CEO of JPMorgan has Throat Cancer

Image from Wikipedia by Steve Jurvetson

The CEO and President of JPMorgan, Jamie Dimon, announced that he has throat cancer and is currently undergoing treatment at Memorial Sloan Kettering Cancer Center in Manhattan for the next eight weeks. According to a letter he sent to shareholders on July 1, 2014:

"I wanted to let you know that I have just been diagnosed with throat cancer. The good news is that the prognosis from my doctors is excellent, the cancer was caught quickly, and my condition is curable. Following thorough tests that included a CAT scan, PET scan and a biopsy, the cancer is confined to the original site and the adjacent lymph nodes on the right side of my neck. Importantly, there is no evidence of cancer elsewhere in my body." [link]

Based on this information, he has a Stage 3 or 4 (out of possible 4) throat cancer. Stage 1 is the early and best stage to have. It is less clear exactly where the throat cancer is whether it be tonsil, tongue, oropharynx, or some other location. Based on probabilities, he most likely has squamous cell carcinoma which is the most common type of cancer of the head and neck including the throat.

Although he states the prognosis is good, it is not as good compared to patients where no neck mass is present (Stage 1 or 2) where chemotherapy may not even be necessary.

He also mentions the word "curable" which I am leary of when he has just started treatment. Even if no cancer is detectable at the end of treatment, throat cancer, especially stage 3 or 4, has the potential to come back.

Recall the case of actor Larry Hagman of Dallas fame... He had throat cancer and was declared "cured" 8/29/12. Than on 11/24/13, he died of cancer recurrence and complications.

The risk of cancer recurrence is highest within the first 2-3 years after treatment completion, and markedly decreases after 5 years.

Typically if cancer has not come back after 5 years, the word "cure" may than be used, but even than, such patients are seen yearly for the rest of their life for cancer monitoring.

Because the risk of cancer recurrence is so high in the first few years after treatment completion, patients are seen frequently for the first 2-3 years after treatment.

Every 2 months for the first year. Every 3-4 months in the 2nd year. Every 4 months in the 3rd year. Every 6 months in the 4th year. Yearly starting at 5 years after treatment.

This type of follow-up applies to all head and neck cancer.

Source:
JPMorgan CEO Jamie Dimon has cancer. USA Today 7/2/14

JPMorgan CEO Jamie Dimon's letter to shareholders. USA Today 7/1/14

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LeBron James and His Broken Nose

LeBron James suffered a broken nose. He first broke it Feb 2014 when playing against Oklahoma City. He than got hit to the nose again (while wearing a mask) when playing against Houston in March 2014. [link]

Regardless of whether you are an NBA player or not, treatment of most nasal and even facial fractures do NOT require surgical repair.

The key elements that lead towards a decision for facial and/or nasal fracture surgery are the following (not all-inclusive, but general pointers):

- Any functional deficit (i.e., inability to open and close the jaw)
- Change in occlusion (the way teeth come together).
- Double vision (blurry vision does not count).
- Cosmetic deformity due to nasal/facial fracture (bruising and swelling does not count).
- Nasal obstruction not due to swelling.

In any case, when a nose is broken, steps should be taken to further minimize trauma to the nose. For athletes, that usually means wearing a facial mask such that any hits to the face does not connect with the broken nose.

Although LeBron James had his facial mask custom made by Marvel, for us mere mortals, you can buy one on Amazon.

Source:
Just like every other superhero, LeBron has his Kryptonite. Fox Sports 3/5/14

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Book on Hoarseness

My fellowship mentor, Dr. James Thomas, taught me much of all I know about the voicebox both when it works and when it doesn't leading to hoarseness.

Much of his knowledge is imparted in a book he wrote which is now available for purchase on Amazon.com. Although healthcare professionals interested in the voice will find the book very helpful, it is written in such a way that any layperson without a medical background can also find it understandable and helpful.

Check it out here!

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