by The Welthi Bureau | 13 MAR 2018
Dr.Sachin Harave, Radiational Oncologist, Narayana Medical Centre, Bengaluru explains about oral cavity cancers and the increasing incidence in India.
More than 77,000 new cases of lip and oral cavity cancers were detected in 2012 in India with an incidence rate of 7.2/ 1 lakh population (for both men and women) and more than 50,000 died of the disease. When you hear those numbers it sends shivers down your spine isn’t it? It is even more disturbing if the next victim to this deadly disease is someone known to you. So, let’s understand this disease before it claims its next victim. One frustrating aspect is that the symptoms are deceptive and evolve slowly. Some of the common symptoms are, a non-healing ulcer which is painless lasting for more than 2-3 weeks, swelling in the mouth or neck which is gradually progressive, pain in the mouth on taking spicy food, foreign body sensation, reduction/difficulty in mouth opening, ear ache etc.. The first thing we Indians commonly do, we ignore. We do not consult a Doctor unless it is very painful or causes discomfort.
To add to the problem the number of government centres with oncology department are few, especially in villages and our belief in alternative medicines as they are cheap and readily available. All these add up to the delay in making the diagnosis, by the time a suspected patient lands up in an oncology department, it would be too late. These things happen even in metros due to lack of awareness. The most common cause of oral cavity cancer in 80-90% is smoking. Abstaining from smoking reduces the risk in 30% of the patients who quit after 1-9 years.
Tobacco in any form is dangerous either it is smoking, reverse smoking ,ghutka ,pan masala ,masher ,chutta and the risk of developing cancer persists even up to 30 years after cessation. Chewing betel nut with lime and tobacco is a common practise in the village side which is a dangerous health hazard. So let’s understand more about this tobacco and smoking. There are three major components of tobacco smoke namely: incompletely combusted hydrocarbons, heavy metals and nitrosamines(nicotine).
Nicotine is the substance which gives all the pleasure and it is not a carcinogen(substance which causes cancer) per se but helps a mutated cancer cell survive long. Hydrocarbons and the heavy metals are the carcinogens. These carcinogens can be effectively filtered by adopting better curing and storage practises, which are often compromised in countries like India to keep the production cost low, this is the reason why beedi is more dangerous than cigarette .
E-Cigarettes (electronic) which have only nicotine and nicotine chewing gums are better alternatives and stepping stone to quit smoking. It is not only the person who smokes is at risk but also those in vicinity, a concept called second hand smoke i.e. when a person inhales smoke exhaled by the smoker. In this way indoor smoking is dangerous, as it affects all the family members. A concept called third hand smoke is also a dangerous phenomenon where in the residue from the smoke of the exhaled smoker settles down on the floor and other surfaces and these residue can come in contact or can be inhaled by people living with the smoker either at home or at work place. Risk of getting a lung cancer is as high as 20-30% for second hand / third hand smoker. The cost of treatment once oral cancer is detected depends on the stage of the disease. The approach to early stage oral cavity cancer would be Surgery / Brachytherapy and advanced stage would be Surgery followed by Radiotherapy and +/- Chemotherapy.
The total cost of the treatment could be around 2-3 Lakhs depending on the stage and type of surgery and radiotherapy. So let’s see how much a person spends on cigarettes before he gets detected with oral cavity cancer. If considering today’s prices of cigarettes,if a person smokes half a pack per day for 10 years where each pack of Gold flake kings / Classic costs Rs.300/- for a pack. A smoker would roughly spend more than 3 Lakhs minimum in 10 years, keeping in mind the addiction threshold is only going to get higher with time and weekends and special occasions requiring booster doses.
The countless hours lost because of morbidity and mortality due to smoking is unimaginable and is not helping the economy in any way. The financial burden that a family has to bear and then the emotional agony associated with the treatment is heart wrenching. According to a study done in University of Bristol “one cigarette reduces your life by 11 minutes”. So keep in mind the above facts before your next puff.
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