DEAR DR. ROACH: I am a healthy 69-year-old female. I walk every day and belong to an exercise group. I’m writing because during a routine dental cleaning, my dentist noticed a spot on the left side of my tongue that turned out to be squamous cell carcinoma.

I’ve never smoked, and I drink less than one alcoholic drink per month. I’ve had my surgery, and my PET scan was negative for the cancer spreading into my lymph nodes. So, I was fortunate to catch it fairly early. My message to your readers is to please get your routine teeth cleanings; it just might save your life.

• Anon.

ANSWER: This is a message worth publishing. I congratulate you on your apparent cure and appreciate your writing. My own dentist is diligent about doing a careful mouth exam for cancer every visit.

The traditional risk factors for squamous cell cancer (SCC) of the head and neck have been smoking and tobacco use, including chewing tobacco. However, human papilloma virus (HPV) has recently emerged as a major risk factor for SCC. The treatment is the same for HPV-related SCC as it is for non-HPV-related SCC, but the prognosis is better if the cancer is associated with HPV, which the pathologist normally tests for.

DEAR DR. ROACH: Can having a bunion cause a different problem on the same leg? I saw an orthopedist about a bunion eight to nine years ago and was told it could be fixed, but since the bunion doesn’t hurt, he recommended waiting until it does hurt. I’ve now developed arthritis on the inside part of my knee on the same leg. Rehab exercises mostly keep the pain under control.

I’m wondering whether having a bunion can cause the knee to develop arthritis?

• B.J.S.

ANSWER: A bunion is an acquired malformation of the large toe at the metatarsophalyngeal joint, so the joint sticks out toward the outside of the foot. You are right that problems in one joint can affect another. When you are in pain, the body learns to walk in such a way as to minimize pain, but this abnormal gait can put stress on other joints. I often see people who don’t notice the pain in the original location as their body is so adept at changing pressures to avoid the pain.

On the other hand, one of many underlying conditions that can lead to a bunion deformity is arthritis. It is possible that you were destined to develop knee arthritis, and the bunion had nothing to do with it.

ToYourGoodHealth@med.cornell.edu.