Why did Jamie Theakston get laryngeal cancer? Oncologist explains causes, symptoms and treatment

Cancer can present in many different ways and, as an oncologist for thirty years, I thought I'd seen them all - until Jamie Theakston's announcement on Tuesday (September 17), revealing he has throat cancer. The popular Heart Radio breakfast DJ, decided to go to his doctor only after concerned listeners posted on Instagram that his voice had changed. They must have known that this is usually the first sign of problems with the vocal cords. 

A hoarse voice does not necessary mean cancer, in fact many presenters, singers, teachers, public speakers, and others who use their voice extensively are prone to ‘singer's nodules’, also known as vocal cord nodules. These are benign (non-cancerous) growths that form on the vocal cords due to repeated vocal strain contributed by other factors such as acid reflux and smoking. These can usually be treated with rest, stopping smoking and taking antacids (if relevant), vocal training, or even laser surgery. They are, however, associated with an increased risk of laryngeal cancer which is why Jamie sensibly agreed to go for a biopsy.

In his announcement, on Instagram, Jamie indicated that the cancer is early - stage 1 in fact - which, carries a good prognosis. Latest figures from Cancer Research UK suggest that 95% of people are cured but about 10% still require removal of the voice box (laryngectomy). This is only required if initial treatments fail.

Laryngectomy, although lifesaving, is devastating for anyone having to go through it, but losing the natural voice would be even more impactful for a radio presenter. Good alternative communication methods, such as a voice prosthesis or electronic device, mean people can get by on a day to day basis but continuing to be a DJ would be unfeasible. The likelihood of needing this surgery does up with advancing stage so his fans may not have only helped saved his life, his quality of life and career too.

Why did Jamie get cancer of the larynx?

Some people get cancer with no obvious causes but this is rare with those arising in the larynx or rest of the head and neck area. By far the most common cause of throat cancer is smoking cigarettes and other forms of tobacco such as cigars, pipes and more recently even smokeless tobacco products such as vapes. It is know that Jamie Theakston had smoked in the past although the amount or for how long is not public knowledge.

Laryngeal cancer can also be associated with chronic acid reflux from the stomach which irritates the vocal cords. More recently Human papillomavirus (HPV) infection has been established as a contributory factor in over 70% of cases particularly HPV-16, which was thought to be the case with Michael Douglas' throat cancer. Over 90% of adults already have HPV so avoiding oral sex is unlikely to reduce the impact now. Fortunately, the vaccine is dramatically dropping HPV related cervical cancers in women and following the introduction, of HPV vaccines in 12 year old boys it is hoped that the rates of other HPV related cancers in men, including the throat, will drop.

What next for Jamie Theakston after cancer diagnosis?

Medical treatments depend on how small the cancer is. For really small cancers, a surgeon may be able to use a laser to remove the tumour, often preserving the voice. Careful observation would be required for many years after this procedure to make sure there is no relapse. External beam radiation using high-energy X-rays will kill the cancer completely in 95% of cases. With modern precision techniques most people's voice will recover well after about two to three months. In some people post radiotherapy the quality of the voice may become rougher (hoarse), more breathy, strained or quiet, and may tire more easily.

Self-help strategies to reduce the risk of cancer relapse

As an oncologist specialising in lifestyle and integrative care, people often ask what they can do to reduce their risk of their cancer coming back and lower their risks of side effects. With laryngeal cancer in mind, these are my tips:

• Smoking (if relevant) - although the initial damage has been done, further smoking increases the relapse rates and will significantly reduce the chances of the voice recovering.
• Avoid being overweight or obese especially the combination of abdominal obesity raised sugar, fats, blood pressure and inflammation, a condition called metabolic syndrome.
• Regular exercise for about 2.5 - 3 hours a week, has been linked to about a 30% lower cancer risk. It's important to find an activity which is enjoyable, hence sustainable including running, brisk walking and even cycling. 
• Adequate vitamin D levels lower the risk of many cancers. Sun bathing, without burning, is the best way to increase vitamin D levels. Otherwise, vitamin D supplementation, especially if combined with a probiotic that enhances its effect, is a sensible alternative.
• Try to get a good night's sleep: Chronic insomnia can lead to fatigue, demotivation to exercise and undertake healthy living programmes. Going through cancer treatments is a worrying time but there are lots of dietary and lifestyle tips to improve sleep patterns
• Be careful with alcohol: One or two glasses of red wine a week could help  gut health, probably due to its high phytochemical content. Anything more than this, especially neat spirits, can irritate the throat and has been linked to higher throat cancer risk.
• Eating more fruit, nuts, cruciferous vegetables, and spices which increases the intake of vitamins, essential minerals and healthy phytochemicals, which protect us from cancer by reducing excess inflammation and improving gut flora. There is some evidence that boosting the diet with phytochemical rich supplements may also have a role for some cancers. 
• Reducing meat and ultra-processed foods (UPF) intake such as grilled sausages, bacon, sliced ham and tinned meats and even veggie burgers will reduce the risk of cancer by 20%.
• Poor gut health has been linked with a higher risk of many cancers. Factors which affect gut health include lack of exercise, processed sugar, smoking, obesity and stress. Bacteria rich foods such as kefir and kimchi help and probiotic capsules also help boost gut health. 
• Keeping the teeth clean reduces chronic inflammation in the gums and elsewhere in the body which encourages cancer cells to grow. 
• Omega fatty acids improve immunity and inflammatory pathways, so we should be eating more omega oil rich foods such as nuts, flax, avocados, pumpkin and chia seeds, as well as seafood including algae, seaweed, mackerel and sardines. 

Signs of throat cancer 

Fortunately throat cancer is fairly rare especially in non-smokers but you should go to the doctors if you, or someone else has noticed a change in your voice, such as sounding hoarse; pain when swallowing or difficulty swallowing; a lump or swelling in your neck; a long-lasting cough or breathlessness; a persistent sore throat or earache or a high-pitched wheezing noise when you breathe.

In conclusion, although we cannot completely eliminate cancer or relapse after treatment, we can do a lot to reduce the risks. For those of you who are interested in more evidence based practical advice you may be interested in my book "How to Live" which provides more in-depth explanations of how and why lifestyle interacts with cancer disease and effects longevity.