(Continued from page 8)

member another case of a metastatic cancer first discovered in the brain, but on autopsy the occult primary was from the lung. The medical meaning of occult is nothing mystical or magical, just unknown, and sometimes devastating.
• Looking for the source of such a head and neck cancer I did some research and learned of the following risk factors for squamous cancer of the

head and neck: exposure to excessive amounts of alcohol; tobacco smoke or chew; wood dust; fine nickel and metal particles; formaldehyde; preserved or salted foods; paan (an addictive leaf or nut chewed in Southeast Asia;) and bitter mate (a tea-like beverage sipped in South America.)
• Our patient is a typical retired college professor originally from a farm on the Dakota prairie, with little tobacco, wood, industrial, or travel history; only having lived a dedicated life helping students and savoring time with his wife. 
• For now, after removing the nodule, we've provided no other treatment; our patient is doing fine; and still the origin for the cancer remains occult. 
• Dr. Rick Holm wrote this Prairie Doc Perspective for "On Call®," a weekly program where medical professionals discuss health concerns for the general public.  "On Call®" is produced by the Healing Words Foundation in association with the South Dakota State University Journalism Department. "On Call®" airs Thursdays on South Dakota Public Broadcasting-Television at 7 p.m. Central, 6 p.m. Mountain. Visit us at OnCallTelevision.com.