Oral Cancer and Tobacco: Treatments, Diagnosis & Prevention

In the realm of oral cancer, India holds a disheartening record. It surpasses the rest of the world in the number of cases reported. This alarming statistic can be attributed to a single cause—tobacco. As the largest consumer and producer of tobacco, India finds itself grappling with the devastating consequences of this addictive substance. Shockingly, over 90% of head and neck cancers in India can be traced back to tobacco use.

Treatment of head and neck cancer

The aim of treatment is to cure the disease and also give a useful quality of life to the patient. This encompasses the involvement of a team specialised for the purpose – oncologist - surgical, medical and radiation, speech and swallowing therapist, physiotherapist, dental specialist, dietician, nursing and counsellors.

• Surgical treatment - Treatment of head and neck cancer is no more the same. The surgical assessment and planning involve preoperative 3-D reconstruction and virtual resection. The restoration of the resected area is done by a fine microvascular surgeon specialised for the purpose of giving much-needed cosmetic and functional rehabilitation.

• Radiotherapy - The role of radiotherapy is also being redefined with more sophisticated machines. Tomotherapy and the True beam linear accelerator at MICC deliver highly precise radiation for which higher doses can be given but with minimum side effects of radiation. With this, we can achieve higher cure rates and better quality of life.

• Medical treatment- The medical treatments for Head and Neck cancers are no more limited to chemotherapy alone. The advent of Novel therapies like immunotherapy and targeted therapies have improved the outcomes of Stage IV head and neck cancers. The side effects of these therapies are easily manageable, enabling the patient to take the treatment for a longer period of time. Tremendous research is being done to find out appropriate targets for treatment.

Early detection is the key

Oral Cancers are easily detectable, Easily Curable and most interestingly, easily preventable. However, the saddest part in India is that most Oral cancer patients visit the doctor in the later stages. Early cancer can be cured, and the patient can be rehabilitated both functionally and anatomically.

All tobacco users and others are advised to examine their oral cavity once a month as a routine. Look for these early signs.

• Mouth opening – should be around four fingers

• White lesions - white patches anywhere in the oral cavity

• Red patches – Redness anywhere in the oral cavity

• Ulcer or bleeding – self or on touch

• Nodules or thickening in the oral cavity

• Swelling/palpable nodes in the neck or cheek

If you notice any of the above early signs, visit your doctor immediately

Prevention – Tobacco user is a health hazard to themselves and to society. A non-tobacco user is passively affected because of the environmental pollution caused by smokers and chewers.

Tobacco use is a disease. It has to be treated. Tobacco cessation needs proper planning and a scientifically proven medical approach. There are medications available for the same. For cessation, you have to visit a trained tobacco specialist. The associated co-morbid conditions have to be treated too.

Our responsibilities

1. Be aware of tobacco and its health hazards

2. Make sure that our younger generation is not seduced into this habit.

3. Avoid second-hand tobacco exposure -both smoking and chewing

4. Volunteer to help a tobacco consumer to quit

5. Sensitise tobacco vendors to choose an alternative healthy product

6. Regularly examine your Oral Cavity for signs of early cancer

7. Visit your doctor/dentist at the earliest and regularly