• 2/10/2004
  • John Morgan
  • USA Today

Basic Instinct scribe Joe Eszterhas is known for his dark tales populated with seductive killers. But like a character from one of his famous movies, Eszterhas was being slowly murdered by two killers he thought he loved cigarettes and alcohol. Their murder weapon was cancer of the larynx. And they almost got away with it.

“I started smoking when I was 12 years old and drinking when I was 14,” says Eszterhas, whose just-released novel Hollywood Animal will hit the New York Times best-seller list this week. “By 2000, I was smoking four packs of Salem lights every day and drinking a significant amount. My voice began to get hoarse.”

Eszterhas says he wasn’t concerned. He had experienced hoarseness before on several occasions after having nasal polyps removed. So the million-dollar screen writer casually went in to see his “hot shot Beverly Hills ENT guys.”

“I was diagnosed with a benign polyp that was wrapped around my vocal cords,” Eszterhas recalls. “They said that it was nothing alarming. It was outpatient and no rush. It was just a polyp not unlike all the other ones.”

But it wasn’t.

After moving his family back to Ohio in March of 2001, the hoarseness got worse. With the renowned Cleveland Clinic nearby, Eszterhas decided to have the polyp removed rather than wait any longer.

“The Cleveland Clinic throat guy performed the same test as the Beverly Hills doctors,” Eszterhas explains, describing the flexible laryngoscope, a lighted tube with a camera that was snaked up his nose and down into his throat to examine the larynx. “He looked at the ‘polyp’ and kept looking at it and finally said, ‘We might have a problem here.'”

The “problem” was cancer of the larynx, often called the voice box or Adam’s apple.

According to the American Cancer Society, more than 10,000 Americans will be diagnosed with laryngeal cancer this year. A little less than 4,000 will die of the disease. Men are four to five times more likely than women to get laryngeal cancer, and African Americans are more at risk than whites.

Other risk factors include:

• Increased age

• Smoking

• Drinking alcohol

• Poor diet

• Weakened immune system

• Occupational exposure to wood dust, paint fumes, certain chemicals and asbestos

Sobering news

Eszterhas then met with throat cancer specialist Marshall Strome, chairman of the Cleveland Clinic Head and Neck Institute in Cleveland. Strome also immediately suspected cancer.

“If your voice has changed for more than three weeks, then you should have someone look at it, especially if you’ve had a history of smoking, drinking or a family history of cancer in the head and neck,” Strome advises.

Other symptoms of laryngeal cancer include:

• Persistent sore throat

• Constant coughing

• Difficulty or pain when swallowing

• Lump or mass in the neck

But before Eszterhas, 59, could even undergo the biopsy Strome ordered, the writer had to get sober.

“Dr. Strome told me that if I wanted any kind of a chance to live, I had to stop smoking and drinking,” says Eszterhas, who went through withdrawal pre-operatively at the Cleveland Clinic and then had the biopsy performed.

“I think I was both terrified and in absolute denial because I was still hoping there was a mistake,” the screen writer admits. “I kept thinking that the biopsy would reveal it wasn’t cancer. I kept hoping the Beverly Hills guys were right.”

They weren’t.

“He absolutely had squamous cell cancer of the larynx,” Strome says. “He presented at stage two without any evidence of nodal disease. The cancer had crossed across the front of the voice box to the other side so he had cancer involving both vocal cords.”

In April 2001, Eszterhas had two options: radiation therapy or surgical management.

“Dr. Strome felt that he might have to remove my entire larynx which meant I’d have to have a feeding tube because I wouldn’t be able to swallow or talk,” Eszterhas says. “My wife and I talked, and I decided that I really didn’t want to live that way.”

So Strome went back to the drawing board.

Instead of seven weeks of radiation therapy, Strome was then beginning to develop a surgical treatment using a laser followed by cryotherapy to destroy any microscopic disease left behind. To date Strome says the results are “very promising.” Of the 20-plus patients treated so far, there have been no recurrences as long as 2½ years out.

“We believe this new approach is going to completely revolutionize the way early cancers of the larynx are treated,” Strome states.

Survival instinct

This new treatment sends patients home the next day with voices the equivalent to, if not better than, after radiation therapy has healed. The limitation is that the surgeon must be able to expose the tumor through the mouth. Some people’s anatomy precludes getting a scope past the tongue base to view the very front of the larynx.

“If you can’t see it, you can’t remove it,” Strome says. “And that was Joe’s case. Since we could not use this technique, I had to do an open operation and rebuild his vocal cords.”

But neither the doctor nor patient would know if Eszterhas could swallow until after the surgery. “If I couldn’t swallow, I’d have to go on a trach,” says Eszterhas, referring to a tracheostomy, or direct opening into the windpipe below the larynx. “He came into the recovery room and told me to swallow. And I did.”

Strome recently examined Eszterhas and calls the writer’s recovery “remarkable,” considering him cured after almost three years.

But the drama wasn’t over.

“Of course I had immediately stopped smoking and drinking and was going through the worst nightmare of my life because I realized that everything was tied into those two activities,” Eszterhas notes. “I turned my life upside down trying to ease the cravings.”

With his wife’s help, Eszterhas says he changed his diet, religiously walked five miles a day, lost 45 pounds and most importantly re-established his relationship with God.

“I asked God to help me,” Eszterhas says. “I think changing everything about my life and rediscovering prayer were the reasons I was able to get through my addictions. It’s been nearly three years, and I have not had a cigarette or a drink. I consider it one of the great achievements of my life, but I am humble about it.”

Strome gives his patient all the credit for his recovery.

“The reason Joe has done so well is because he has changed his life,” Strome states. “Joe is living proof that if you really change you can achieve great outcomes.”

One outcome Eszterhas hopes to script is educating people, especially kids, about the dangers of smoking.

“I was guilty of glamorizing smoking on the big screen,” Eszterhas says. “I can’t tell you how many people tell me that they started smoking because they saw Robert Mitchum smoking on screen or saw Madonna in Dick Tracy. Yet Hollywood keeps promoting smoking even though all the evidence is in about how smoking on screen influences people, particularly kids. I want to try and wake people up. Because this disease called addiction will at a minimum maim you, and ultimately it will kill you.”