The first was incredulity – since when was oral sex related to throat cancer? Even the reporter thought he had misheard.
The second was sheer embarrassment. This was too much information, not only about sexual behaviour but also about one’s partners.
Douglas apologised, and maybe the world was not ready to hear the greater truth behind what he was suggesting.
That was four years ago.
Today, there is no doubt in the medical community that the increase in HPV-related cancers such as the one Douglas described – which he later explained was found at the base of his tongue – is caused by sexual practices, in his case, cunnilingus.
And there is an urgency to better treat and prevent what is becoming the one type of oral cancer on the increase, especially among men in the prime of their lives who have decades to live with the consequences of their cancer treatment.
The number of people diagnosed with HPV-related oropharyngeal cancer – tumours found in the middle of the pharynx or throat including the back of the tongue, soft palate, sides of throat and tonsils – is relatively small, about 12 638 men and 3100 women in the US each year, according to the Centers for Disease Control and Prevention.
But these numbers are expected to continue to rise, overtaking the incidence of cervical cancer by 2020.
One study revealed the presence of HPV in 20.9 percent of oropharyngeal tumours before 1990, compared with 65.4 percent in those sampled after 2000.
Health agencies are pushing hard for HPV vaccinations.