Patient: Good morning, Doctor.
Doctor: Good morning, Mr. Mark. What brings you to me today?
Patient: My last visit with you took place a year ago, and then everything was all right. However, for some time I have had a little scab on my bottom lip. It does not hurt me, but sometimes it’s a little itchy, and once when I broke it, it was bleeding a little.
Doctor: And when has it occurred exactly?
Patient: I do not know exactly, but I noticed this change just about three months ago.
Doctor: Do you smoke cigarettes?
Patient: Well, unfortunately, I smoke quite a lot. I can use the whole pack of cigarettes a day, and sometimes even more.
Doctor: I see. I’ll examine you first. Maybe externally first. I’m particularly interested in the lymph nodes assessment. Please bend your head. Oh yes, that’s just right. Is it hurting you when I’m pressing?
Patient: No, it’s not painful, but I feel a strong pressure.
Doctor: Okay. Now please open your mouth wide. Oh yes, that’s good. I have to check your tongue, so I’ll twist it around just a bit. Well, because this change has been present on your lip for three months and I can feel your lymph nodes are enlarged, I must refer you to a specialist. I’ll give you a referral letter to the Department of Oral Surgery where they’ll diagnose you exactly.
Patient: Can I do it the next time I come to Poland. I work abroad and I’m planning to come back in half a year for the holidays. I do not have much time now.
Doctor: No. You must go to a surgeon as soon as possible. It may be a very serious matter. In order to provide a proper diagnosis, the surgeon will probably decide to do a biopsy.
Patient: All right. I will try to go before my departure.
Doctor: Mr. Mark, I repeat once more, that this is a very serious matter and you absolutely must go to a specialist. It could be something trivial, but it can also prove to be a cancerous change. That’s why I’m writing you a referral letter, and in addition, I’ll put into your card information that I referred you to the surgeon with suspected neoplastic lesion.
Patient: Is it cancer?
Doctor: I do not know. That’s why performing additional tests is crucial in your situation, so your visit to a specialist is necessary.
Patient: I see. Now I’ve understood. Tomorrow morning I will definitely go to the hospital. Thank you for an explanation, because to tell you the truth, I did not realize the seriousness of the situation.
Doctor: It is good that you’ll go there so quickly. I hope that everything will be all right.
Patient: So do I. Again, thank you and goodbye.
Complete the sentences with words from the table.
1.Mouth cancer is more __________ in men than women.
2._________ tobacco („snuffing” or chewing tobacco) is associated with cancers of the cheek, gums and inner surface of the lips.
3.___________ smoke also increases oral cancer risk.
4.Over-exposure to _____________ can also increase the risk of cancer of the lips.
5.The current studies indicate that HPV may ___________ to the development of oral cavity cancers.
6.The common symptoms of oral cancer include: sore which does not want to_________, persistent lump or white/red patch on gums, lips or a tongue.
7.Biopsy is one of the diagnostic procedures which involves taking a small portion of the ___________ tissue which is then sent to a pathologist to be examined under a microscope to check for abnormal or malignant cells.
8.Mouth cancer can ___________ to other parts of the body if it accesses the bloodstream or lymphatic system.
9.Treatment of oral cancer _____________ on the size, type and location of the cancer and whether it has spread.
10. If mouth cancer is recognised early, then the chances of a _________ are good.
Complete the crossword puzzle
- Asmall circumscribed area differing in color or structure from the surrounding surface.
- An open, shallow lesion in the oral cavity that causes pain.
- Removal and examination, usually microscopic, of tissue from the living body, performed to establish precise diagnosis.
- Abbreviation for Human Papilloma Virus.
- Any of numerous bean shaped masses of tissue, situated along the course of lymphatic vessels, that help to protect against infection by killing bacteria and neutralizing toxins. They are sources of lymphocytes (2 words spelt together).
- One of the common symptoms of throat cancer, when patient’s voice gets changed.
- These tobacco products , which contribute highly to development of oral cancer, include: chewing tobacco, snuff or snus.
- Pain when swallowing.
Put the words in order to form questions you’d ask your patient.
smoke/ cigarettes/ do/ how/ you/ many/ daily/?
patch / you/ how/ for/ this/ have/ long/ had/?
when/ is/ painful / touch / it/ I/?
tobacco/ do/ any/ you/ use/ smokeless/ products/?
your/ dental/ when/ last/ was/ check-up/?
Lesson 43 answers