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A visit to the dentist can save your life
The early sign of presentation in these cancers varies from a non-healing ulcer, white or red patches in mouth, growth or swelling in mouth or neck to sudden or gradual difficulty in mouth opening.
Oral cancer ranks among top three type of cancers in India and accounts for about 30 per cent of all cancers, the current incidence of oral cancer in India is about 20 per 100,000 population, annually this is transcending to major public health crisis, further; occurrence in lower socio economic population, late stage of presentation, high treatment cost and inaccessibility to treatment result in low survival of these patients.
80 per cent of oral cancers are associated with use of tobacco in various forms, smoking in form of cigarette, bidi and chewing in form of chyne or gutka and pan are major forms of tobacco use, chewing areca nut is another factor for oral cancer in the Indian subcontinent, other minor contributor for oral cancer is HPV virus and irritation from sharp tooth or a denture. Smoking along with alcohol have a multiplied effect in development of oral cancer.
The early sign of presentation in these cancers varies from a non-healing ulcer, white or red patches in mouth, growth or swelling in mouth or neck to sudden or gradual difficulty in mouth opening. Any non-healing ulcer for greater than 2 weeks with hardening of the base of ulcer in a tobacco user must be suspected for cancer and needs immediate biopsy.
Oral cancers have a survival of about 80 per cent by 5 years when diagnosed and treated in early stages; this rate sharply declines to 50 per cent in later stage of presentation. The survival of oral cancer particularly in India is lower than the global average because of differential demographics, habitual patterns, health infrastructure, socioeconomic issues.
The current NCCN guidelines for oral cancer suggests that surgery for early stages and surgery followed by radiotherapy with or without chemotherapy in late stages is needed for best results in these patients. The overall result of the patient highly depends on the adherence of the treatment protocols.
However; despite best treatment cancer recurrence is possible, especially in advanced staged patients, first year after surgery is crucial to detect the recurrences for further treatment as early as possible. The oral cancer is almost curable; but only in early stages with appropriate treatment, the patients with spread of cancer from mouth to other parts of body.
Overall oral cancer can be prevented by avoidance of tobacco, other non-tobacco related cancers are usually less aggressive and curable, prolonged follow up and appropriate therapy is needed for best survival and quality of life in these patients. (The writer is MDS, Consultant Head and Neck Oncology and Reconstructive Surgery, KIMS Hospitals)
By Dr Sandhya Gokavarapu
