HPV alters oral-cancer expectations
Source: www.dispatch.com Author: staff Demographics are important to physicians. Demographics help guide us toward more-likely and less-likely diagnoses in patients.In their most basic form, they mean we are surprised when we learn that the 90-year-old woman with hand pain suffered the injury while boxing. On the other hand, demographics are why a doctor tells the overweight man with a history of hypertension that he is “a heart attack waiting to happen.”Most disease processes can be characterized by a typical patient and are based on age, gender and sometimes ethnicity or socio-economic class. This has long been the case with oral-cancer cases. Most physicians have an idea of a typical oral-cancer patient. We envision an older, male patient with few teeth following a lifetime of poor oral health. They generally have lower income and are lifelong smokers. That’s why the tonsillar-cancer patient was such a surprise to me. He was 34, upper-middle class and did not smoke or drink. He had recently undergone surgery to remove his tonsils and a good portion of the back of his throat. He had come into the emergency department that day because he was having difficulty breathing and swallowing. When I walked into the room, he was sitting on a gurney and drooling into a garbage can that he kept between his knees. The skin around his neck looked swollen and tight, leaving me to imagine how much swelling there was in the back of his throat.His surgery had been six days earlier, and he [...]