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Tuesday, June 17, 2014

Tony Gwynn Succumbs To Facial Cancer: An Appropriate Time For A Desperate Appeal

"Tony Gwynn (two-sport star) always wanted to play in the NBA, until realizing during his final year at San Diego State that baseball would be the ticket to the pros.

"After spending parts of just two seasons in the minor leagues, Gwynn made his big league debut on July 19, 1982. He had two hits that night. After Gwynn hit a double, all-time hits leader Pete Rose, who been trailing the play, said to him: 'Hey, kid, what are you trying to do, catch me in one night?'"

(Bernie Wilson. "Tony Gwynn, Sweet-Swinging 'Mr. Padre,' Dies at 54." 
Atlanta Journal-Constitution. June 17, 2014)

One of my all-time favorite baseball players has passed away. Hall of Famer and 15-time All Star Tony Gwynn won eight batting titles in a career that sported 3,141 hits and a .338 batting average. And, most importantly, he was a wonderful man.

Gwynn had been on a medical leave since late March from his job as baseball coach at San Diego State, his alma mater. He died on June 16, 2014, of cancer of the salivary gland. He was 54 years old.

According to his hitting coach Merv Rettenmund, Tony, Mr. Padre, was special, one of a kind:

"Gwynn spoke with a twang in his high-pitched voice, often filled with an infectious child-like laughter. He possessed a cheerful personality, being friendly towards others while being critical of himself. His demeanor was even-keeled; Rettenmund said, 'You couldn't tell if [Gwynn had] gone 3-for-3 or 0-for-3.'"

(John Kuenster, John, ed. The Best of Baseball Digest: The Greatest Players... 2006)

Gwynn was diagnosed with cancer in 2010. He was one of more than 40,000 people diagnosed with oral cancer yearly in the U.S., according to the Oral Cancer Foundation.

ESPN reported at the time that the then-50-year-old faced chemotherapy and radiation to fight the "slow-moving but aggressive" cancer. He had two operations for cancer in his right cheek between August 2010 and February 2012. The second surgery was complicated, with surgeons removing a facial nerve because it was intertwined with a tumor inside his right cheek. They grafted a nerve from Gwynn's neck to help him eventually regain facial movement.

Gwynn believed the cancer was caused by his longtime use of chewing tobacco, a habit maintained even after retiring from baseball. He once said, “Of course it caused it … I always dipped on my right side.”

An Appropriate Time For A Desperate Appeal

According to the Centers for Disease Control and Prevention, smokeless tobacco contains 28 carcinogens. It is a known cause of oral cancer. Mark Agulnik, an oncologist at Northwestern University's  Robert H. Lurie Comprehensive Cancer Center in Chicago, states, “Cancers that form are just as aggressive in the smokeless tobacco as in smoked tobacco.”

“Chewing tobacco, specifically snuff, actually has [compounds] that rough up the mucous [membrane]; this is meant to aid the absorption of nicotine, but it also creates a more permeable place for carcinogens to enter the tissue,” Dr. Chad Zender, in the otolaryngology department at UH Case Medical Center, told  “And just like tobacco smoke, tobacco itself has cancer-causing compounds in it.  If you add it to things like alcohol, it works together synergistically.”

Additionally, a study presented at the American Association for Cancer Research’s annual meeting in 2012 revealed that a chemical found in smokeless tobacco called (S)-N'-nitrosonornicotine, or (S)-NNN, is a strong oral carcinogen.  Some physicians have even noted that how a person chews tobacco can predict where subsequent cancer will develop.

“For several of my patients, if they chew tobacco on one point of the mouth, that is the part of the mouth that develops cancer,” Dr. Krzysztof Misiukiewicz, assistant professor of medical oncology at the Icahn School of Medicine at Mount Sinai, told  “It’s proof that direct contact matters.”

 (Loren Grush. "Tony Gwynn's Cancer: How Smokeless Tobacco 
Can Contribute to Disease." Fox News. June 16, 2014)

Only a little more than half of patients diagnosed with oral cancer will be alive in five years, U.S. health officials say, mostly because oral cancers are usually discovered only after they’ve spread to another location, such as the lymph nodes in the neck. It’s estimated that at least 75 percent of those diagnosed with oral cancer at 50 have been tobacco users.

Primarily a male habit, the most normal use of smokeless tobacco is accomplished by placing it in the mouth and sucking on it, periodically spitting out the juices. In 2012, approximately 11.2% of high school boys used smokeless tobacco; only 1.5% of girls did. Nationally, an estimated 6% of adult men use smokeless tobacco, compared with just 1% of adult women.

 (Jacque Wilson. "Tony Gwynn and a Habit All Too 
Common in Baseball." CNN. June 17, 2014)

Although current use of smokeless tobacco is about half of what it was in the mid-1990s, only a modest decline has occurred since 2010 and no change occurred between 2012 and 2013. Suffice it to say, the habit is hard to break. It may be having a resurgence with the youth of America.

Jacque Wilson reports Gwynn isn't the only former ballplayer to battle oral cancer. Most notably, Babe Ruth, Brett Butler and Bill Tuttle were all diagnosed after years of chewing tobacco use. Butler became a passionate advocate against tobacco after he returned to the field following treatment, according to the Oral Cancer Foundation.

Still, hitters like Big Papi, David Ortiz, claim the tobacco helps keep them "smooth" and puts them in a "good mood" at the plate. Ortiz says he doesn't even use smokeless tobacco after the season. But, the American Cancer Society says, "Over time, a person becomes physically dependent on and emotionally addicted to nicotine." Those who do try to quit experience withdrawal, often for weeks after their last spit or chew. Withdrawal symptoms can include irritability, dizziness, depression, headaches and weight gain.

Joe Garagiola, former major-league catcher and broadcaster who for decades has been an advocate against the use of smokeless tobacco, said the strongest steps should be taken to rid the game of the product. Smokeless tobacco is prohibited in high school and college baseball, and also in the minor leagues. It is not banned in the Majors.

While Major League Baseball prohibits the use of chewing tobacco within the view of fans, Garagiola wants a complete ban of what he calls “spit tobacco.”

As part of the last labor negotiations in 2011, the league sought to have it banned, only to be thwarted by the MLB Players Association. The late Michael Weiner, the former Executive Director of the MLBPA said, “Our members understand that this is a dangerous product, there are serious risks associated with using it. Our players felt strongly that those were appropriate measures to take but that banning its use on the field was not appropriate under the circumstances.”

“The players' association has to vote on it,” Garagiola said in a telephone interview. “I just wish that they would take a more serious look at it and don’t wait for good people to die, good guys like Tony Gwynn. That’s a big loss for baseball.”

(Sonali Basak and Mason Levinson. "Gwynn’s Chewing Tobacco Death Renews 
Baseball Ban Call." Bloomberg. June 17, 2014)

Children idolize baseball players, especially talented stars like Tony Gwynn. Major League Baseball must seize upon this opportunity -- no matter how tragic or regrettable -- to ban completely the use of smokeless tobacco. I'm sure Gwynn would want it that way, and the action by baseball would add so much to the wonderful legacy of one of the game's greatest players. Rest in peace, Tony. You are gone much too soon.

"I had no idea that all the things in my career were going to happen. I sure didn't see it. I just know the good Lord blessed me with ability, blessed me with good eyesight and a good pair of hands, 
and then I worked at the rest." 

--Tony Gwynn

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