I could go back and never have dipped. Not once.”

If you have questions about oral cancer or cancer prevention, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Chewing Tobacco” and “Diet and Prevention of Oral Cancer.”

Reduce Your Risk of Oral Cancer With a Healthy Whole Food Diet

While genetics certainly plays a role in a person's susceptibility to various forms of cancer (including oral cancer), there are lifestyle factors that also play a role.

In the case of developing oral cancer, there are a number of prominent lifestyle changes you can make to help reduce your risk: protect yourself from too much sun exposure; avoid the use of any type of tobacco (smoke and smokeless); limit your intake of alcoholic beverages to a moderate level; abstain from risky sexual behavior; and eat a diet rich in fresh fruit and vegetables, as well as other whole foods.

That last lifestyle change not only reduces your level of negative exposure from the environment, it may also provide a positive effect as well. For example, normal cellular function produces unstable molecules known as “free radicals” that can damage the DNA structure within the cell; this could be a precursor to the development of cancer. There are natural substances, however, that can help protect cells against the damage caused by free radicals. These are known as “antioxidants” and they are abundant in many plant-based foods. You, of course, may know them by other names: vitamins, carotenoids (found in red and orange fruits and vegetables) or fiber, to name a few.

A well-balanced diet can provide these and other kinds of cancer-fighting nutrients. And, it's important that you eat the source of these nutrients — fresh plant-based foods. Studies have shown that dietary supplements can't match the effectiveness of actually eating fruit and vegetables.

Besides lowering your cancer risk, a plant-based, whole food diet will also result in better oral health. Diets heavy in processed foods with high amounts of sugar or other bacteria-friendly substances inhibit good oral health.

If you would like more information on the role of diet in reducing your risk to cancer, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Diet and Prevention of Oral Cancer.”

Are You at Risk for Oral Cancer?

Oral cancer accounts for approximately 3% of cancers in men and 2% in women. That may not sound like a lot, but the disease often isn't detected until it has progressed to its later stages when it's harder to treat and the outlook for survival is significantly diminished.

The main areas where oral carcinomas (cancers) occur are:

• the tongue (most common location, particularly the sides and underneath)
• the lip (especially the lower one),
• the oral cavity (the mouth), and
• the pharynx (back of mouth and throat).

Risk Factors You Can't Control

Even if you can't change these risks, awareness helps raise your vigilance in order to catch potential problems early when treatment options and positive outcomes are greatest.

• Heredity
• Aging — More than 90% of all oral cancers occur in individuals over 40. However, the incidence among younger people has been on the uptick recently, perhaps related to lifestyle behaviors.
• Race — African Americans have a higher incidence of oral cancer than Caucasians.

Risk Factors You Can Address

• Smoking and chewing tobacco — Smokers are at five to nine times greater risk and snuff and tobacco chewers at about four times greater risk
• Alcohol — Moderate to heavy drinkers are at three to nine times greater risk; the higher the alcohol content, the greater the risk
• Diet — A high intake of fruits/vegetables, which are high in antioxidants, has been found to have a protective effect against a variety of cancers, including oral.
• Chronic sun exposure — Often connected with lip cancers.
• Viral infections — Namely the human papilloma virus “HPV 16,” which has been linked to sexual transmission (oral sex) and cervical cancer in women.

As part of your routine oral hygiene, you should be closely monitoring any non-healing changes in your mouth (e.g., ulcers or sores, white or red patches on the tongue). And rest assured that as part of your regular check-ups, our office performs a comprehensive visual screening for signs of oral cancer.

If you would like more information about oral cancer prevention and detection, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Oral Cancer” and “Diet and Prevention of Oral Cancer.”

Seven Things You Should Know About Oral Cancer

Let's talk about oral cancer. Yes, it's a scary subject — but the truth is, the more you know about it, the better able you are to protect yourself.

1. Who is more likely to get oral cancer? Because of your genetic disposition — heredity — men are twice as likely to develop oral cancer as women. African-Americans have a higher incidence than Caucasians. The disease is also related to aging, although in recent years many young people have been diagnosed with this disease.
2. Are some habits related to development of oral cancer? Risk factors include use of tobacco in any form, both smoking and chewing, chronic exposure to sun, and consumption of alcohol. Moderate to heavy drinkers have a three to nine times greater risk than non-drinkers. Tobacco smokers are at five to nine times greater risk than non-users, and users of snuff or chewing tobacco are at four times greater risk than non-users.
3. Where do most oral cancers occur? The most common areas are in the mouth itself, the lips, the tongue, and the pharynx (back of the mouth and throat).
4. What are the statistics for survival after treatment for oral cancer? Conquering cancer depends most on early detection. Since most cases of oral cancer are discovered at a late stage, survival is poor, with less than 60% surviving five years after treatment. When oral cancers are detected early, the survival rate is more than 80%.
5. What are some of the symptoms of oral cancer? Most oral cancers are “squamous” (small scale-shaped) cell carcinomas in the lining of the mouth. Signs of these cancers can be seen as white or red patches in the early pre-cancerous stage. These develop into an ulcer that does not heal.
6. When should you seek medical help? If you notice color changes (white or red patches) or sores or ulcers anywhere in your mouth that do not heal within two or three weeks, go to your dentist for a checkup right away. Sometimes the sores resemble cold sores. A definitive diagnosis requires a tissue biopsy, in which a small piece of tissue is removed under anesthesia and taken to a lab for microscopic examination.
7. What about regular routine examinations? An oral cancer examination should be part of your visit to our office. We will inspect your face, neck, lips and mouth for signs of cancer, feel the floor of the mouth and sides of the neck for any lumps, examine your tongue and the back of your throat. The American Cancer Society recommends a cancer related check-up annually for all individuals aged 40 and older and every three years for those between 20 and 29.

Contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment to discuss your questions about oral cancer. You can also learn more by reading the Dear Doctor magazine article “Oral Cancer.”