Pain in the neck could be throat cancer

Pain in the neck could be throat cancer

Credit: myRegence

Cancer diagnosis.


by LISA CANNON / myRegence Contributor

Posted on November 13, 2009 at 11:22 AM

Updated Wednesday, Oct 30 at 9:40 AM

Wyatt Starnes is not afraid of tackling big challenges. For the last 30 years, he's worked in the high technology industry. He's worked in eight different startups and cofounded a nonprofit alliance to help develop technology for homeland security. But in 2003, he faced one of the biggest tests of his life.

Pains in the Neck
In the summer of 2003, Starnes was travelling a great deal. When he returned from a long business trip to Asia, he felt more run-down than usual. He decided to spend some time on the Oregon coast to recharge his batteries and spend time with family.

"My nephews came up for the fourth of July," he recalls, "And the youngest was just getting over strep throat, and I ended up getting it too. I went in and my doctor treated it with antibiotics."

But Starnes still had pain in his throat after three weeks, and he'd seen evidence of bleeding. After another course of antibiotics the pain continued, and he developed an earache. "I started researching those symptoms on the Internet," he says, "And I saw that they could be more serious than a persistent case of strep throat."

By this time, Starnes was getting ready to go on another long business trip to China. "I went in and saw an ear, nose and throat specialist. He used an optical scope on me, and then he started to make a disapproving "hmmm" sound. He got one of his colleagues to come look and they both started making the same sound. The doctor let me know they'd need to do a biopsy. I told him, 'But I'm leaving for China next week' and he said, 'Oh no, you're not.' "

Starnes quickly made an appointment with Oregon Health and Science University (OHSU) for the biopsy. "I was immediately impressed by the efficiency of their medical system," he says, "Especially in their approach to cancer--because that's what it turned out to be."

A Lump in the Throat
Cancer of the throat was the diagnosis--specifically, squamous cell carcinoma (SCC), which is the second most common form of skin cancer. Every year, there are 250,000 new cases and it causes approximately 2,500 deaths.  Many people don't realize that SSCs can occur inside your body as well as on your skin--specifically in your mouth, your throat, and on your lungs.

Starnes' tumor was located above the esophagus, just below the tongue. "It was a significant-sized tumor," he says. "But right after the diagnosis, a team of doctors were assigned to me, which was wonderful. They decided that surgery wasn't advisable--it was early enough that we could go with chemo and radiation."

During the 16-week treatment program, Starnes would go for morning appointments, several days a week for either chemotherapy or radiation. He discovered that eating was his biggest problem--and not just on account of the nausea from treatment. Because the chemo and radiation was focused on his throat, Starnes was unable to swallow--his throat was constantly sore and irritated. He depended on a feeding tube inserted into his stomach to get the nutrients he needed.

"That was the hardest part," Starnes admits. "You don't really appreciate food until you can't have it. I couldn't sleep, so I would stay up at night watching cooking shows, feeling sorry for myself." Starnes started treatment weighting 190 pounds. Just 17 weeks later, he weighed 135 pounds.

Waiting for the "All Clear"
Even after finishing the course of treatment, Starnes had to wait at least an additional month for the "all clear" signal. "There was a lot of tissue damage," he says, "so they couldn't see what kind of success they had." Once the tissue had healed, the doctors told him they didn't see any signs of the tumor. They couldn't be 100 percent certain, but they believed that he had responded extremely well. They kept close tabs on him, however. Starnes visited his doctors once a month for the first year to see how things were going.

"They told me that the chances of recurrence are greatest during the first and second year, but that it drops dramatically during the first five years--there's less than five percent recurrence after five years." That's great news for Starnes, who has been in full remission since 2004.

Credit for the Cure
Starnes has a huge appreciation for the care his doctors provided him during his most challenging time. He says, "I really had some of the best doctors in the world. Dr. James Cohen was my primary care oncologist - and I even had Lance Armstrong's chemo guy [Dr. Craig Nichols]. When my doctor told me I was in the clear, I said to him, 'I realize I haven't really thanked you for everything you've done--the overall treatment, the quality of care, it was all very professionally administered.' He said, 'Look, you did most of the work. I knew you were going to be a survivor. When we gave you a 60 percent prognosis, you said that those were pretty good odds!' "

According to Starnes, his insurance coverage was completely transparent during the ordeal. "Essentially they stepped in right away--the entire process of claim and payment was seamless. I can't remember one problem where I had to deal with anything. The hospital and doctors worked with Regence Blue Cross Blue Shield of Oregon and everyone seemed to have the process really well understood."

It made a big difference in his recovery. Starnes says: "At the time I had other things on my mind, but afterwards I realized a lot of people have to fight for their health--and sometimes they have to fight with their doctors and their insurance at the same time. But I was able to focus my entire attention on getting better. And that's what I did."

Starnes also gives a lot of credit to his family for their support and understanding--and especially his nephew who had strep throat: "If I had noticed a sore throat, I would have ignored it. Like most men, I avoid the doctor. I would have probably put it off for months, if not longer. But because I knew it was likely to be strep, I went in, and they found the cancer. These kinds of cancers in the soft tissue are extremely dangerous. But if you can catch them early, your chances are much better. In a way, it was a miracle for me."

About the Author

Wyatt Starnes was diagnosed with squamous cell carcinoma of the throat in September, 2003, and has been cancer-free since May, 2004.  He currently lives in Portland, Oregon and spends his time working, traveling, and playing golf.