Catherine Zeta-Jones blames doctors for Michael Douglas’ throat cancer

Why is Catherine Zeta-Jones so mad?

It’s a facetious question. Her husband, Michael Douglas, was recently diagnosed with throat cancer he described at “stage 4.”

She was quoted by People magazine as saying, “It makes me furious they didn’t detect it earlier.” They have young children, and anyone who hasn’t personally been faced with this threat can only imagine her fear and anxiety. I suspect no number of large houses, expensive cars, or entourage members reduce her emotional pain.

Mr. Douglas reacted more humbly, saying, “Without having to blame anybody … these things sometimes just don’t show up.”

I don’t know any details beyond those reported in the mainstream press. However, her quoted reaction to her husband’s illness speaks volumes about some of the underlying forces that contribute to America’s, inefficient bloated healthcare system. Her primary frustration was that he had seen several doctors for throat pain over a six-month period before he was diagnosed with throat cancer.

Her implied assertion was that the doctors screwed up by not catching the disease early, which worsened his prognosis. The problem with this assumption is there is no evidence that any cancer of the throat is more likely cured if caught early. It’s a fallacy, perpetuated by many special interest groups in American healthcare. There are dozens of different kinds of cancer. The prognosis of only three are widely accepted to be improved by early detection (breast, colon, and, cervical). Other cancers have evidence that early detection doesn’t make any difference, but the media rarely reports on those.

Her quoted statements also lack any recognition of his role in the cancer. He has a smoking history, which probably was a contributor (though I can’t be sure because the cancer type wasn’t disclosed). Grief makes considering the whole story difficult. Maybe that will come in time.

We can all understand why she lashed out at the doctors. Anger and denial are expected reactions to bad news. However, I hope she doesn’t go on a series of talk shows imploring the viewers to rush out to a doctor to have a scope shoved down their throat to look for a cancer. It would be just another technophilic waste of American healthcare dollars.,

One of the hallmarks of the British healthcare system is the humility of patients and doctors about the limits of aggressive medical care. Ms. Zeta-Jones, who is originally from Wales, has become Americanized in more ways than geography.

Richard Young is a physician who blogs at American Health Scare.

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  • AnnR

    In my experience with cancers it’s not been out of the question for figuring out what a person’s real problem is to take 3-4 months.

    I’ve know people who died because they were treated for the wrong thing, say one type of cancer when they really had another type. It’s frustrating to go through the process but having been through it I’m not all that surprised that it could take six months to get to the bottom of his problem.

  • http://www.consentcare.net Martin Young

    Richard, as someone with experience in diagnosing throat cancer, I have two comments, also being aware that we don’t know all the details.

    The first is that early diagnosis of the commonest throat or oral cavity cancer is feasible, and as critical as in the other types you mention. All begin small, and almost without exception can be treated with excellent prognosis and without resorting to mutilating surgery or radiotherapy if found at that stage. But doctors need to have a high index of suspicion. All ENT’s know that any smoker with a sore throat that does not get better within two weeks must have a thorough examination under anaesthetic if necessary, along with whatever investigations required to be sure the pain is not due to cancer. If MD has had those tests, and the cancer was missed, then he is one of the very unlucky few who do not get picked up early. If he did not, and without any other extenuating information, in my opinion someone screwed up. So I can’t agree with your statement about the relative non-importance of early diagnosis.

    The second is this – as you say, MD smoked. He knows he smoked, she knows he smoked, and we all know smoking is bad for your health, and may cost your life.

    Ms Zeta-Jones could do more good as an advocate for the dangers of smoking, knowing the consequences, than being an angry ‘victim’ of the medical system.

  • stargirl65

    It took them 6 months to diagnose my daughter’s cancer. She saw 6 doctors before they figured things out. I don’t blame any for missing it. It was rare and her symptoms were vague. I am simply glad the last person found it.

  • Ben

    The prognosis of only three are widely accepted to be improved by early detection (breast, colon, and, cervical).

    How about Melanomas?

    Theres a 99% 5 year survival if the Breslow thickness less than 0.76 mm
    40% 10 year survival if its more than 4.0 mm.

    • Vox Rusticus

      Ben,

      With skin melanoma and Breslow thickness, prognostic benefit does not necessarily correspond with early detection. Even small lesions that are biopsied early can demonstrate deep penetration and thus earn a higher Breslow scale score. Of course neglecting to biopsy a lesion with suspicious features invites discovery at a more advanced stage with a poorer prognosis.

  • http://chefshie.wordpress.com Steven Shie

    As a non-doctor, I’m a strong believer that early detection will make a huge difference in cancer treatment, at least, that’s what I hear from the media. Having said that, I totally understand her anger. When facing her stage IV husband, she’s not a movie start but a wife first. Like other families of cancer patients’, Ms. Zeta-Jones deserves sympathy from us.

    It’ll be good to see if she can become a advocate for cancer.

  • http://thehappyhospitalist.blogspot.com/ Happy Hospitalist

    But, but, but, but….

    I thought specialists were special. How could they have possibly missed a diagnosis?

  • http://www.practitionersolutions.com Niamh van Meines

    The issue here with CZJ’s comments is really a testimony to how she is coping with a new reality, which is a husband who has a life limiting disease, must undergo aggressive treatment, whose career as an actor is most likely over and who will die sooner than expected. Rather then becoming defensive regarding the statements that she has made, I can only feel compassion for her. She is clearly in the anger / disbelief stage of coping with the illness (if you follow Kubler Ross’s staging system) We all know that the cause of the cancer can be linked to MD’s own behavior but the knowledge really is of no value and cannot add to a positive outcome….. We just see a person whose reaction is in keeping with her current disposition, which is to react in anger to something that is out of control or unexpected. I hope that this phase will pass and she will concentrate on ensuring that her husband is well cared for, comfortable, makes plans for end of life and creates meaningful moments in an open, honest and supportive environment.

  • guest

    Steven Shie:

    You do realize that the media may very well be wrong? Just because you believe something does not mean that it is true. For example, I may believe that daily lunches at Burger King are healthy but I may be incorrect.

    • gzuckier

      Yeah, unfortunately, it’s hard to distinguish “we’re seeing more cancers now but early diagnosis is resulting in a lot of cures” from “we’re seeing the same number of cancers and the same death rate but we’re ‘discovering’ a lot of similar but nonfatal little lumps that we’re taking out and calling them cured cancers” without doing some unethical experiments. Of course, as we’ve seen (again) this week, just because experiments are highly unethical hasn’t stopped us from doing them.

  • Bruce Small

    We may not know if smoking was the cause of his particular cancer, but we can safely say it didn’t help. Her focus ought to be on getting people to stop smoking before it happens to them.

  • ninguem

    Martin Young – “Ms Zeta-Jones could do more good as an advocate for the dangers of smoking, knowing the consequences, than being an angry ‘victim’ of the medical system.”

    Well said.

  • anonymous

    This post and most of the ensuing comments are inappropriate. We don’t know the details of the case. We don’t know if there were prior concerns about neck/throat issues that were downplayed or not followed up. We don’t know the prognosis; we don’t know anything about the histology.

    Apparently some people feel it’s entirely OK to judge Mr. Douglas’s spouse based on how she’s reacting and what she’s saying during what is obviously a scary and vulnerable time. Some of you even have the gall to recommend what “her focus ought to be.”

    Give me a flipping break here.

    • anon doc

      CZJ criticized her doctors publicly, and in my opinion her credibility went down. Your doctor screwed up? Sue him and prove it in court, don’t blast him all over US Weekly.

      • anonymous

        I’d agree that criticizing physicians publicly is not a class act.

        But IMHO this is a separate issue from the presumptiousness of total strangers who’ve decided they know the correct way she should feel and react.

      • http://Www.Twitter.com/alicearobertson Alice

        Maybe she doesn’t care about money? She has just experienced a huge harmful hurt and she has every right to vent. I saw the Michael Douglas interview on Jay Leno and he was honest about their smoking…but that doesn’t exonerate the earlier misdiagnosis. It’s like blaming a rape victim for dressing provocatively.

        I surmise the doctors who messed up may have apologized….it usually prevents a lawsuit. And it is a smart move for the doctor not to blame the patient…..just admit, apologize and take your consequences if there are any. If a doctor is misdiagnosed I, also, surmise they will talk to others about it…..you are angry and hurt…..and injured people rant when there is no closure via acknowledgement.

        The court of public opinion for the perpetrator is effective. Are we supposed to button up because it was a doctor? People complain about contractors at the Better Business Bureau online, so what gives with doctors asking for carte blanche?

        • DeAnne FNP

          1. who said anything about money? Anon doc said prove it.
          2. right to vent. sure. in private but not in People magazine by bashing doctors who were likely within the standard of care
          3. Blaming the victim? That’s silly, Did anon doc do that?
          4. You assume docs messed up. big assumption, and probably wrong in this case.
          5. who said anything about don’t complain or carte blanch? Use celebrity to complain publicly about malpractice? Do it with proof. Evidence is more credible. like the saying goes, “put up or shut up”

          • HJ

            DeAnne says, “You assume docs messed up. big assumption, and probably wrong in this case.”

            So it’s ok for you to make assumptions and not ok for anyone else?

            DeAnne says,”People magazine by bashing doctors who were likely within the standard of care”

            Catherine says, “It makes me furious they didn’t detect it earlier.” and “He sought every option and nothing was found.”

            I don’t see any blame here, just frustration over what happened. She seems more frustrated by fate than anything else. But then again, these are just assumptions.

            anon doc says, “Your doctor screwed up? Sue him and prove it in court, don’t blast him all over US Weekly.”

            I believe in the US, Catherine has the freedom to say things as publically as she wants as long as she tells the truth. If it’s not the truth, the doctor that is being accused of screwing up can sue her for slander. I would guess if there is negligence, that Michael Douglas, or someone on his behalf, will sue.

          • DeAnne FNP

            I didn’t assume anything HJ. The probability is indeed that the doctors acted within the standard of care. What are you talking about?

            CZJ, like you, can say whatever she wants, and I can evaluate the credibility of hers and your statements. No assumptions there.

        • HJ

          “The probability is indeed that the doctors acted within the standard of care.”

          Another assumption about probabilities?

          • http://www.twitter.com/alicearobertson Alice

            DeAnne I think you should do your homework before defending docs on some ideology that boils down to some type of…..they had their reasons. Instead of reading into truthful statements and getting defensive I really think you should read what the Douglas’ have really said. And then put yourself in their place. So, if your husband had went to doctors with a complaint (watch the Jay Leno interview first) you would just be the picture of serenity and calm and put your finger in your dimples(Shirley Temple style please:) ) and say, “Yeah…….he went to a couple of docs, but golly those degreed people didn’t listen, and golly my husband is only in stage four cancer because of their non-listening skills.” NOT! You would be angry and hurt………how do I know? An arrogant doctor at Cleveland Clinic misdiagnosed my child (despite my pleas with him, he discounted me and said all was well and claimed he had read the lab results. He didn’t). and the cancer spread during the months he assured me all was well…….and my daughter just had to have 49 lymph nodes removed. He was cited for it……..but no apology.

            And, yes, I am upset, angry, hurt………and completely understand why someone would rant.

  • thedocsquawk

    I’ve already had one patient worried she had Michael Douglas’ cancer.

  • http://drpauldorio.com Paul Dorio

    For the most part I agree with “anonymous,” except for the moniker. And I add that it is particularly unpleasant to see a doctor putting blame on another doctor, as the ENT post did, without any facts at hand.

    • http://www.consentcare.net Martin Young

      Paul, your ill-considered comment demands a reply.

      As celebrities, the Douglas’s have taken their story into the public eye. I assume noone forced them to do this – and it was voluntary. CZJ’s anger will have swayed public opinion in some way and there are bound to be consequences. I believe this discussion can be held in the public domain because they have chosen to make it so.

      Both the author and I acknowledge there are no definite facts at hand. The purpose of my comment was to correct misinformation about throat cancer, i.e. that it can and should be picked up early. If you bother to read what I said carefully, you will see I present one of two possible alternatives, i.e. either he was very unlucky, or, assuming there is no other special information, someone screwed up. What other alternatives are there? None that the wider public will be made aware of, most certainly.

      You assume that the ‘someone’ I refer to was a doctor – I don’t say that specifically. It may have been an admin clerk, or a nurse, or a well-meaning family member. Or indeed a doctor. I don’t know. I’ve seen similar mishaps due to administrative error rather than medical error.

      Nevertheless the whole purpose of the media attention is to say that, for whatever reason, the system is wrong.

      Your comment suggests you would rather we doctors all remain part of the ‘conspiracy of silence’ that often surrounds medical malpractice.

      I don’t buy into that for a second. Accountability breeds responsibility – that’s the way it should be when lives are at stake.

      • http://drpauldorio.com Paul Dorio

        Well, not to make this a Martin vs Paul thing, but perhaps a reply to your reply:

        The Douglas cancer story is both tragic and public — Of course.

        I also agree that CZJ can feel any way she wants, but hope that she doesn’t misplace or misdirect anger where it is not deserved.

        You said: “I present one of two possible alternatives, i.e. either he was very unlucky, or, assuming there is no other special information, someone screwed up. What other alternatives are there?” – There are of course a million other possibilities. Since neither of us has, nor ever will have, the facts, this type of speculation simply fuels the fire of public misperception about what we do every day – care for people to the best of our abilities.

        My goal is to help people understand that there are more than two possibilities to every medical result. Of course, mistakes happen and people/doctors should be held accountable. But to suggest guilt before any evidence is at hand is, in my opinion, irresponsible and impolite.

        And to suggest that I am part of the “conspiracy of silence” is ludicrous and impolite as well. Let’s be better than that.

  • http://ProstatitisSurgery.com Arnon Krongrad, MD

    One can only infer so much specific validity from a health report in People. Still, generic facets come up.

    Here’s another facet: Celebrity medicine. As reviewed in Medical Mongers and Misfits, when you are sick, it may be bad to be a celebrity.

  • http://drpullen.com Ed Pullen

    Maybe he saw a different doctor each visit. She says he saw many physicians. Maybe a primary care physician seen with continuity would have had him get an ENT exam earlier?

    • jsmith

      That’s what I was thinking. If you go to a bunch of different docs and start all over again and then move on to the next one, delay can happen.

  • Michael F. Mirochna, MD

    I’d like to see evidence about how useful a sore throat that lasts longer than 2 weeks needs a full ENT exam, even under anasthesia. I don’t think it’s a bad idea, but to blanketly say that… I guess it’s not a “screening” exam but still diagnostic.

    I personally struggle with the issue of people needing help, personal freedom/free will, and the consequences of their unhealthy actions… smoking, not exercising, drinking excessively, not getting enough sleep, eating fast food all of the time.

    This case will fit right in there with check your neck your neck marketing.

  • Patient

    What she’s likely reacting to is being told that it was nothing.

    I was pretty ticked at having throat pain ignored and dismissed and being told it was globus hystericus It was not.

  • ridiculous

    Reality check: does anybody here really care with Catherine Zeta-Jones thinks about doctors? Are we doctors really that insecure? Sad, if true.

    It would be far better to spend our time and energy examining statements by celebrity morons who crusade against childhood immunization. These folks are the true menace.

    • jsmith

      “Celebrity morons. “–nicely said. I’m gonna steal that one from you and use it prn.

  • pat

    Yes smoking is bad but that doesn’t mean Michael or anyone else deserves it! He & Catherine have the right to deal with this sad diagnosis in the best way for them. I pray he gets a miracle and many more happy healthy years with his beautiful family. No one deserves illness or bad luck! We’re all human and trying to make it in a stressful world.

  • Thorton212

    Actually the cancer Michael Douglas has been diagnosed with is Oropharangeal (squamous cell) Carcinoma. It is a condition which arises in the squamous tissue of the oropharynx (ear throat tube). His doctors were wrong to have not been able to diagnose this as he had shown classic symptoms of this cancer. Coupled with the fact of his smoking/drinking habits it should have been relatively urgent to “shove a scope down his throat”. Any sore throat lasting longer than two weeks can generally be ruled out for trauma or acute infection (especially if a culture has been performed) and thus a cancer diagnosis needs to be investigated. The author is also very ignorant to make a comment like “only breast, cervical, and colon cancer are generally accepted to have improved survival rates if caught early”. I sincerely hope you are not a doctor because if you are then you can point the finger at yourself for playing a major role in America’s declining health care situation. In fact, every cancer if caught early enough would offer a better survival rate as well as a better prognosis. Throat cancer in general is highly curable at the earliest stages of the disease (90% + cure rate for stage 1 oropharangeal cancer and less than 10% for stage 4 cancer with current medical treatments). I hope the author will find it worthwhile to do the necessary research before spreading dangerous, ignorant information to the masses.

  • http://www.twitter.com/alicearobertson Alice

    It would be far better to spend our time and energy examining statements by celebrity morons who crusade against childhood immunization. These folks are the true menace.
    [end quote]

    Hmmm……now that would be ridiculous! :) Teasing, but they are in no different category than the educated docs who can’t read and research. Some docs and some celebs are ridiculous, so write an article and let the conversation begin.

  • Molly Ciliberti, RN

    A little compassion folks, she is angry (early stage in Elizabeth Kubbler-Ross staging) and scared and threatened. We were not privy to what was said or done when he went to physicians seeking help, so we should not make assumptions. Hard to believe that any cancer caught early wouldn’t be easier to treat. I am glad that Michael Douglas is so open about his cancer because that could save someone else’s life.

  • http://www.aneurysmsupport.com/ Mike

    I am not by any means a celebrity follower but was aware of Michael Douglas’ cancer. Instead of worrying so much about his wife, who is understandable angry and upset how about a brief comment of Mr. Douglas. From the little I have seen it appears that he is handling his diagnosis with calm dignity. My hat’s off to him for that. Good luck Mr. Douglas and may God be with you.

  • Valerie RNP

    Martin Young – “Ms Zeta-Jones could do more good as an advocate for the dangers of smoking, knowing the consequences, than being an angry ‘victim’ of the medical system.”

    DITTO !!

  • http://www.twitter.com/alicearobertson Alice

    Martin Young – “Ms Zeta-Jones could do more good as an advocate for the dangers of smoking, knowing the consequences, than being an angry ‘victim’ of the medical system.”

    DITTO !!
    [end quote]

    I hope she becomes a non-smoking patient advocate against doctors who don’t do their jobs properly (because the reasoning here is the patients need to be completely responsible….not the doctors. I guess smokers [and I have never smoked] should lay down and accept the mess-ups because……hey….they are smokers…….the vilest of creatures…not the doctors who don’t listen) If you would read up you would see Mr. Douglas takes the blame for smoking. He is stage four and we will never know what stage he was at when he started to complain. For those who comment without facts he said he has an 80% chance of living, but God forbid he gets frustrated with doctors. My daughter didn’t smoke and a foolish doctor flubbed it. Wonder what I did to bring this on……oops…….was it the dental xrays…..gosh I am such a bad mother for getting her braces….yeah the arrogant doctor is off the hook……it was me and my bad habits.

    It’s not an either/or and why the medical profession here has tried to do a type of bait-and-switch on the patient is well…….in the name of the pseudonym poster……ridiculous. And when people give up cigarettes research shows we will need less doctors and hospitals. Now that would be a win/win situation for mankind.

    • http://drpauldorio.com Paul Dorio

      I appreciate that there are medical mistakes made. And it sucks. I get it. Believe me, I dislike it at least as much as you do and probably much more. (Have you ever caused harm to a patient inadvertently and despite your best efforts to the contrary??) But I also appreciate the efforts made by doctors for your and everyone’s benefit 24/7/365. Perhaps you might look in the mirror and ask yourself if you truly believe that doctors are bad people, profiteering and conniving at every moment. Personally, though I’m a biased doctor, I know that most of us are out there every day trying valiantly NOT to screw up so we can go home at night and tell our loved ones we tried our best to make other people’s lives a wee bit better.

      Sorry for the sarcasm. But the I-hate-doctor comments get old after a while.

      • http://www.twitter.com/alicearobertson Alice

        Sorry for the sarcasm. But the I-hate-doctor comments get old after a while. [end quote]

        I can appreciate this. I love my daughter’s doctors and write to them and tell them so. But……..I really think you need to look at why patients complain….and when a mistake is made there is really no excuse for some of what I have seen here. Just admit it……your colleagues mess up (you at least started out with that). Some of your colleagues stink…..and aren’t honest…….that’s why we complain. It’s not like we are charity cases. You are paid for a service. What I can gather is some of the medical profession posting here don’t like complaints. Fair enough……..remember that when it’s your kid, your mate, your house that has water and sewage backed up from a bad contractor, and you are considering suing the guy who hit you in the back because he is denying being irresponsible and won’t apologize. Think about how it feels when a cancer person could have received treatment much earlier and had a far better chance of survival. Play kill the messenger or the perpetrator?

        • http://drpauldorio.com Paul Dorio

          I think we’re probably on the same page. When mistakes are made, people should own up to them and communicate communicate communicate. Personally, that’s how I try to avert any complaints being made about me.

          Clearly got off the People magazine topic that started all of this interesting discussion.

          Best to MD and CZJ.

          Thanks.

  • http://www.healthscareonline.com Richard Young

    Wow! Thanks for the great comments everyone.

    I’ll address just a few issues that came up. The only evidence that I’m aware of that early detection of melanomas improves survival is a national screening program in Australia that has seen a drop in the melanoma death rate. Keep in mind this is a high-risk population — a bunch of fair complexion northern Europeans living in a sunburned country. There are no randomized trials proving early detection saves lives.

    Other people clearly assume early detection always makes a difference, which is a myth perpetuated by the media and many entities in the healthcare industry who sell these services. The fancy-schmancy terms for the phenomena that explain this are lead time bias and length bias (if anyone wants to Wikipedia this). These concepts boil down to the reality that slower growing less toxic tumors are first detected at smaller sizes because they are slow growing, not because they were detected early. I have more information on this issue under the POEM assumptions tab on my webiste http://www.healthscareonline.com.

    Thank you for taking the time and thought to respond to my article.

    • http://Www.Twitter.com/alicearobertson Alice

      Hi! So our doctors are selling us a lie about early detection? Speaking in generalities beyond melanomas…..If my daughter’s cancer had been detected early it would have meant the cancer would not have spread to operable and inoperable areas.

      Okay, let’s say early detection isn’t the grand act breast and colon cancer experts tell us (note to Dr. Oz who is grateful for his recent early detection, just as I would have been) does it exonerate doctors who do not diagnose in a timely manner?

  • lilkunta

    What did you mean by hallmark?
    ” One of the hallmarks of the British healthcare system is the humility of patients and doctors about the limits of aggressive medical care. Ms. Zeta-Jones, who is originally from Wales, has become Americanized in more ways than geography. ”

    I thought the NHS in Uk and Canada wasn’t good, in that one must wait a long time for care. That is why many journey to the USA and just pay for the surgery. An exmaple is Canadian Premier Danny Williams who didnt wait for the Canadian NHS. He flew his wife & himself to Florida and paid for his minimally invasive mitral valve heart surgery (read more here:)
    http://www.americanthinker.com/2010/02/danny_williams_surgical_sojour.html
    http://www.redstate.com/racebannon/2010/02/23/canadian-premier-comes-to-us-for-surgery-note-this-loudly-thurs/

    • http://Www.Twitter.com/alicearobertson Alice

      This is informative…thank you for the links. I did not see the quotation you caught…so thank you for calling that poster out over misinformation. British healthcare stinks…and her husband would most likely have died on a waiting list. The majority of my family, and my husband’s family lives there and how we wish they could have received care here….they may still be alive. Monied Americans would not go to the UK for care….and that means Dr. Berwick who wants to duplicate it here……
      God help us!

  • http://www.drrendon.com lasertreatments

    I accept that they would have recognised it in earlier stage, but some times it is very difficult to find the symptoms untill the last stage.

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