Patient began smoking in her early teenage years and continued to smoke at least a pack a day throughout her adult life as well as drink alcohol moderately. She continued to smoke despite watching her mother pass away from lung cancer, and being diagnosed herself in her 40s with breast cancer for which she had a mastectomy. No radiation or chemotherapy was needed at that time.
In her 60s, she noticed changes on the inside of her cheek and face and then presented with the following. The patient was referred to an oral surgeon to evaluate these lesions and was diagnosed with an advanced squamous cell carcinoma (Figures 13‑14).
She had surgeries to remove all of her maxillary teeth along with a portion of her face and palate, as well as place a graft to repair her face (Figure 15). Ultimately, her only source of nutrition was through a feeding tube. She survived for two years after her diagnosis in significant pain.
Despite watching his sister suffer and being diagnosed himself with a blood dyscrasia and aneurysms, and the warning by his physicians that he must quit to survive, the patient’s brother continues to smoke over one pack a day.
This case highlights the power of a nicotine addiction and how difficult it is to get patients to quit their tobacco use. It also reminds us why it is our duty to try.