Don Imus, Prostate Cancer and Emphysema

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don imusDon Imus wore an old cowboy hat as the confrontational radio host of “Imus in the Morning,” who shouted tasteless, obscene, sexist, homophobic and even racist remarks about people in the news over more than 100 radio stations to become the “shock jock of radio.” His almost 50 years of broadcasting were frequently affected by his alcoholism, cigarette smoking, addiction to cocaine, various illnesses including prostate cancer, accidents, being fired several times, and several lawsuits and other legal problems. In the later part of his career, his broadcasts were supported by more than $50 million a year of advertising and he was paid more than a million dollars a year.

In 2009 he was diagnosed with localized prostate cancer and treated with watchful waiting. He suffered from serious lung damage called emphysema, most likely from his smoking. On December 24, 2019, he was hospitalized at Baylor Scott & White Medical Center in College Station, Texas, and died three days later at age 79, most likely from pneumonia or heart failure. Men with prostate cancer rarely die from that disease. The majority of men with prostate cancer die from heart attacks or heart failure.

Early Years
Imus was born in Riverside, California, to wealthy parents who ran a 35,000-acre ranch near Kingman, Arizona. He was a horrible student who went from one private school to another. His parents divorced when he was 15 and his father died when he was 20. He never was graduated from high school, spent a few years in the Marines, then worked as a window dresser, moved to California where he failed as a musician and ended up homeless and slept on the streets. Then he worked as a brakeman for the Southern Pacific Railroad and in a uranium mine in Arizona, where an accident broke both of his legs and collapsed a lung.

Broadcast Career
In 1968, at age 28, he worked for radio station KUTY in Palmdale, California. At age 31, he began his “Morning Show” on WNBC in New York City. At age 37 he was fired and at age 39 he was rehired and worked there until age 48 when the station was sold. Imus’s show moved to WNBC’s successor station, WFAN. In April, 2007 at age 67, he was fired for racist remarks about the Rutgers University women’s basketball team. He claims that he has never been a racist and his remarks were misinterpreted, but the controversy ended his show on WFAN. He resumed his show on other stations and in March, 2018, he ended his broadcasting career when the radio company went bankrupt.

His Unhealthful Lifestyle
In 1973, at age 33, he started to drink heavily and at age 37, he missed 100 days of work, and WNBC fired him. At age 39, he was rehired to do morning broadcasting on WNBC.  He was using large amounts of cocaine which he says he quit using at age 43, but he continued to drink alcohol to excess, showed up for work in bare feet and slept on park benches. At age 41 he was earning $500,000 a year as WNBC’s morning host, and started a name-calling feud with Howard Stern, the afternoon host. At age 43 he started attending Alcoholics Anonymous and stopped drinking in public, although he continued to drink in private. At age 47, he was hospitalized after drinking vodka heavily for nine days.  At age 50, he fell off a horse, and claimed that the fall caused his breathing problems. At age 51, he became a vegetarian. At age 54 he married his second wife, Deidre, who made him give up his heavy smoking.

At age 69, he was diagnosed with localized prostate cancer and refused radiation treatment. The average 10-year survival for localized prostate cancer with no treatment is greater than 95 percent, which is the same as for treatment with radiation and/or surgery. He went on a stricter plant-based diet, took a tremendous amount of vitamin pills and plant extracts advertised to treat prostate cancer, and started an exercise program.

What Killed Imus?
As far as I know, the family has not released the cause of his death. Various reports say that he died of a lung infection or “complications from lung disease” (AP News, December 27, 2019). Most likely he died from serious lung damage called emphysema (caused by his many years of smoking), which deprived his body of oxygen and probably sent him into heart failure. Smoking damages the tubes that carry air in and out of your lungs and the air sacs in the lungs through which oxygen passes from the lungs into your bloodstream. Once a person develops emphysema, treatment can slow the progression of lung damage, but it cannot heal the damage.

Other possibilities include prostate cancer or a heart attack. It is unlikely that he died from prostate cancer; the vast majority of men who suffer from prostate cancer die from heart attacks, not prostate cancer. He had lots of risk factors for a heart attack:
• He was a heavy smoker until he stopped at age 54, 24 years before his death. Generally, smokers are no longer at increased risk for heart attacks from smoking four to ten years after they stop smoking.
• He had used cocaine and other drugs
• He suffered from alcoholism but had remained sober after 1987
• He had a very unhealthful diet until he became a vegetarian in 1991

Prostate Cancer
Almost all North American men will develop prostate cancer if they live long enough, but only a very small percentage will die from it. More than 50 percent of North American men will develop prostate cancer by age 60 (J Natl Cancer Inst, 2013, 105 (14): 1050-1058). A review of 29 studies showed that five percent of men already have prostate cancer at age 30 years of age, while 60 percent of men will have that cancer by age 80 (Int J Cancer, 2015 Oct 1; 137(7): 1749–1757). Unlike most other cancers, more than 95 percent of all prostate cancers grow very slowly and do not kill the men who have it. However, a small number of prostate cancers are called rapidly progressive, grow rapidly and can have a fatal outcome. Unfortunately, at this time there is no reliable test to prove that a man has the more common type that is not likely to kill him. Under the current standard of care, if you are diagnosed with prostate cancer, you and your doctor must choose between no treatment and frequent testing, called “watchful waiting,” or treatment with surgery or radiation. Urologists often use “watchful waiting” to follow patients with low level prostate cancer, to see if the prostate cancer cells change to look increasingly more malignant, or if the cancer spreads or grows larger.

Lifestyle Changes to Help Prevent and Treat Prostate Cancer
If you are diagnosed with prostate cancer, you should work with your doctor to decide what treatments are best for you. All men with prostate cancer should be aware that they are far more likely to die from a heart attack than from prostate cancer (J Am Geriatr Soc, 2009;57(1):24–30). Most of the risk factors for heart attacks are also risk factors for prostate cancer:
• High blood sugar, high insulin levels or high cholesterol (Horm Cancer, April 2016;7(2):75-83)
• Obesity (Int J Oncol, Mar 2006;28(3):737-45)
• Fasting sugar over 100 (Prostate Cancer Prostatic Dis, June 2013;16(2):204-8)
• Eating a lot of sugar and refined carbs (Ann Oncol, Jan 2013;24(1):245-51)

Try to exercise every day and work to lose excess weight if you are overweight. Exercise reduces risk for prostate cancer (Journal of Urology, November 2009;182(5):2226-2231). The most beneficial diet to prevent and treat prostate cancer includes eating lots of fruits and vegetables, and restricting refined carbohydrates, red meat and processed meats, and fried foods (BMC Medicine, March 24, 2015;13:3). Data show that vitamin and mineral supplements (vitamin E, vitamin C, vitamin D or selenium) do not help to prevent prostate cancer, and high intake of calcium has been associated with increased risk for prostate cancer.

Men who adopt a more healthful lifestyle after being diagnosed with cancer are less likely to have that cancer spread or recur (Journal of Clinical Oncology, Oct 20, 2012;30:3697-3704). Follow ABCDE, the heart-attack-preventing mnemonic:
Aspirin if indicated
Blood pressure monitoring
Cholesterol management and Cigarette avoidance
Diet and Diabetes prevention: eat lots of fruits and vegetables; restrict sugar-added foods and drinks, red meat and fried foods
Exercise
Also keep blood levels of hydroxy Vitamin D above 20 ng/ml and lose excess fat if overweight.

Healthful Lifestyle Reduces Risk of Dying from Prostate Cancer
Risk Factors for Prostate Cancer
Prostate Cancer Treatment Choices
Prostate Cancer and Heart Attacks

Donald Imus, Jr.
July 23, 1940 – December 27, 2019