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Detecting oral cancer: story of a survivor

May 5, 2011
Maria Perno Goldie, RDH, MS, conducts a recent interview with Bill Wilson and dental hygienist Kim Anzalotti. During one of his routine dental checkups in 2003, Anzalotti suggested Wilson see a medical specialist following an oral cancer exam that Anzalotti performed as part of the checkup. Wilson was later diagnosed with base of tongue cancer.
By Maria Perno Goldie, RDH, MS
I had the pleasure of interviewing Kim E. Anzalotti, RDH, of Palm City, Fla., and Bill Wilson (William J. Wilson Sr.). Kim has worked with Dr. William Bohen for twelve years, and Kim thinks they make a great team! Dr. Bill would concur!
Oral cancer survivor Bill Wilson credits dental hygienist Kim Anzalotti (right) with helping save his life.
Bill Wilson is Kim’s patient, and she found oral cancer on him in 2003. Bill was born in New York City, was in the United States Air Force and served during the Korean Conflict, and was a Police Officer for two years. Bill is married to Patricia, has three children, and nine grandchildren. I became acquainted with both Kim and Bill in 2006 when I was Editor in Chief of Modern Hygienist magazine. Bill wrote me the following letter in 2006:“I need to tell my story to your magazine that I have been putting off much too long. Kim E. Anzalotti is my hygienist and she works for Dr. William Bohen in Stuart, Florida. I visit my dentist about every four to five months and this healthy routine paid off for me in the best way possible. During one of my visits back in 2003, I was scheduled for a routine cleaning by Kim. During the beginning of her procedure, Kim always probes the neck area and looks carefully at the mouth and gums. While Kim was probing my neck area she put her finger on the right side of my neck and pressed and asked me, "Do you have any pain in this area?" I was a little startled by this question because I was experiencing occasional pain right in the very spot where her finger was. When I answered in the affirmative, she said to me, "You should see an Ear, Nose, and Throat Doctor just to be on the safe side with the pain you are having once in a while." When I left the dental office I thought to myself ... well, when I get time I will take care of this matter. A few months later the pain was coming on more frequently and I made up my mind to have it looked at. And it was a good thing that I did. I was diagnosed with "BOT" cancer--base of tongue. I required rapid action because it was a fast spreader. I received 21 hours of chemo and 62 radiation treatments, 2 per day for 31 days in a row. Thanks to Kim, my religious beliefs, and excellent doctors and a superior nurse (my wife), I am now in complete remission. As far as I am concerned, Kim was very instrumental in saving my life and I am very happy she is still with Dr. Bohen and I am one of her lucky patients. Kim deserves some type of recognition and I hope maybe your magazine will run some type of article illustrating how a person such as her can make an impact on a human life. Thank you, Bill Wilson”As you can see, this is a very moving letter. We featured Kim and Bill in the June 2006 issue of Modern Hygienist, and told their story. Kim was even our Cover Girl! I wanted to catch up with them to see how they are both doing, and had the pleasure of speaking with them April 22, 2011.MPG: It has been a few years since I wrote an article on you and Bill, at Bill’s suggestion. I still have Bill’s original letter to me from 2006. Kim, are you still seeing Bill as a patient? KA: Yes, I see Bill every 3-4 months.MPG: And Bill, how have you been this last 5 years?BW: I am fine regarding my oral cancer, but have been having serious Mohs surgery for two to three skin cancers on my face. One was removed July 2010, and it was deep. I have them on my nose, forehead, and lip area. I call it the Irish Curse! I also had prostate cancer but I am free of that now, too.MPG: Bill, prior to your diagnosis in 2003, what were your habits? Did you smoke? Drink alcohol?BW: Prior to the cancer that was found on the base of my tongue in August of 2003, I had not been smoking for 15 years. I only drink occasionally, I am not, nor ever have been, a heavy drinker. MPG: How often are you checked by your physician? BW: I see Dr. Sharkey (Dr. Daniel Sharkey, MD, General Surgeon, Otolaryngologist, of Stuart, Fla.) every six or seven months, and I see my oncologist yearly for a PET scan. Dr. Sharkey scopes my throat every time I see him. MPG: Are you still attending the cancer support group that meets each week? BW: Yes. I have been going to the group once a week since 2004. It is a group through the Martin Memorial Cancer Center, headed by Kim Humphries. I get such a good feeling when I am there, just like going to church! I had an opportunity to travel north to receive my treatment at Sloan Kettering in 2003, but I opted to try the Cancer Center in Stuart, Fla., and I know I made the correct choice. MPG: I see you worked for BATUS (Tobacco Division) from 1956-1987 as a Divisional Sales & Marketing Manager before you retired. What is BATUS? BW: British American Tobacco Company. MPG: Have your daily habits changed since your diagnosis? BW: Yes. I went from 247 lbs to 209 to 212 lbs. I didn’t try to lose weight but my appetite was not there. And all my saliva has come back! I would say I am a 7 on a scale of 1-10.KA: Well, I think he still has xerostomia so we have him using a daily 1.1% sodium fluoride. BW: I had a feeding tube for 14 months, and my taste came back after two years, I would say an 8 on a scale of 1- 10 . But my voice changed, too.MPG: So Kim, this may seem like a silly question, but are you performing oral cancer screenings on all of your patients? KA: YES, every patient, every time they come in. And if they have risk factors I check them twice!MPG: Kim, are you still educating dental hygienists and the community about oral cancer screening and prevention? KA: Yes, I have been a guest at the Cancer Center talking to Bill’s support group…. it is the Robert and Carol Weissman Cancer Center at Martin Memorial Hospital. I discuss what they need to do before and after surgery, what they should be looking for, and how to take care of their mouths. One woman lost all her teeth because she was unaware of the oral problems that could develop, so I stress prevention before treatment. I also go to schools to speak, especially in February during Children’s Dental Health Month. I speak to women’s groups, and in the fall I will be speaking to a group of about seventy women on what to ask for of your dental hygienist and dentist, and to be sure they are getting oral cancer exams. I also volunteer at the dental hygiene program at Indian River State College. MPG: Bill, what about you? Are you still doing radio and TV commercials for Martin Memorial? BW: I have not done any for awhile, but I am still spreading the word. I completed one set of TV and radio commercials for the hospital. As of this date, I have not been asked to do more. Needless to say, I would gladly do them because I feel they have the necessary impact on the public.MPG: So Kim, you mentioned in your note to me that you have been diagnosed with head and neck cancer. Please tell me more.KA: In February 2009, I felt a lump on the left side of my throat area. So I did what I would do with a patient. I waited 7-10 days and it did not resolve, and in fact, I had some difficulty swallowing. I went to the physician and had an ultrasound that showed a growth or mass. I was sent to Dr. James Vopal (Dr. James J Vopal, MD, DDS, FACS, Oral & Maxillofacial Surgery). I was diagnosed with Follicular Adenoma on the left side, a common benign tumor of the thyroid gland. During surgery, another growth was seen on the right side and that was diagnosed as Papillary Carcinoma, the most common type of thyroid cancer representing 75% to 85% of all thyroid cancer cases. A total thyroidectomy was performed. About 60% of oral cancers are papillary or HPV based. The other thing that happened is that my mom developed thyroid cancer, too, as well as one of my neighbors! MPG: Wow Kim, what a coincidence! I hope they are both doing OK. Kim, are there any parting thoughts you would like to add?KA: Well, I seem to be seeing “deeper” head and neck cancers, like in the neck and thyroid areas. We are considering using the Oral DNA test (OralDNA Labs, Brentwood, Tenn.) in our office, the OraRisk HPV**. I would like to stress the importance of always performing oral cancer exams and palpating the neck in the office. I believe we need to be educating our communities as well about oral cancer awareness, prevention, and screening. Bill and I were featured in an article in a local newspaper called “Catching Cancer in Time.” These kinds of things heighten awareness.MPG: Well, I want to thank both of you, Kim and Bill, for taking the time to chat with me. I wish you both all the best of health and happiness!To listen to one of Bill's radio commercials, go to** Editor’s Note: OraRisk HPV - Determines who is at increased risk for HPV-related oral cancers. It is a non-invasive, easy-to-use screening tool to identify the type(s) of HPV, a mucosal viral infection that could potentially lead to oral cancer. OraRisk HPV enables the clinician to establish increased risk for oral cancer and determine appropriate referral and monitoring conditions. Patient Profiles: Patients who are sexually active; Patients with signs and symptoms of oral cancer; Patients with traditional risk factors for oral cancer; and Patients with suspicious oral lesions. For more information, go to *** Editor’s Note: For more on thyroid cancer,

Maria Perno Goldie, RDH, MS

To read previous articles in RDH eVillage FOCUS from 2011 written by Maria Perno Goldie, go to articles.