In 20 seasons, Tony Gwynn proved to be one of the most prolific hitters ever. He made every plate appearance and battle with the opposing pitcher seem effortless. Now he steps up to the plate against a much more formidable opponent – cancer.

Gwynn underwent surgery Tuesday to remove a cancerous tumor from his right salivary gland. It marks his fourth procedure, having had two prior biopsies on the right side of his mouth. In August 2010, surgeons removed a large amount of a malignant tumor but left some remaining because it wrapped around his facial nerve. Had the surgeons removed the entire tumor and the nerve, he likely would have had permanent paralysis on the right side of his face.

Despite chemotherapy and radiation, Gwynn developed a new growth in that same area. According to Gwynn’s wife, surgeons at the Moores Cancer Center at the University of California, San Diego believe they removed the entire tumor from his parotid gland during a 14-hour operation. They had to remove his facial nerve but transferred a nerve from his shoulder to try to restore nerve function.

The Hall of Fame outfielder strongly believes that his tumors resulted from a lengthy history of smokeless tobacco use. While I can’t state definitively that tobacco did cause his condition, it is hard to argue its medical risks. Smokeless tobacco is associated with multiple forms of cancer, gum disease, hypertension, and cardiovascular disease. And most importantly from a sports medicine standpoint, it can lead to nicotine addiction.

According to a 2009 study by the Centers for Disease Control and Prevention, 11% of male high school students are current smokeless tobacco users. And despite bans on it by the NCAA and the minor leagues, some believe that up to one-third of baseball players use it. And numerous stories exist warning of current Major League Baseball players who started using it due to peer pressure or to emulate their idols. Now they can’t quit.  Tweet this statistic.

Baseball batterGwynn reportedly started while playing rookie ball to calm his nerves. Soon his use spread outside of the game, with routine use early in the morning or while falling asleep. He claims to have used one and a half cans each day. He tried quitting “cold turkey” or switching to gum or sunflower seeds, but his efforts usually resulted in 2:00 AM trips to the convenience store.

Recently Major League Baseball and the players union agreed that players wouldn’t carry smokeless tobacco in their pockets when fans are present at the ballparks or use it during interviews or team functions. Many players oppose a full ban, believing that they can weigh the risks and make personal decisions. Many health organizations and several Congressmen have pushed for a full ban.

Regardless of whether a full ban is adopted, it seems clear to me that many current players are addicted to smokeless tobacco and could not quit even if they wanted to stop. But I fear for the future baseball stars. We have to do everything we can to keep them from ever starting to use it. We must educate kids of the risks. Players, parents, and coaches must set good examples. If kids never start using smokeless tobacco, they will never become addicted to it.

In the coming days, the baseball world will learn how Tony Gwynn will fare in this battle. Hopefully surgeons rid him forever of this tumor and preserve his facial nerve function so that he can warn future players himself.

I want to hear your thoughts? What should Major League Baseball and other baseball and sports organizations do about smokeless tobacco, if anything?

Note: The following post appears as my regular sports medicine column in the February 16, 2012 issue of The Post and Courier.