Disorders of the Gastrointestinal System, 2nd Edition
6
Oral cavity cancer CASE STUDY 1
Cheri’s story is not uncommon. Near- ly 54,000 individuals in the U.S. receive a diagnosis of oral or pharyngeal cancer annually, and only 57% live longer than five years after diagnosis. Worldwide, this number is 657,000 new cases diagnosed yearly, which is likely an undercount, as many countries do not have standard re- porting systems. Oral cancer is not diffi - cult to diagnose, but it is often identified in later stages due to inconsistent screen- ing processes for early diagnosis. It has spread by the onset of symptoms (Oral Cancer Foundation [OCF], 2022). Risk factors associated with the de- velopment of oral cancer include (OCF, 2022): ● Use of tobacco products, including smokeless and chewing tobacco. ● Exposure to radiation and sunlight (x-rays, tanning beds, sunbathing) increases the risk for lip cancers. Frequent alcohol ingestion, especially if also using tobacco products. ● Infection with certain viral infections. Human papillomavirus (HPV) version 16. HPV-16 has been linked to an increasing number of oral cancer diagnoses. Epstein–Barr virus and cytomegalovirus are also associated with developing oral cancers. ● Race/ethnicity is a risk factor. Oral cancer affects twice as many African Americans as Whites. ● Historically, oral cancer occurred much more frequently in men, affecting six men for every woman; however, the ratio has now decreased to two men for every woman. It is believed that this is because of an increase in women who smoke and present with HPV infection (OCF, 2022).
Cheri is a 45-year-old manager of a busy upscale women’s boutique. She attends many social events related to business and drinks about two to three glasses of wine per day. Cheri smokes half a pack of cigarettes daily and loves to lay out in the sun and visit tanning beds in her spare time. About a month ago, she noticed a painless white patch about 1 cm in diam- eter on the inside of her left cheek. Be- cause it was not causing any discomfort, Cheri dismissed it as unimportant. Today, she visited her dentist for her regular six- month check-up. He expressed concern and recommended that she have her family doctor evaluate the white patch. A biopsy indicated that Cheri has oral can- cer. Question Cheri has all of the following risk factors for the development of oral cancer EXCEPT: a. Stressful work environment. b. Tobacco use. c. Regular alcohol consumption. d. Exposure to UV rays. Answer/Rationale: The correct answer is a. Stress levels are not linked to oral cancer. The use of alcohol, tobacco, and tanning beds is linked to oral cancer.
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