The Aftermath of Treatment
- “Full House” star Dave Coulier’s remission came with lasting treatment fallout, such as an altered voice and significant weight loss, underscoring how cancer recovery continues long after the disease is gone and inspiring him to share his story to help others.
- Radiation Oncologist Dr. Subhakar Mutyala explains that radiation is “a treatment where you don’t feel the treatment itself. Now, sometimes, you might feel the place where we place the tumor. If we’re placing applicators in the cancer, you might feel that. Or if you’re lying on a table and we’re holding you still, you might feel that. But the actual treatment is just ionizing energy.”
- Before radiation begins, patients undergo a simulation—a planning session designed to ensure the highest accuracy once treatment starts. No radiation is delivered during this step.
- For head and neck radiation, patients are fitted with a custom-molded mask to keep positioning exact, critical because today’s highly focused treatments can target disease down to the millimeter, Dr. Chelsea Pinnix, a radiation oncologist at MD Anderson Cancer Center, notes.
- Chemotherapy can cause intense mouth sensitivity, from a “shredded” feeling on the tongue to painful teeth and gums, making even basic brushing difficult, Dr. Danoosh Amrooei, a breast cancer survivor and dentist, explains.
Coulier’s radiation treatment for head and neck squamous cell carcinoma, a form of oral cancer. The radiotherapy targeted tissue close to his vocal cords, altering his voice — a lesser-known but well-documented side effect of head and neck radiation.
“Melissa said to me, You were honest, you were vulnerable, and you could feel that you really are trying to help people. And that message resonated with everyone.’ And so that became my mission,” Coulier told Detroit News.
Coulier’s oral cancer was identified as P16-positive squamous cell carcinoma at the base of his tongue. Research published in the American Journal of Surgical Pathology notes that HPV-related oropharyngeal squamous cell carcinoma generally carries a more favorable prognosis than other head and neck cancers.
Squamous cell carcinoma of the head and neck (HNSCC) is often linked to high-risk human papillomavirus (HPV).
According to the National Cancer Institute, HPV is associated with several cancers, including cervical and throat cancers.
The Centers for Disease Control and Prevention (CDC) explains that HPV-related cancers occur in areas where the virus is commonly found, such as the cervix, vagina, vulva, penis, anus, and oropharynx (the back of the throat, including the base of the tongue and tonsils).
Fortunately, HPV-related throat cancers tend to respond well to treatment, especially when addressed with radiation and chemotherapy.
Preventive tools like the HPV vaccine—such as Gardasil 9—offer protection against nine strains of the virus, including HPV 16, which is responsible for the majority of head and neck cancers.
Coulier’s oral cancer came just a year after Coulier learned he had stage 3 non-Hodgkin lymphoma, a type of blood cancer, in 2024. He underwent six rounds of chemotherapy, coping with hair loss and profound fatigue along the way.
Coulier says radiation for his oral cancer was a “different animal” entirely, he explained on the “Today Show.”
Coping With Radiotherapy Side Effects
Radiation therapy remains a foundational cancer treatment, but misconceptions about these procedures often fuel unnecessary fear. Dr. Andy Chen, a radiation oncologist at Texas Oncology, emphasizes the importance of educating patients about modern techniques and manageable side effects.
Coulier says the radiotherapy took a toll on his body and continues to this day.
While radiation aims to target cancer cells, nearby healthy tissues may also be affected.
According to the National Cancer Institute, typical side effects of radiation to the head and neck may include:
- Fatigue
- Hair loss
- Changes to the skin or sense of taste
- Difficulty swallowing
- Mouth issues
- A less active thyroid gland
“Radiation therapy is actually ionizing energy, where energy goes through your body and essentially causes DNA damage,” Radiation Oncologist Dr. Subhakar Mutyala explained to SurvivorNet.
“It is a treatment where you don’t feel the treatment itself. Now, sometimes, you might feel the place where we place the tumor. If we’re placing applicators in the cancer, you might feel that. Or if you’re lying on a table and we’re holding you still, you might feel that. But the actual treatment is just ionizing energy,” Dr. Mutyala continued.
Reflecting on his earlier battle with non-Hodgkin lymphoma, he credited early detection for saving his life twice. “Early detection saved my life, not just the first time but the second time as well. So I hope you’re getting your check-ups,” he urged.
Preparing for Radiation Treatment
Patients may be able to prepare for radiation therapy before it begins in earnest.
Dr. Chelsea Pinnix, a radiation oncologist at MD Anderson Cancer Center, says many patients are more afraid of radiation therapy than they need to be.
“Radiation is often a big black box for patients and very scary at first,” she explains. “You read things online or come across older studies that focused on toxicity, and that can heighten the fear.”
But much of that fear, she says, is rooted in outdated information. To illustrate how far the field has come, she compares radiation therapy to the evolution of the cell phone.
“Decades ago, cell phones were huge. Now we have smartphones that can do everything. Radiation therapy has evolved in the same way.” While the way radiation destroys cancer cells hasn’t changed, she notes, “a lot has changed in how precisely we target and deliver treatment.”
Before radiation begins, patients undergo a simulation—a planning session designed to ensure the highest accuracy once treatment starts. No radiation is delivered during this step.
WATCH: Preparing for Radiation Treatment
What Happens During Radiation Simulation
The first task is determining the exact position your body should be in for treatment. The position must give the machine the best access to the treatment area while still being comfortable enough for you to stay completely still for several minutes at a time.
Depending on the treatment site, you may lie on your back, stomach, or side. Specialized cushions and supports help keep your body in the same position for every session.
For head or neck treatments, a custom plastic mask is molded to your face and secured to the table to prevent movement.
“We have a lot of sophisticated devices to help with setup because we can now target down to the millimeter,” Dr. Pinnix says. “Consistency in positioning is crucial with today’s highly focused radiation.”
Once you’re positioned, the team performs a CT scan of the treatment area. These images guide the radiation plan and help pinpoint exactly where the beams should be directed.
Next, the team marks your skin—either with a temporary marker or tiny tattoo dots about the size of a freckle—so the radiation can be delivered to the same precise location each time.
The entire simulation typically takes up to an hour and offers a valuable opportunity to ask questions about the process, what to expect, and how treatment works.
Expert Resources on Radiotherapy
- “No, You Won’t Be Radioactive” & 4 Other Answers to Frequently Asked Questions Around Radiation Treatment
- Benefit Of External Beam Radiation: It’s Non-Invasive
- CyberKnife Targets Radiation with the Same Effectiveness as Traditional Treatments
- Esophageal Cancer: What to Ask About During Radiation Consultation
- High-Dose Radiation: The Benefit May Outweigh The Risk
Coping With Treatment Side Effects that Impact the Mouth
“Your tongue starts to feel super wrong, kind of like you put it against a shredder or something,” Dr. Danoosh Amrooei, a breast cancer survivor and dentist at Monaco Dentistry in Apollo Beach, Florida, previously told SurvivorNet.
“Depending on the chemo, your side effects could be better or worse, but I know with the chemo that I underwent that you get really sensitive teeth and gums; even something like brushing your teeth becomes really painful.”
RELATED: Majority of Throat Cancer Diagnoses Caused by the Human Papillomavirus (HPV)
Dr. Christina Wood, a dentist at Station Dental in Colorado, told SurvivorNet that she recommends that all chemo patients visit the dentist before treatment.
In addition to a regular check-up, individuals should also request a fluoride treatment, said Dr. Wood.
“These provide a high dose of fluoride for your teeth to help increase mineralization of the enamel [strengthen the teeth] and prevent mucositis [painful mouth inflammation],” she explained in a previous interview with SurvivorNet.
She also shared a list of tips for once chemo starts to mitigate pain and keep the mouth clean:
- Try to have a dental exam and teeth cleaning before chemo starts
- Steer clear of mouthwash with alcohol in it; this can be extremely painful for sensitive gums and teeth
- Stay away from spicy and acidic foods, which can exacerbate pain
- Try eating foods that can soothe the mouth, such as dairy items
- Keep different toothpaste options as your taste buds change during chemo, and certain flavors might suddenly become unappealing.
- Steer clear of whitening toothpaste, which has more grit and can further irritate the gums.
If your treatment is making you vomit frequently, try mixing 1/4 teaspoon of baking soda with 1/8 teaspoon of salt and 1 cup of warm water as a mouth rinse; this can help make your mouth less acidic, which can protect the enamel on your teeth.
HPV-Linked Head and Neck Cancers Have Surged 300% Since the 1980s, Experts Warn
The rate of HPV-related head and neck cancers has skyrocketed over the past few decades—a trend that has medical experts sounding the alarm.
“From the 1980s to the 2010s, the rate of HPV-related head and neck cancers has gone up by 300 percent,” said Dr. Ted Teknos, a head and neck cancer specialist and president and scientific director of University Hospitals Seidman Cancer Center in Cleveland, Ohio, in an interview with SurvivorNet.
While not all oral cancers are caused by the human papillomavirus (HPV)—the most common sexually transmitted infection in the U.S.—there is a well-established link between the virus and certain types of head and neck cancers.
RELATED: Why the HPV Vaccine Is So Important in Preventing Cancer
WATCH: Understanding the Human Papillomavirus
According to Dr. Allen Ho, a head and neck surgeon at Cedars-Sinai, HPV infection is incredibly common among Americans.
“The vast majority of humans in the United States, both men and women, will eventually get infected with HPV,” Dr. Ho told SurvivorNet.
However, only a small fraction of those infected are at risk of developing cancer.
“The important thing to know about HPV is that there are many different strains, and only a couple of them tend to be more cancer-inducing,” Dr. Ho explained.
“Probably less than 1 percent of the population who get infected happen to have the cancer-causing virus that somehow their immune system fails to clear, and over 15 to 20 years it develops from a viral infection into a tumor and cancer.”
Treatment for HPV-related oral cancers often involves surgery to remove the tumor, but may also include chemotherapy, radiation, or targeted drug therapies. In advanced cases, these treatments can affect a patient’s ability to eat or speak, although rehabilitation therapy can help many regain these essential functions.
The rise in HPV-related cancers underscores the importance of prevention, early detection, and public awareness—especially when it comes to the life-saving potential of the HPV vaccine.
What You Should Know About HPV
The human papillomavirus (HPV) is a common but often misunderstood virus.
HPV is “a group of more than 200 related viruses, some of which are spread through vaginal, anal, or oral sex,” according to the National Cancer Institute. While many sexually active individuals will contract HPV at some point in their lives, the virus is linked to several serious cancers.
Though HPV is most commonly associated with cervical cancer, its reach extends far beyond. The virus is also known to cause cancers of the throat, vagina, penis, anus, and vulva. In fact, HPV is believed to be responsible for:
- 90% of anal and cervical cancers
- Approximately 70% of vaginal and vulvar cancers
- Around 60% of penile cancers
Despite its widespread impact, screening options remain limited—especially for throat cancer.
“There are no screening guidelines to screen for throat cancer, unlike cervical cancer with pap smears,” said Dr. Jessica Geiger, a medical oncologist at the Cleveland Clinic Cancer Center, in an interview with SurvivorNet. “There are no standard tests to determine if you harbor the virus.”
The good news? HPV-related throat cancers tend to respond well to treatment.
“The cure rates for people who have HPV-related disease are a lot higher than those who have tobacco-related throat cancer,” Dr. Geiger explained.
Dickinson’s experience highlights the importance of HPV awareness—not just for women, but for everyone. With no routine screening for throat cancer, prevention through vaccination and education remains a critical tool in the fight against HPV-related diseases.
Protecting Against HPV: Why the Vaccine Matters More Than Ever
Nearly 80 million Americans are currently living with human papillomavirus (HPV), according to the Centers for Disease Control and Prevention (CDC). While most people won’t experience serious health issues, for a small percentage, HPV can lead to cancer.
To reduce that risk, health experts strongly recommend the HPV vaccine, which protects against the strains most likely to cause cancer.
What the Vaccine Covers
Gardasil 9, the most widely used HPV vaccine, offers broad protection.
According to the National Cancer Institute, it guards against “nine HPV types: the two low-risk HPV types that cause most genital warts, plus seven high-risk HPV types that cause most HPV-related cancer.”
One of the most dangerous strains is HPV 16, which is responsible for 92% of head and neck cancers. The vaccine triggers an immune response that prevents infection from this strain, making it a powerful tool in cancer prevention.
“The key with the vaccine is that you receive it before you have sexual encounters,” explains Dr. Geiger. “So that’s why these vaccines are approved for young children ages 9, 10, 11 years old, up to age 26.”
Who Should Get Vaccinated—and When
- The CDC recommends the HPV vaccine for all male and female preteens at ages 11 to 12, administered in two doses spaced six to twelve months apart.
- The series can begin as early as age 9.
- Teens and young adults through age 26 who didn’t start or complete the vaccine series should still get vaccinated.
- Those who begin the series between ages 15 and 26 or who have weakened immune systems should receive three doses instead of two.
While adults over 26 can still receive the vaccine, it’s generally less effective, as many have already been exposed to HPV. Still, individuals up to age 45 may choose to get vaccinated after consulting with their doctor about potential benefits.
WATCH: Should children get the HPV Vaccine?
Changing the Conversation Around HPV
Vaccine hesitancy remains a barrier, often rooted in concerns that the vaccine encourages early sexual activity. To counter this, many health professionals are shifting how they talk about it.
“I think rebranding the vaccine as a cancer vaccine, rather than an STD vaccine, is critically important,” says Dr. Teknos.
Dr. Teknos believes that focused efforts to “change the mindset around the vaccine” can make a meaningful difference.
By reframing the HPV vaccine as a powerful tool for cancer prevention, experts hope to boost vaccination rates—and protect more lives in the process
Coulier’s Non-Hodgkin Lymphoma Journey
Coulier’s rise to fame came about when he landed a recurring role on Full House, a popular sitcom that ran from 1987 to 1995. It featured notable stars, including the late Bob Saget, John Stamos, Lori Loughlin, Mary-Kate, and Ashley Olsen. The show focused on a widowed sportscaster (Saget) as he raised his three daughters with help from his rock-and-roll brother-in-law (Stamos) and best friend (Joey).
Many of the cast members remained friends for many years after the show ended.
Coulier revealed he had been battling stage 3 non-Hodgkin lymphoma in early November 2024. The actor was no stranger to the impact of a cancer diagnosis. His mom and sisters were all diagnosed with a form of cancer.
“I saw what those women in my family went through, and I thought to myself, ‘If I can be just 1/10th of a percent as strong as they were, then I’m going to be just fine,’” Coulier told US Magazine.
What is Non-Hodgkin Lymphoma?
“Non-Hodgkin lymphoma is a big category,” Dr. Julie Vose, chief of hematology/oncology at the University of Nebraska Medical Center, previously told SurvivorNet.
All non-Hodgkin lymphomas begin in white blood cells known as lymphocytes, which are part of your body’s immune system. From there, doctors separate these cancers into types depending on the specific kind of lymphocytes they grow from — B cells or T cells.
WATCH: For treatment, the type of lymphoma you have matters.
Knowing which of these you have can help steer you to the most appropriate treatment.
One way doctors divide up these cancers is based on how fast they’re likely to grow and spread. “The two main classifications I think of in terms of non-Hodgkin lymphoma are lymphomas that are more indolent and those that are more aggressive because those are treated very differently,” Dr. Jennifer Crombie, medical oncologist at Dana-Farber Cancer Institute, told SurvivorNet.
Most non-Hodgkin lymphomas, about 85%, affect B-cells. These cells produce antibodies and proteins that react to foreign substances like viruses or bacteria in your body. The antibodies attach to another protein on the surface of the invading cells, called an antigen, to target and destroy them.
Questions for Your Doctor
If you are concerned about your cancer risk related to the human papillomavirus or whether HPV caused the cancer you have, you can use one of the conversation starters below when talking with your doctor:
- I am unsure if I received the HPV vaccine when I was younger. What can I do to know for sure?
- If I experience symptoms that could be caused by HPV, what tests can I undergo to determine?
- How can I know if HPV caused the cancer I have?
Learn more about SurvivorNet's rigorous medical review process.
