Remembering Val Kilmer — and Understanding Throat Cancer

A decade after treatment, still living with it

Val Kilmer played Iceman in Top Gun, Jim Morrison in The Doors, and Doc Holliday in Tombstone. TODAY reports that he was diagnosed with throat cancer in 2015, kept it private at first, and later spoke about it openly. The 2021 documentary Val showed him using a voice box to speak.

BBC News reported that chemotherapy and radiation left him with a tube in his trachea and difficulty breathing. That change was written into his brief return as Iceman in Top Gun: Maverick in 2022, his last film.

He died on April 1, 2025, at his home in Los Angeles, aged 65. His daughter Mercedes Kilmer told the Associated Press that the cause was pneumonia. TODAY noted that his family did not say whether the pneumonia was connected to his cancer history, and this page will not assume it was.

What his story shows unusually clearly is the part of head and neck cancer that outlasts treatment.

Where "throat cancer" actually is

The phrase covers several distinct sites. The National Cancer Institute groups them as head and neck cancers, and says they usually begin "in the squamous cells that line the mucosal surfaces of the head and neck."

Those sites include the oral cavity and the nasopharynx behind the nose. They also include the oropharynx in the middle of the throat, the hypopharynx lower down, and the larynx, or voice box. The sinuses, nasal cavity, and salivary glands round out the list. Each site has its own staging and its own treatment.

The oropharynx runs from the soft palate down to the hyoid bone. It takes in the base of the tongue, the tonsils, the soft palate, and the throat walls. Most cancers there are squamous cell carcinomas.

The two causes, and why they matter differently

NCI names tobacco and alcohol as "the two most important risk factors for head and neck cancers," and notes that using both together is worse than either alone. Betel quid chewing raises mouth cancer risk in some populations.

Then there is the virus. NCI states that "about three-quarters of all oropharyngeal cancers are caused by chronic HPV infection," usually HPV type 16. That is a fact about the disease in general, not a claim about any individual.

HPV status changes the disease so much that NCI reports the AJCC eighth edition "separates oropharyngeal staging by HPV status," with entirely separate scales. NCI cites three-year overall survival of 93 percent in a low-risk HPV-positive group, compared with 46.2 percent in a high-risk group defined largely by HPV-negative disease and smoking. A p16 test on the biopsy is what sorts one from the other.

When to get checked

Head and neck symptoms get blamed on colds, allergies, and reflux for months. Three weeks is the line.

• A sore throat lasting over three weeks, especially one-sided
• A neck lump lasting over three weeks, even painless
• Pain or difficulty swallowing that is not improving
• Hoarseness for more than three weeks
• A white or red mouth patch that will not heal
• One-sided ear pain with a normal ear exam
• Unexplained weight loss, or coughing up blood

Being a nonsmoker does not rule this out. HPV-related disease often appears in people who never smoked, and a painless neck lump is frequently the first sign.

How the diagnosis is made

NCI lists the tools as PET-CT scanning, magnetic resonance imaging, endoscopy to look at the throat directly, and "biopsy and p16 testing to assess for HPV status." Imaging maps the extent, tissue names the disease, and the p16 result changes both the stage and the plan.

Treatment, and what it costs to get through

NCI describes treatment by stage. Stage I and II disease is usually handled with one method, either radiation therapy or surgery. Stage III and IV disease generally calls for concurrent chemoradiation, meaning chemotherapy given alongside radiation. The alternatives are surgery followed by radiation, or chemotherapy given first. For cancer that has spread or returned, NCI lists surgery, further radiation, and immunotherapy.

The difficulty is anatomical. Swallowing, tasting, speaking, and breathing all happen in the treated area. Treatment there routinely affects all of them. A tracheostomy, a tube placed into the windpipe, is sometimes needed when the airway or the larynx is compromised.

The part that happens after treatment ends

NCI's guidance on oral complications is worth reading before treatment rather than after. It states that management "should be based on state-of-the-science and implemented in an interprofessional practice setting." It then lists that team. The members are oncologists, oncology nurses and navigators, dental generalists and specialists, dental hygienists, social workers, and dieticians.

Dental work comes first, and the reason is mechanical. NCI recommends identifying teeth that need removing before treatment. It names advanced decay reaching the pulp, infections symptomatic within the past 90 days, and dentures that could injure the lining of the mouth. Radiation reduces the jawbone's ability to heal. An extraction that would be routine beforehand becomes risky afterward. The danger is osteoradionecrosis, meaning bone death in the jaw.

NCI also recommends jaw opening and closing exercises to reduce the risk of trismus, a permanent tightening that limits how wide the mouth opens. It calls for ongoing monitoring for osteoradionecrosis and for new or recurrent mouth cancers. It also calls for periodic dental evaluations long after treatment.

Two requests are reasonable to make before the first radiation session. Ask for a dental evaluation, and ask for a swallowing assessment with a speech and language pathologist. Both are far easier to arrange in advance than in the middle of treatment.

What the numbers show

For 2026 the American Cancer Society projects 60,480 new cases of oral cavity and pharynx cancer and 13,150 deaths in the United States, figures SEER, the federal cancer surveillance program, republishes. That is 2.9 percent of all new cancers, at 11.7 per 100,000 people per year. The median age at diagnosis is 65, and men are affected far more often, at 17.5 new cases per 100,000 against 6.6 for women.

Five-year relative survival across all stages is 69.9 percent, from cases diagnosed between 2016 and 2022. By stage, SEER lists 88.7 percent for localized disease, 69.7 percent for regional spread, and 36.0 percent once distant. Only about 26 percent are caught while still localized.

Prevention exists for this cancer. Not using tobacco and limiting alcohol addresses the risk factors NCI ranks highest. NCI also notes the FDA has approved Gardasil 9 to prevent HPV-caused cancers in people aged 9 through 45. Vaccination works best before exposure, which is why it is given in early adolescence.

Sources

• https://www.today.com/health/news/val-kilmer-cause-of-death-cancer-timeline-rcna199306
• https://www.bbc.co.uk/news/articles/c4n7xy3ew8mo
• https://www.cancer.gov/types/head-and-neck/head-neck-fact-sheet
• https://www.cancer.gov/types/head-and-neck/hp/adult/oropharyngeal-treatment-pdq
• https://www.cancer.gov/about-cancer/treatment/side-effects/mouth-throat/oral-complications-hp-pdq
• https://seer.cancer.gov/statfacts/html/oralcav.html