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Cary A. Presant, M.D. Headshot

Tony Gwynn's Biggest Hit and His Advice for Us

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To me, Tony Gwynn had 3142 hits. But wait! You say the major league record books list him as having only 3141 hits? Where did that other hit come from?

I think his last hit was the most important and did not happen on the baseball field. After Tony had his life-changing surgery to remove a cancerous parotid gland in his cheek, he made his biggest hit (in my opinion) when he went public and told people not to use tobacco. As he put it:

Think about the decisions you are making... When you make a bad one, there's things you'll have to deal with later on.

Tony Gwynn had a lifetime average of .338, the highest since Ted Williams, achieved over 20 major league seasons. He was a 15-time All-Star. After wearing number 19 for the San Diego Padres, he was elected to the Hall of Fame on the first ballot on which he was eligible. Those are no small accomplishments.

But his biggest accomplishment (to me) was when he courageously faced cancer surgery on his face in August 2010. He was addicted to using smokeless chewing tobacco since being in the minor leagues, and it became a heavy habit during his years in the majors. He used one-and-a-half cans of tobacco daily. He noticed a growth where he always put the tobacco in his right cheek in 1991, and a biopsy showed no cancer. He could not stop using his chew, and in 2010, nine years after he had retired from the Padres and was then working as the head coach at San Diego State, he found a marble-sized lump in his right cheek, again near where he used his chewing tobacco.

After biopsy showed that this was cancer, he had major surgery in August 2010. Waking up and unable to close his right eye or put on his famous ever-present big smile, he then had the fortitude to undergo radiation treatments and then chemotherapy. But his courage paid off when he was cancer free, able to return to his team on Valentine's Day 2011 and start coaching again.

Tony was public about the dangers he felt about using chewing tobacco. These warnings helped many kids to think twice about using smokeless tobacco. Its use by two-thirds of major league players influences 13 percent of high school boys to use chews. Tony felt this was a mistake and promoted avoidance. After recurrence of the cancer and a more extensive surgery in February 2012, he continued his advocacy for tobacco cessation. He died June 16, 2014.

But although everyone accepts that smokeless tobacco causes oral cancer, there is controversy about whether it actually causes the salivary gland cancer that Tony Gwynn had. Although some reviews find no link between chewing tobacco use and parotid gland cancer, others find tobacco does increase the risk. Since cigarettes have 60 different carcinogens, and smokeless tobacco contains 28 cancer producing chemicals, which are absorbed into the lymph channels and blood, tobacco does cause at least some cases of salivary gland cancer. This type of cancer also is increased by radiation exposure, exposure to chemicals such as nickel, silica, rubber, asbestos and plumbing agents. Family history of salivary gland cancer, high fat diet, and HPV probably also increases risk.

So what should we learn from Tony Gwynn's advice and what are Dr. Cary's tips about salivary and oral cancer?

• Do not smoke or use smokeless tobacco or even e-cigarettes. They are all addictive and tobacco products contain carcinogens.
• Also, be cautious about what chemicals you are exposed to, especially at work, and use a good diet (low fat and at least five helping of fruits, vegetable or fruit juices daily) while limiting your alcohol intake. Don't expose yourself to excess radiation ever (ask your dentist and your doctors if those x-rays are really needed or not).
• Have your dentist always do a good oral exam for any precancerous changes or early small cancers. Have them biopsied or removed to prevent advanced cancer.
• Like Tony, have the courage to face needed treatments that can save your life most times. For more tips on facing serious illness , see my book Surviving American Medicine.
• Set a good example for your children and support them in trying to stop smoking if they have already started. Be a team with friends, family and physicians to help smoking cessation efforts in your loved ones.

Tony's last hit was setting an example for us of courage, and giving us advice on avoiding cancer. His career was one worth admiring, remembering, and celebrating, even though his life was too short. Heed his advice: avoid tobacco, smoked or chewed.