Roger Ebert still smiling despite cancer surgeries

Legendary film critic Roger Ebert, 67, opened up to Esquire magazine this month about how his life has radically changed after cancer surgery. Most notably, for nearly four years, his treatment for thyroid cancer has left him unable to speak, drink or eat.   First diagnosed with thyroid cancer seven years ago, Ebert originally underwent radiation therapy, and partial removal of his salivary glands to treat the disease.  Unfortunately the cancer recurred in 2006, and he had to have part of his jaw removed. As he was getting ready to leave the hospital, his carotid artery (the main artery that supplies blood to the brain) burst, and with the hospital staff’s quick actions, and emergency surgery which removed most of his lower jaw and placed a tracheostomy tube in his windpipe, Ebert’s life was saved. He has undergone several difficult reconstructive surgeries since that time, but is still unable to speak, and has to be fed through a tube.  Despite all this, Ebert still reviews films, writes books and a column in the Chicago Sun-Times. He communicates with post-it notes and speech production software. His laptop has become a lifeline, and he feels that he is writing better than ever.

Ebert told ABC News: “I’d always heard how blind people developed much better hearing, and deaf people became more observant. It’s true.When you lose something, your mind and body adapt to compensate. In my case, whatever energy I put into speaking has now been channeled into writing, and my writing has benefited.”

The thyroid is a butterfly-shaped gland in your neck, just above your collarbone. It makes hormones that regulate regulates heart rate, blood pressure, body temperature and weight. The thyroid gland contains mainly 2 types of cells — thyroid follicular cells and C cells (also called parafollicular cells).

The follicular cells use iodine from the blood to make thyroid hormone, which helps regulate a person’s metabolism. Too much thyroid hormone (a condition called hyperthyroidism) can cause a rapid or irregular heartbeat, trouble sleeping, nervousness, hunger, weight loss, and a feeling of being too warm. Too little hormone (called hypothyroidism) causes a person to slow down, feel tired, and gain weight.

C cells (parafollicular cells) make calcitonin, a hormone that helps regulate how the body uses calcium.

Source: NCI
There are several types of thyroid cancer:

  • Papillary thyroid cancer: In the United States, this type makes up about 80 percent of all thyroid cancers. It begins in follicular cells and grows slowly. If diagnosed early, most people with papillary thyroid cancer can be cured.
  • Follicular thyroid cancer: This type makes up about 15 percent of all thyroid cancers. It begins in follicular cells and grows slowly. If diagnosed early, most people with follicular thyroid cancer can be treated successfully.
  • Medullary thyroid cancer: This type makes up about 3 percent of all thyroid cancers. It begins in the C cells of the thyroid. Cancer that starts in the C cells can make abnormally high levels of calcitonin. Medullary thyroid cancer tends to grow slowly. It can be easier to control if it’s found and treated before it spreads to other parts of the body.
  • Anaplastic thyroid cancer: This type makes up about 2 percent of all thyroid cancers. It begins in the follicular cells of the thyroid. The cancer cells tend to grow and spread very quickly. Anaplastic thyroid cancer is very hard to control.

Anyone can get cancer of the thyroid gland. But certain factors may increase the risk. These include

  • Being between ages 25 and 65
  • Being a woman
  • Being Asian
  • Having a family member who has had thyroid disease
  • Having radiation treatments to your head or neck

Symptoms of thyroid cancer include:

  • A lump in the front of the neck
  • Hoarseness or voice changes
  • Swollen lymph nodes in the neck
  • Trouble swallowing or breathing
  • Pain in the throat or neck that does not go away

In 2009, an estimated 37,200 adults (10,000 men and 27,200 women) in the United States will be diagnosed with thyroid cancer. It is estimated that 1,630 deaths (690 men and 940 women) from this disease will occur this year. Thyroid cancer is the seventh most common cancer in women.

The five-year relative survival rate (the percentage of people who survive at least five years after the cancer is detected, excluding those who die from other diseases) for all stages of thyroid cancer is about 97%. The five-year relative survival rate of papillary and follicular thyroid cancers and MTC range from 97% to 100% for early-stage cancer and decrease with later-stage cancer (See Staging). Anaplastic thyroid cancer is associated with a much lower survival rate.

For more information:

Thyroid cancer
Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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