Heavy metal legend Dave Mustaine, co-founder of Megadeth and the original lead guitarist of Metallica, has revealed via social media that he is undergoing treatment for throat cancer and said that Megadeth will need to cancel most of its shows for the rest of the year.
“I’ve been diagnosed with throat cancer,” Mustaine, 57, wrote. “It’s clearly something to be respected and faced head on — but I’ve faced obstacles before. I’m working closely with my doctors, and we’ve mapped out a treatment plan which they feel has a 90% success rate. Treatment has already begun.”READ MORE
The musician has been the lead guitarist for Megadeth since 1983, when he was ousted from Metallica amid drug abuse issues and various arguments with guitar player James Hetfield and drummer Lars Ulrich.
Megadeth’s most popular albums include their first album with guitarist Marty Friedman and drummer Nick Menza in 1990, “Rust In Peace”, as well as their innovative 1986 album “Peace Sells… But Whose Buying?” Their 2009 album “Endgame,” was beloved, while their 1992 album “Countdown to Extinction,” was their widest commercial success, entering the Billboard 200 at number two, and ultimately achieving triple platinum status.
Mustaine wrote that the diagnosis would mean can’t tour this year as planned. “Unfortunately, this requires that we cancel most shows this year. The 2019 Megacruise will happen, and the band will be a part of it in some form,” the post continues. “All up to date information will be at megadeth.com as we get it. MEGADETH will be back on the road ASAP”
But that he’d still be making plenty of music in the studio. “Meanwhile, Kiko [Loureiro, guitar], David [Ellefson, bass], Dirk [Verbeuren, drums] and I are in the studio, working on the follow up to ‘Dystopia’ — which I can’t wait for everyone to hear.”
He expressed a lot of gratitude for all the help he is already receiving. “I’m so thankful for my whole team — family, doctors, band members, trainers, and more,” he wrote.
And said he’d be in touch soon. “I’ll keep everyone posted. See you soon, Dave Mustaine.”
Options For Throat Cancer Treatment
We don’t know the details of Mustaine’s case, but we do know that there are a few types of throat cancer, and that some kinds are totally curable. “Hopefully, [the cancer is] just involved in the neck and in the lymph nodes because if that’s the case, then we can use our treatments to cure the cancer,” she says, “But if the PET scan shows that the cancer has moved to the lungs or the liver, then our approach would not be to cure cancer but to treat it and to keep it under control,” says Dr. Jessica Geiger, a medical oncologist specializing in head and neck cancer at Cleveland Clinic Cancer Center.
“It’s really complicated because there’s three stage 4s. It’s not like breast cancer where once you’re Stage 4, you’re incurable,” she continues. “In early stage throat cancer, the cancer is confined to just what we call the primary tumor in the back of the throat or the tonsils or the base of the tongue. That’s often treated with surgery alone or sometimes even just radiation alone.”
“In more advanced throat cancer cases, which is actually the most common stage that we see, we call it locally advanced and so, in addition to the primary tumor where the cancer started, lymph nodes of the neck are involved. Sometimes these are lymph nodes on the same side of the neck that the cancer started,” she says, “Sometimes it involves contralateral or lymph nodes that are on the opposite side of the neck where the primary tumor began.”
“Patients who have disease that has spread outside of the head and neck region, meaning below the clavicles, into the lungs or into the liver, we call that distant metastatic disease and by definition those patients are considered incurable,” she continues, “So our efforts at treatment would be focused on palliative therapy, controlling the disease but, unfortunately, not curing it.”
Throat Cancer and HPV
Often, throat cancer is caused by HPV, or human papillomavirus, which is the most commonly sexually transmitted disease. It usually goes away by itself, but sometimes it leads to other diseases. “The most common type of head and neck cancer patients that we see are patients who have HPV-related throat cancer. So this is cancer that starts in the back of the throat such as in the tonsils or the base of the tongue,” says Dr. Geiger. “They often don’t present with symptoms until they have lymph nodes in the neck that are involved. So they come in because they have a neck mass that they felt just incidentally, with or without pain. Sometimes they have a sore throat, but sometimes all they have is a painless neck mass.”
“The most common symptoms for throat cancer are a painless neck mass that the patient may just feel when they’re shaving or washing their face. Sometimes it’s painful, but a lot of times they don’t feel anything except just a lump there, and that brings them to the attention of their doctors,” says Dr. Geiger, “Their doctors often then will order imaging such as an ultrasound of the neck or a CAT scan and we can see the mass there.”
According to Dr. Geiger, “The treatment for throat cancer, regardless if it’s caused by HPV or tobacco smoking, is the same. We know that this treatment causes a lot of side effects, a lot of longterm side effects. Difficult swallowing, neck fibrosis or scar tissue so it makes it difficult for the patients to turn their head. There’s a lot of longterm side effects from radiation and chemotherapy that come about.”
“Typically, a patient who develops a sore on the tongue or a lesion in the inside of the mouth that doesn’t heal, they’ll be seen by their primary doctor first who then will refer them to an ear, nose and throat surgeon or an oral surgeon,” she tells us, “Oftentimes, we have patients who are referred to our clinics from their dentists office who notice a sore that doesn’t seem to be healing, or a wound that is on the inside of their mouth or around their teeth. Then, we set the patients up with a biopsy to confirm cancer or to show something else and we proceed from there.”
“A lot of our clinical trials, now, are looking at what we call de-intensifying therapy. Reducing the amount of radiation that patients receive, leaving out chemotherapy or substituting another agent such as immunotherapy in place of chemotherapy,” she said. “Shortening the duration of radiation or shortening to doses or frequency of radiation. These are questions that are being asked in clinical trial format and over the next several years we hope to answer whether or not patients with HPV-related throat disease actually need the full course of treatment that tobacco-related cancers need.”
Mustaine has been married to Pamela Casselberry since 1991 and they have two children, Elektra and Justis.