Dave Mustaine endured many tough times in the long months between being diagnosed with throat cancer in February 2019 and being declared cancer-free the following October. There was the emotional pain of breaking the news to his family and friends. There was the physical toll the radiotherapy and chemotherapy treatment he endured took on him. But one of the worst things of all was the mask.
Cancer patients who have to undergo radiation treatment on their head and neck, as the Megadeth frontman did, have to wear a thermoplastic radiation mask – a mesh-like construct that holds the patient’s head rigidly in place while it’s bombarded with pinpoint radiation that destroys the cancerous cells. Dave had been warned by his radiologist that fitting the mask would be uncomfortable, but he didn’t realise just how bad it would be.
“They said they were going to have to put this plastic mesh over my head because I could not move, not even one millimetre,” he recalls today. “I said, ‘OK’ and didn’t think anything of it. But what they do is take this plastic, heat it to a volcanic fucking magma temperature and slap it on my face. I thought I was going to have a baby! I went nuts!”
It took three different attempts in all to fit the mask, and only then with the aid of a little Valium to calm Dave’s nerves.
The mask appears on the cover of his new book, In My Darkest Hour, which charts his diagnosis, recovery and slow return to health. Where Dave’s 2010 autobiography, Mustaine: A Heavy Metal Memoir, was a wild, all-guns-blazing ride through his mercurial life, In My Darkest Hour is more focused, reflective and ultimately moving. It captures the dread and doubt that he went through, and the emotional and physical toll it took on both him and his family. But it also shines a light on his resilience and, ultimately, the sense of relief and hope that came with his all-clear.
“I met a lot of people that had cancer, and a lot of them seemed really hopeless,” he says. “That was pretty much what prompted me to do it, because I wanted to share the hope that was there for me at the end.”
He found out he had cancer during a visit to an oral surgeon in early 2019. He had been suffering from an indefinable ache in his jaw – not quite toothache, but similar. In the book, he relates how the surgeon broke the news to him: “He stands over me, hands folded across his chest and takes a deep breath. ‘Well, looks like you’ve got the Big C.’”
Recalling that moment and the subsequent journey while he was writing the book wasn’t as painful as it could have been.
“Mostly, it was cathartic,” he says. “There were times, of course, after the chemo and the radiation, where I’d be so exhausted that I fell asleep. And they’d have students poking me in the neck with needles over and over trying to find my lymph glands, which made my wife lose her mind. But I knew every inch of the journey, so I knew how dark it got.”
In My Darkest Hour isn’t just Dave’s own recollections of the time. It also features input from people who were in his orbit during this period, from his wife, Pam, and children Justis and Electra, to the singer’s radiologist, Dr Anthony Cmelak (who contributed lyrics for the Megadeth song Dogs Of Chernobyl, from 2022’s The Sick, The Dying… And The Dead!) and even his jiu jitsu teacher. These were the people that helped get him through the ordeal.
“I’ve always needed a lot of help in this world, and I’m not afraid to ask for it,” says Dave. “Family, faith, even my martial arts training – they all helped a lot.”
Dave made his diagnosis public in June 2019. There was never any intention to keep quiet about it.
“I’ve always been pretty open with people,” he says. “There are a lot of people who have prayed for me over the years. The reason I didn’t keep it quiet was to let the people who are my support system know, because I’m the dude who has needed prayer his whole life.”
After the news broke, he received messages of support from several famous friends and fellow musicians. Among them were Ozzy and Sharon Osbourne and, more surprisingly, James Hetfield, the man who had fired him from Metallica back in 1983.
“It wasn’t any more significant than the other people who gave their support to me,” he says of the notable names who reached out. “I’ve always looked at that stuff like one beggar giving another beggar a crust of bread. But I appreciate it, because I know how our time is measured out, and to take the time to stop and do something like that means a lot.”
One person who did offer some useful advice was Bruce Dickinson. The Iron Maiden frontman had gone through treatment for throat cancer a few years earlier. Bruce passed on his own experiences of what to expect, and also gave
Dave one simple but invaluable piece of advice: “Surround yourself with good people… make sure you’re spending time with people who are upbeat and positive.” Or, as the Megadeth man writes in the book: “Stay away from assholes.”
“Bruce had some fantastic stuff to say as a cancer survivor,” says Dave today. “There’s a big difference between someone saying ‘You’re in my thoughts and prayers’, versus somebody who goes into detail about his treatment and tells you about the outcome. I needed hope, and he gave me it.”
Unsurprisingly, the treatment itself was tough: first the radiation, then the chemotherapy.
“I absolutely hated getting up in the morning to go for treatment, but I knew I wouldn’t do it by myself,” he says. “So I hired a person to come into my room, whether I was asleep or not, get me up, make me get dressed, put me in the car, take me to my appointment, bring me home, and pour me back into bed.”
Dave had planned to start work on the follow-up to 2016’s Dystopia just before he received the news about his cancer. It’s a measure of his endurance – or maybe his stubbornness – that he elected to carry on working on new music throughout his treatment.
“There were all the stigmas that come along with it [the cancer diagnosis],” he says. “When I wanted to keep doing the record while I was going through treatment, I know there was doubt about how good it would have been:
‘How can a guy make a record when he’s going through cancer treatment?’
“I only had two days where I was too sick to work and couldn’t go to the studio,” he continues, his voice edged with defiance even now. “The studio was built in a house right next to where I live, so I’d go out my garage door, get into our little four-wheeler, drive through the field, pull up next door, walk through the door, and there was our studio.”
Finishing the new album would ultimately be held up even further by an altogether different illness in the form of the pandemic. The Sick, The Dying… And The Dead! – a title he insists had nothing to do with his own sickness – was eventually released on September 2, 2022, giving Megadeth their eighth US Top 10 album.
If he’d wanted to end the band there, it would have been the perfect valediction. Instead, they returned to the studio to make a follow-up, 2026’s self-titled Megadeth. And that’s when Dave announced that it would be his band’s last album, and that they were embarking on a farewell tour.
Today, he says his decision was down to a hand condition named Dupuytren’s contracture – aka ‘Viking Hand’ – that prevents him from playing guitar to the level he wants.
“It’s a tendon in the centre of my left hand that has nodules on it,” he explains. “That whole area itches, burns and hurts. Whenever I play, that extra activity just makes it worse. My goal is to play until I can’t.”
He’s considering surgery. “But even then, it’s a 50-50 chance whether it turns out good or bad. I don’t want to have someone cut my hand open and have it turn out worse forever. I know what I’ve got right now, so I’m going to put it to work and use it as much as I can. We have a beautiful tour lined up for the next couple of years, and there’s a lot of other Megadeth-oriented stuff we’re still going to do once playing is out of the picture.”
There are at least a couple of songs left over from sessions from the most recent album. One is called Bloodlust, the other Farewell My Love.
“I thought there was a third one called ‘When Robots Rule’,” he says, “But I might be mixing things up. That’s another byproduct of chemo and radiation called ‘chemo brain’, where you have a really hard time remembering things.”
There are definitely a bunch of older unfinished songs kicking around. Will he revisit them? Maybe, though they wouldn’t be his priority if he does get his playing hand fixed.
“If I could play old songs,” he says, “why wouldn’t I want to focus on new songs instead?”
There’s a funny moment in the new book where Dave relates that James Hetfield once jokingly said his former bandmate must have “a horseshoe stuffed up my ass”. How else could he have cheated death so many times other than pure luck?
“Well, maybe the horseshoe had fallen out, or maybe it had rusted over and poisoned my system,” writes Dave, thinking back to the moments after his initial diagnosis.
It’s incorrect to say the frontman cheated death once more – that does a disservice to the medical team that treated him and the people who supported him throughout that period. Still, surely it made him view mortality differently?Apparently not.
“I died once back in ’92 when we were going through some really terrible times [with drugs] and everybody was doing all kinds of hardcore stuff,” he says. “I still know death is final. I still have pain and grief for the friends I’ve lost. The only way that this could change me is just giving me experience in something that other people may not have faced and are terrified by.”
He empathises with anyone who is going through what he went through, though any advice he can offer comes with a quiet caveat.
“The thing I need to be careful with is that there’s not always a happy ending,” he says. “Some people wait too long, or some people don’t follow medical direction. The smartest thing I could say to anybody is: be honest with yourself. You have to know that you need help, and help comes in many forms. And then I would say: be nice to your family, because you’re going to notice when you need them.”
He laughs, and there’s a flash of the Mustaine of legend. “’Cos they’re going to have a hard time helping you if you’re a dick.”
In My Darkest Hour is published on September 24 via Constable
