Babe Ruth was arguably the greatest baseball player who ever lived. When he retired from baseball in 1935, he held the record for most home runs (714), had a batting average of .342, batted in 2,213 runs, had a slugging percentage of 690, got on base 47.4 percent of the time he batted, scored 2,174 runs, hit for 5,793 total bases, and was walked 2,062 times. Forget about comparisons with today’s players; Ruth did all of this without taking anabolic steroids or other performance aids.
At age 19 (1914), Ruth signed to play professional baseball for the minor-league Baltimore Orioles and was soon pitching for the major-league Boston Red Sox. He quickly became the best pitcher in baseball, winning 24 games in 1917. In 1919, he was sold to the New York Yankees and was converted to a full-time right fielder because he was also the best hitter in baseball. His teams won 10 pennants and seven World Series, three with Boston and four with New York. He retired at age 40 in 1935 and was one of the first five players to be elected to the National Baseball Hall of Fame. He died on August 16, 1948, at age 53.
In September 1946, Babe Ruth’s voice became very raspy. He had headaches and constant severe pain in his left eye. Eye pain and headaches are not characteristic of cancer of the vocal cords. The doctors told him that he had “sinusitis” caused by infected teeth, so they pulled three teeth. Then he felt worse. His face swelled, his left eye was swollen shut and he was unable to swallow food.
X-rays showed a mass in the back of his neck, but all biopsies failed to show cancer. The lymph nodes in his neck enlarged. He couldn’t eat, so he had to be fed through his veins. In November 1946 doctors operated on his neck and for the first time diagnosed cancer.
His hoarseness and many years of smoking cigars and drinking lots of alcohol led his doctors, and the rest of the world, to think that Babe Ruth had cancer in his larynx, the “voice box”. He actually had naso-pharyngeal carcinoma that starts in the back of the nose and mouth. His hoarseness and inability to swallow were caused by the cancer spreading from his nose and throat to his neck to press on nerves that controlled the muscles that helped him talk and swallow.
Babe Ruth Day
On Babe Ruth Day at Yankee Stadium on April 27, 1947, the greatest baseball player of all time stood before 60,000 fans, emaciated and in severe pain. He spoke slowly in a raspy and hoarse voice, saying : ”You know how bad my voice sounds . . . well, it feels just as bad.”
On Aug. 16, 1948, Ruth died of pneumonia, most likely because he aspirated food into his lungs and smothered to death. Cancer in his neck attached to and damaged the nerves that control his swallowing muscles. An autopsy showed that the cancer that began in his nose and mouth had spread widely through his body. Hundreds of thousands of his fans stood in line to see his body lying at the main entrance to Yankee Stadium. Today, 73 years later, some patients with naso-pharyngeal cancer are being cured even after that cancer had spread to other parts of their bodies.
Naso-Pharyngeal Cancer, Caused by HPV?
More than a 1,000 cases of naso-pharyngeal cancer are now diagnosed each year in the United States. The most common known causes of naso-pharyngeal cancer are the Epstein-Barr virus and human papilloma virus, HPV (Head Neck, May, 2010;32(5):562-7; Infect Agent Cancer, August 12, 2013; 8:30). Cancer of the larynx is associated with heavy smoking, drinking, and snuffing, but naso-pharyngeal carcinoma is not.
HPV is spread commonly by sexual contact to cause cancers of the cervix, vagina, nose, throat, mouth, tonsils and naso-pharynx. Condoms are only partially protective as the virus is easily spread by skin-to-skin contact. Babe Ruth was a notorious womanizer who was reported to have had “no platonic relationships with women.” Every new sexual exposure is also a potential exposure to the more than 150 different HPV viruses.
His womanizing cost him his friendship with Lou Gehrig. They played together every day as the stars of the New York Yankees, but they had little to do with each other. Gehrig’s wife, Eleanor, was supposed to have been a very close friend of Ruth before she married Gehrig. On a voyage to Japan in 1934, Gehrig found his wife in Ruth’s cabin, smelling of liquor. Gehrig and Ruth didn’t speak again to each other until Gehrig’s Yankee Stadium retirement speech in 1939.
Chemical Weapons as Cancer Treatment
Soon after he was diagnosed with possible cancer, Ruth became one of the first patients to receive a new cancer drug. Mustard gas, a chemical weapon used in World War I, was discovered to be a potent suppressor of blood production. In 1942, researchers at Yale University started using these poisons to kill cancer cells in humans, but nobody knew about their research because the United States Government classified the information on chemicals used for warfare. In 1946, restrictions were lifted and Dr. Richard Lewisohn, at Mount Sinai Hospital in New York, began using a type of nitrogen mustard called teropterin to treat cancer in mice.
In June 1946, Babe Ruth received radiation and six weeks of daily injections of teropterin, to become one of the first humans to be treated with chemotherapy. Ruth apparently did not know he had cancer, but agreed to take the experimental drug. The drug helped him almost immediately. His neck lymph nodes shrank, his pain lessened and he regained much of his recently-lost 80 pounds. Unfortunately the benefits of teropterin were temporary, but this was the start of experiments with chemotherapy. In 1947, the Wall Street Journal reported that scientists were about to cure cancer (WSJ, Sept. 11, 1947). Methotrexate, a chemical similar to teropterin, is still used today to treat cancer and autoimmune diseases.
Breakthrough in Treatment of Naso-Pharyngeal Cancer Today
Symptoms of naso-pharyngeal cancer are nose bleeds, lumps in the neck and hearing loss in one ear. Doctors often make the diagnosis by inserting a needle into swollen lymph nodes and removing tissue to be checked under a microscope. MRIs also can detect small swellings and lumps that may be caused by cancer. Today this condition is usually treated with radiation and chemotherapy and 40 percent of patients with advanced naso-pharyngeal cancer survive at least five years. An exciting breakthrough in treatment of these cancers is the use of checkpoint inhibitors that have been shown to slow the spread of naso-pharyngeal cancer (Brazilian J Otorhinolaryngology, April 27, 2021) and to cure some cases even after the cancer has spread to other parts of the body (Int J Cancer, Apr 15, 2020;146(8):2305-2314).
How Common is HPV?
Almost all sexually active adults have had HPV at some time. An estimated 79 million North Americans are contagious from infection with HPV, and more than 14 million are newly infected each year. There are more than 150 different types of HPV viruses. Infection with one type does not protect you from being infected with other types. You can have many different HPV viruses at the same time. You may have small bumps (warts) on your genitals or mouth or you may have no symptoms at all. Most infected people do not know that they are infected. All genital warts and almost all cervical cancers are caused by HPV. Cancers of the vagina, genitals, rectum, penis, mouth, nose, throat, neck and lymph nodes can be caused by HPV. Today most of these cancers can be prevented with the HPV vaccination, but it must be given before any exposure has occurred.
Dr. Gabe Mirkin is a Villager. Learn more at www.drmirkin.com