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The Head and Neck
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
The pharynx and the cervical esophagus are exposed to the same carcinogens of smoking, alcohol, and mucosal irritants as the oral cavity. In addition, Plummer-Vinson syndrome has been blamed as a predisposing factor to the development of epidermoid carcinoma of the hypopharynx and cervical esophagus, especially in women. Lye and other chemical burns play a role in the etiology of carcinoma of the esophagus. Again, malnutrition and vitamin deficiencies, especially Vitamin A and C, may play some role in the pathogenesis of carcinoma of the hypopharynx.
Pharyngeal Cancer
Published in Dongyou Liu, Tumors and Cancers, 2017
NPC has annual incidences of 5–30 per 100,000 and mainly affects middle-aged persons (especially in the fourth to sixth decades, males) in Asia and children in Africa. About 95% of NPC cases involve moderately and poorly differentiated pathological types. Oropharyngeal cancer affects people of >45 years of age, although an increasing number of people aged 20–30 have been diagnosed in recent years. Hypopharyngeal cancer typically occurs in males aged 55–70 years with a history of tobacco and/or alcohol use and rarely in people of <30 years. The tumor is present in the pyriform sinuses (65%–85%), posterior pharyngeal wall (10%–20%), and postcricoid area (5%–15%). Women tend to develop more postcricoid cancer (due to Plummer–Vinson syndrome) than men.
Cell Turnover in the Gastrointestinal Tract and the Effect of Ethanol
Published in Victor R. Preedy, Ronald R. Watson, Alcohol and the Gastrointestinal Tract, 2017
Helmut K. Seitz, Ulrich A. Simanowski
The authors have investigated the effect of chronic ethanol consumption given as liquid diets over 6 months on cell regeneration in male Wistar rats.99 Morphometric analysis showed that in the ethanol rats the size of the nuclei of the basal cells of the oral mucosa from the floor of the mouth, the edge of the tongue, and the base of the tongue were significantly enlarged when compared to controls. The size of the basal cell layer in these rats was also increased and the stratification of the cells was altered. The percentage of cells in the S-phase of the cell cycle was significantly higher in ethanol-fed rats as compared to controls. Mean epithelial thickness of the mucosa from the floor of the mouth was significantly reduced after chronic alcohol ingestion. This indicates an atrophy of the mucosa and it is remarkable that this finding was most pronounced for a location within the oral cavity which is believed to have most intensive contact with alcoholic beverages. A reduction of epithelial thickness increases the vulnerability of epithelium toward chemical and physical noxae. It is noteworthy that patients suffering from Plummer-Vinson Syndrome, a disease associated with an atrophy of the mucosa, have an increased risk of head and neck cancer.100 These findings in the animal experiment are in agreement with the data of the post-mortem study performed by Valentine et al.101 When ethanol diets were supplemented with vitamin A (10,000 U retinol palmetate per kg body weight) mucosal atrophy was only slightly affected by vitamin A, while parameters of mucosal hyperregeneration were significantly influenced by vitamin A supplementation. Vitamin A suppressed the ethanol-induced mucosal hyperregeneration in almost every location of the oropharynx.102 In this context, chronic ethanol consumption resulted in increased rather than decreased vitamin A concentrations in the esophagus of experimental animals.103,104 Also in humans, alcoholics with oropharyngeal carcinoma exhibited a similar or increased concentrations of a great variety of carotinoids.105 Thus, the protective role of vitamin A or carotenoid supplementation in alcohol-associated oropharyngeal cancer is still questionable.
Iron Deficiency and Anemia in Cancer Patients: The Role of Iron Treatment in Anemic Cancer Patients
Published in Nutrition and Cancer, 2020
Behnaz Abiri, Mohammadreza Vafa
The mere occurrence of iron deficiency may be related to various complications. Usual symptoms are weakness, fatigue, pallor, and cold skin (15), angular cheilitis, brittle nails, deterioration of cognitive functions, headaches, insomnia, restless, leg syndrome, depression, dyspnea, loss of libido, thrombocytosis, tachycardia, elevated thromboembolic complications, alopecia, and in some cases of Plummer-Vinson syndrome (16).