Nicko McBrain, drummer of the legendary heavy metal band Iron Maiden, said being hoarse in the hours and even days after a show or tour was typical.
“When I play drums with the band, I actually sort of scream and yell while I play, like a Judo guy slapping the mat,” McBrain said.
But in 2019, he noticed a change in his voice that could not be explained by a performance or touring.
“When you are lying down in a quiet room and you speak and hear your voice in your head and have a cold, you sound different.," McBrain said. "This happened to me. I thought this is very reminiscent — this different sounding voice of mine — to when I finish a tour or after a show. I didn’t have a cold or any symptoms of illness at all. I started to feel that I was clearing my throat more when I was in conversations. So, I just took it on myself to call my doctor.”
And it’s a good thing he did. McBrain was diagnosed with stage 1 laryngeal cancer, but fortunately landed at Sylvester Comprehensive Cancer Center, one of only 71 National Cancer Institute-designated cancer centers in the United States and one of only two in Florida. Cancer in this part of the body can grow in and around vocal cords and other structures near the voice box. It takes sub-specialists like those at Sylvester to accurately diagnose and treat these types of cancers.
Referral Led to Diagnosis
McBrain’s family doctor referred McBrain to David E. Rosow, M.D., FACS, director of the Division of Laryngology and Voice at the University of Miami Health System, who performed the endoscopy in 2020 that revealed McBrain’s cancer.
Dr. Rosow removed the cancer the following week and McBrain, who gets check-ups every few months to make sure the cancer hasn’t returned, is in remission and getting ready to go back on the road with Iron Maiden in June 2022 for the band’s "Legacy of the Beast Tour."
“I thoroughly recommend that anyone who may feel there is something different with their voice to go and get it checked out," McBrain said. "And don’t put it off. It was very good for me that I caught it in stage 1."
Laryngeal cancer is extremely curable with excellent quality of life if it is caught early, according to Dr. Rosow.
“Anyone who is experiencing a voice change that lasts longer than three weeks should see an otolaryngologist who can evaluate a person’s vocal folds,” said Dr. Rosow, who is also an associate professor of Otolaryngology at the University of Miami Miller School of Medicine. “Many cases present with a voice change like Nicko's and often when the tumor is as small as one to two millimeters, which makes the tumor easier to completely remove. The prognosis with early (stage 1) tumors is excellent, with published cure rates of 95% and up.”
Dr. Rosow and others published a paper in 2018 in the journal Laryngoscope showing that the potassium titanyl phosphate laser, which he used to treat McBrain, is equivalent to radiation in terms of survival outcomes, while causing less harm to surrounding tissue.
“We are often able to provide patients with improved voice and swallowing quality compared to radiation treatment,” Dr. Rosow said. “More recently, we have also been pioneering the use of a new blue laser to treat these cancers, which appears to be equally effective as the KTP and may result in less scarring.”
Enjoying Every Minute
More than 12,600 new cases of laryngeal cancer are diagnosed in the U.S. each year, according to the American Cancer Society. While most people diagnosed with the cancer are men who are 55 years and older, laryngeal cancer can affect anyone. In about 60% of cases, laryngeal cancer starts in the part of the throat containing the vocal cords. In other cases, it might start above the vocal cords.
The 69-year-old McBrain had the cancer in a part of his vocal cords and said Adam Lloyd, SLP-D, CCC-SLP, M.M., assistant professor of otolaryngology and speech pathology at the Miller School, has worked with him to maintain his voice with vocal exercises and more.
In the meantime, Iron Maiden’s popularity is soaring with now four generations of fans and, aside from the tour planned for next year, the band just released a new record called Senjustu.
Some 40 years into his rock star career, McBrain seems to be enjoying every minute.
“Music is an amazing thing," he said. "There are no borders, no parameters that say you can or cannot listen to this band. That’s the beautiful thing about it. We get these young kids that their mums turn them on or even their grandparents turn them on to the band. I have known stories where the kids have turned the mums and dads on to Iron Maiden. It’s lovely.”