Val Kilmer has starred in some of Hollywood’s most memorable films like Top Gun, Heat, Tombstone, Batman Forever and Willow, which he was set to reprise his role in the Disney+ reboot series, but was forced to pull out at the last minute due to health issues. “We really wanted Val to come be in the show,” showrunner Jonathan Kasdan tells Entertainment Weekly. “And Val really wanted to come out and be in the show. I remember going to see Val right after this thing started to get some momentum, and I said, ‘Listen, we’re doing this. And the whole world wants Madmartigan back.’ And he was like, ‘Not as much as I do.’
In 2015, the actor was diagnosed with throat cancer and has been battling the disease for years, leaving fans wondering if he’d ever come back to the big screen. Although he vanished from acting for years, the 62-year-old made a triumphant return. Kilmer reclaimed his iconic role as Iceman in this summer’s blockbuster Top Gun: Maverick, however in a very limited appearance. After rounds of chemotherapy, radiation and surgery, the star needed a tracheostomy tube and feeding tube, which left him unable to speak as he once had. “Now that it’s more difficult to speak, I want to tell my story more than ever,” Kilmer said in his 2020 documentary, Val–a film that highlights his career and life.
While he’s not taking on projects for the time being, Kilmer hopes to join the Willow series at some point. Kasdan told EW, “As COVID overtook the world, it became insurmountable,” he explains. “We were prepping in the spring of the year that it was most happening. And Val reluctantly didn’t feel he could come out. We had to figure out a way to preserve the story we wanted to tell with him about how his story was playing out.” But that doesn’t mean we won’t see him again. “We wanted to leave open the door to any possibility in the future and also honor the spirit of him,” Kasdan says. “We’ve tried to do that and work with him in a way so that he is felt and heard, if not seen.”
Eat This, Not That! Health spoke with doctors, who have not treated Kilmer, but explained what to know about throat cancer and symptoms to be aware of, as well as a throat cancer survivor who shares his journey. Please consult your physician for medical advice. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.
1. What to Know About Throat Cancer
Dr. Marc Kerner, Board Certified ENT Otolaryngologist and Facial Plastic Surgeon with Dignity Health Northridge Hospital says, “Throat cancer is a broad category that includes cancers of the various structures of the larynx (voice box) and includes cancers arising from the base of the tongue and tonsil region. In referring to laryngeal cancer, there are about 180,000 new cases diagnosed per year with about 100,000 deaths per year. The primary symptoms are hoarseness or change in the voice, a lump in the neck, and/or difficulty swallowing or breathing. If diagnosed early is it highly curable, but if diagnosed late the prognosis drops considerably. Overall for all stages there is a 60% 5 year survival rate.”
Dr. Sidney Stoll, Medical Director of the Dorothy Leavy Cancer Center at Dignity Health Northridge Hospital tells us, “Throat cancer has definitely been detected more often over the past few years. It is considered to be a type of ‘head and neck cancer.’ It can be caused by tobacco use, alcohol consumption, and a virus called HPV or Human Papilloma Virus. This virus can be transmitted through oral sex. Head and neck cancers constitute about 3 % of all cancers in the United States.”
Mark Lacy, a throat cancer survivor from Washington state shares, “There are a variety of “throat cancers” the same tumor can start in your jaw, other areas inside your throat and mouth. If you are diagnosed, do your research. Virginia Mason Hospital has information on their website. There is the Head and Neck Cancer Alliance also. It is a silent killer. You likely do not know you have it until it is too late. Dentists have been taking up the mantle of early detection. Ask your dentist to do an oral exam of the areas at risk. If the dentist says they do not.. Find another dentist. If your diagnosis DO NOT DELAY. Get in front of a head and neck specialist today. Get a treatment program. This will kill you if you ignore it, and the tumor can grow quickly, but it is not a death sentence. I understand today the chemo and radiation treatments have improved to where there are less long term effects.”
2. The Connection Between Oral Sex and Throat Cancer
The Centers for Disease Control and Prevention states, “Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States. HPV vaccines can prevent some of the health effects HPV causes. There were about 43 million HPV infections in 2018, many among people in their late teens and early 20s. There are many different types of HPV. Some types can cause health problems, including genital warts and cancers. But there are vaccines that can stop these health problems from happening. HPV is a different virus than HIV and HSV (herpes).
You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. It also spreads through close skin-to-skin touching during sex. A person with HPV can pass the infection to someone even when they have no signs or symptoms. If you are sexually active, you can get HPV, even if you have had sex with only one person. You also can develop symptoms years after having sex with someone who has the infection. This makes it hard to know when you first got it.”
Dr. Manu Dave Kacker DDS, AAACD explains, “There has been rumbling and questions by patients and in the media in regards to oral sex and throat cancer. In reality oral sex does not cause throat cancer however it can spread HPV. It has been shown that HPV can cause pre-cancerous changes in the cells.”
Dr. Stoll says, “We now know that there is a direct correlation between oral sex and throat cancer, especially among those who are HPV positive. HPV positive throat cancer is usually found in younger patients. The subtype of cancer found in these individuals is called squamous cell carcinoma. Interestingly, people who have HPV positive throat cancer have improved treatment outcomes compared to those whose throat cancer is caused by something else such as tobacco use or heavy alcohol consumption.”
Dr. Kerner explains, “Many of these throat cancers are now known to be caused by human papilloma virus. This virus can be transmitted through oral sex so that is why this has gotten so much publicity in the last few years. My research during my residency training identified HPV virus in specimens of various types of throat and larynx cancers which was one of the earliest projects to report that the virus was present in these cancer specimens.”
3. Cases of Throat Cancer are Increasing
Dr. Stoll shares, “We are seeing more and more throat cancer patients in our oncology clinics likely due to earlier detection and better technology and imaging modalities. Specifically, we are seeing more HPV related throat cancers. As I stated earlier, it is crucial to know that HPV can be transmitted through oral sex. I would highly recommend that if you are planning on being intimate with your partner, please get checked for HPV. Testing can prevent cancer and save lives down the line. Finally, I would like to say that it is a good idea, especially for higher risk individuals to be examined at least once a year either by a dentist, primary care physician, or otolaryngologist.”
Dr. Kacker adds, “The risk of throat cancer is much higher in men compared to women, almost 3 times higher mostly due to higher use of tobacco and or alcohol. Age is a risk factor as the incidence is more like in the 55-year-old and above age range. Sadly, however, the growing segment of the disease is in younger patients. The higher incidence of throat cancer is likely attributed to the prevalence of HP virus. There are some ways to limit the risk of HPV: limit the lifetime number of different sex partners, get vaccinated, get regular screenings, visit your dentist, limit smoking and alcohol.”
2. Risk Factors
According to Dr. Stoll, “People typically at risk for throat cancer are those who smoke cigarettes on a daily basis, those who drink a lot of alcohol, and individuals who are HPV positive. It is very important to know that HPV can be transmitted via oral sex. Therefore, I would recommend that if not already tested, go out and get an HPV test, especially if you are planning on being intimate with your partner. Testing could potentially prevent cancer , more specifically head and neck cancer, and can therefore save lives. A particular theory as to why certain people are at risk of acquiring throat cancer may be due to the accumulation of carcinogens which can be seen with tobacco and alcohol, especially if they are combined.”
Dr. Kerner says, “The primary risk factors however remain smoking and drinking alcohol in excess. Many of these patients had both heavy smoking and alcohol use histories.”
Lacy reveals, ” My tumor on the back of my tongue began to appear in December of 2003. It burst in February 2004, which set me on a course of surgery, chemo, radiation. No professional was willing to say it was caused by XX. My guess is you look at my age. My date of birth is 1957. I was in high school during the 1970s. I am guessing it was a side effect of the lifestyle at the time. I was diagnosed with stage 4.”
5. Signs of Throat Cancer
Lacy says, “I began snoring. I had never snored before. I could feel a change in the way air came in and out of my throat. I will say when the tumor was removed my ability to breath improved significantly.”
Dr. Stoll says, “Signs of throat cancer to be aware of are chronic cough, dysphagia or difficulty swallowing, odynophagia or pain on swallowing, noticing a lump or mass in the throat , hearing issues, pain in the mouth and back of the throat (oropharynx) , hoarse voice, non- healing ulcers, bleeding, weight loss, and a decreased appetite.”
According to Dr. Kerner, “The primary symptoms are the onset of hoarseness or voice changes that don’t resolve within a month or so, or a new onset of a new mass which can indicate local metastasis from a laryngeal cancer.”
Dr. Kacker states, “The most common signs of throat cancer are a persistent and long-standing sore throat, voice change, and hoarseness that doesn’t go away. Undetected throat cancer or throat cancer that has the opportunity to linger and spread to other tissues in the body is not a curable disease. The cancer will greatly affect your quality of life and as it progresses patients are often bed ridden and may require a feeding tube to survive. In your daily life speech or the ability to speak and communicate verbally can and often is greatly disrupted. The 5-year survival rate of throat cancer that is localized is around 85%, it drops to 65% if there is a regional spread, and gets really bleak to around 35% if there is a distant spread of the cancer. It is important to note the early detected throat cancer is curable particularly if it has not spread to the surrounding tissues and lymph nodes.”
6. How Throat Cancer Affect Daily Life
Lacy tells us, “The chemo damaged my hearing, I wear hearing aids, food today I eat what I want except apples still taste bad. The radiation damaged my saliva glands so I drink water all day.”
Dr. Stoll explains, “Throat cancer can affect one’s life in several ways. A lump or mass felt in the throat can definitely be very uncomfortable and cause a lot of pain. Throat cancer can cause swallowing issues and therefore an individual with throat cancer may not want to eat or drink. This can lead to severe malnutrition and weight loss. Throat cancer, believe it or not, may also make it more difficult to hear and speak. In summary, throat cancer can be quite debilitating and can really cause many issues during one’s daily life.”
Dr. Kerner tells us, “Throat cancer after being treated has a profound effect on speech and swallowing. If after treatment with radiation and sometimes chemotherapy, there can be persistent swelling that can put the patient at risk for airway obstruction, thus necessitating the placement of a tracheostomy and sometimes a feeding tube directly into the stomach.”
7. How to Prolong Quality of Life with Throat Cancer
Lacy says, “I did everything my medical team told me. Including nutrition guidance. Also at Virginia Mason in Seattle I was with the best and brightest. I went through surgery first to remove the tumor from the back of my tongue. It was a several hour event. I had a GREAT surgeon who was also a cosmetic surgeon so you cannot see anything. After surgery about 10 weeks of recovery then started chemo 5 days a week for 6 weeks 22 minutes a day. It was with the head brace down on the table. During this period every Wednesday I had 8 hours of chemo being dripped into my system.
In addition, they assigned me a nutritionist. Right away they put a feeding tube in my stomach. They of course advised a healthy diet. The usual. After a couple of weeks of radiation, eating food became almost impossible. I went 100% to the liquid diet which they prescribed. It came in two cans at each meal time. I did the feeding tube for several months after the radiation because they wanted to make sure I was getting a nutritionally controlled diet to help my recovery. I do believe that was a big help. We think we are eating right… we usually are not. My insurance paid for all the food. Not all insurance does. You can substitute the insurance provided with ENSURE. ENSURE has several versions.
Note: I witnessed patients at the treatments who refused to get a feeding tube. (vanity) Most of them ended up in the hospital due to lack of food and water. One guy had to be airlifted. GET A FEEDING TUBE. Not the one through the nose, directly into the stomach (I had the stomach one).”
Dr. Stoll states, “How long someone can live with throat cancer really depends on the stage of the cancer and how far advanced it is. Earlier stage throat cancers, if caught quickly, can usually be cured. These folks can live completely normal lives after being treated. The usual treatment consists of chemotherapy and radiation with and without surgery. For those patients who have what we call “locally advanced disease” , it is more challenging to treat. However they still can live a long time if treated properly and appropriately. People with stage IV or metastatic disease, meaning the disease has spread beyond the throat, usually have a cancer which unfortunately cannot be cured.
The best way to improve quality of life in patients with throat cancer is to keep them as comfortable as possible. This can certainly be challenging given the location of the cancer and the treatments which are used to treat the malignancy. If the pain is controlled, breathing is adequate, and nutrition is being maintained, I think that would be a great start.”
8. Sometimes a Tracheostomy Tube and Feeding Tube is Required
Dr. Stoll tells us, “Sometimes, similar to Val Kilmer’s situation, a tracheostomy tube ( trach ), and feeding tube is required because the cancer in the throat itself can cause blockage and therefore does not allow one to breath properly or take in enough nutrition. In cases where the cancer is treated or potentially cured, both the trach and feeding tube may be removed at some point.”
According to Dr. Kerner, “Typically in end-stage laryngeal cancer, these measures are necessary for patient comfort and survival. Talking is possible with a tracheostomy but if the cancer is so advanced, the patient may not be able to use their vocal cords and won’t be able to speak. Laryngeal cancer can be a devastating disease because of the speech and swallowing dysfunction that comes with both advanced disease and aggressive treatment required for managing the disease. Patients treated for it have life long disabilities from radiation and chemotherapy effects, and the effects of surgery on those anatomical sites.”