Dave Coulier, of “Full House” fame, just revealed he’s been diagnosed with HPV-related oropharyngeal tongue cancer. His news comes a little over one year after he was diagnosed with Stage 3 non-Hodgkin lymphoma. We asked our chief medical officer, Sohaib Imtiaz, MD, if there’s a chance the two cancers could be linked.
Q: Dave Coulier was diagnosed with lymphoma last year and now he has tongue cancer—is there a link between the two?
Imtiaz: I’m not part of Coulier’s care team, so I can’t speak to his specific case, but second primary cancers like this can occur in patients with lymphoma, or types of blood cancer that affect the lymphatic system.
Upfront, it should be noted that lymphoma does not directly cause head and neck cancers.
As my colleague Amit Garg, MD, an oncologist and hematologist based in California, told me: “Evidence does not show having lymphoma causes head and neck cancers. The most common risk factors for head and neck cancer include smoking, heavy alcohol use, HPV infection, and being immunocompromised.”
However, research has shown that patients with lymphoma have a significantly increased risk of developing second primary cancers—new, unrelated cancers that develop in people who have previously had cancer—including head and neck cancers, such as tongue cancer. These patients have more than a three-fold higher risk than the general population.
This elevated risk is well-documented, and particularly notable for non-Hodgkin lymphoma and Hodgkin lymphoma survivors.
In general, the relationship between lymphoma and subsequent tongue cancer depends on many different factors.
Immunosuppression—whether from the underlying disease or its treatment (chemotherapy, radiation)—plays a major role, as does exposure to shared risk factors such as viral infections (Epstein-Barr virus, HPV).
Treatment-related effects, especially following hematopoietic stem cell transplantation (sometimes used to treat lymphoma), further increase susceptibility to solid tumors in the oral cavity.
The bottom line: There is no evidence of a direct biological link between lymphoma and tongue cancer—but lymphoma patients, like Coulier, face a higher risk of second primary cancers due to immune system suppression, overlapping risk factors, and effects from treatment options.
