Case Study Bob's Bad Habit
Bobs Bad Habit Skin Body Membrane Case Study Bob, a 49-year old painter, arrives for his appointment with Mary, his dental hygienist, to have his teeth cleaned. He has not had a dental examination for three years. Mary takes a complete health and dental history. She makes note of the fact that Bob smokes approximately two packs of cigarettes a day, occasional cigars at parties, and drinks two or three beers daily after working in the hot sun. He is concerned about the appearance of his lips and teeth. Mary begins treatment by carefully observing Bobs face and lips for any abnormal moles (nevi) or lesions. She notices that Bob has a deep tan and that the left side of his lower lip is raised, firm, and scaly. The lesion is about 9mm in diameter. Bob tells her that his lip has had that appearance for about a year. Mary also notes that Bobs skin is quite wrinkled for someone his age. Mary urges Bob to make an appointment with a physician for an examination of the scaly lesion. Bob does so that following week. The physician performs a biopsy on the lesion. Histologic examination of the biopsy confirms that Bob has squamous cell carcinoma. Squamous cell carcinoma is the most common type of oral cancer. Its cause is associated with exposure to the sun, consumption of alcohol, and the use of tobacco in all forms. Snuff, chewing tobacco, cigarettes, and cigars are the major risk factors for oral cancer. Cells in the stratum spinosum of the epidermis undergo anaplasia (reversion to an immature, undifferentiated form), transforming into cancer cells and dividing rapidly. Incidence of metastasis is low if the lesion is removed at an early stage. Bobs physician recommends immediate surgical excision of the lesion. Following excision of the lesion, which had tumor-free margins, further examination and testing revealed no signs of metastasis (migration to other tissues). Bobs lesion was small, and he is told all cancer cells were removed. He will however,