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 Cancer

June 2010
Mouth Cancer
Dr Kumaresh Krishnamoorthy
 
Oral cancer remains one of the most devastating and disfiguring of all malignancies. It has a higher ratio of deaths-per-cases than that of breast and cervical cancer.

The rate of secondary cancer in these patients is also higher than that of any other malignancy. Mouth cancer has a long waiting period and spreads very quickly.

The Tobacco Risk
  • The use of tobacco causes 85 percent of all head and neck cancers.
  • Although the use of tobacco and alcohol are risk factors for the development of oral cancer, researchers at the Harvard School of Public Health and other institutions have found that smoking was by far the biggest culprit, causing 21percent of overall deaths. The incidence of oral cancer in women has increased significantly, largely due to an increase in women smoking.
  • The chewing of gutka, paan, zarda etc. has increased the incidence of oral cancer within the Asian sub-continent. 11 and 12-year-old children are now being seen with pre-cancerous growths after just two years of chewing!
  • Over the past decade, an increasing number of young, non-smokers have developed mouth and throat cancer associated with the human-papillomavirus (HPV).
  • Chewing tobacco has always been seen as socially acceptable in India. Unaware of the danger of cancer, tobacco is offered at the end of a meal, regarding it as little more than mouth freshener.

Effects of Chewing Paan
  1. Bad breath
  2. Gum and Tooth Disease: Paan permanently discolours teeth. Its direct and repeated contact with the gums causes them to recede, which can cause your teeth to fall out.
  3. Cancer of the mouth and throat are very common among paan users.Surveys reveal that risk of cancers of the cheek and gum may reach nearly fifty - fold among long - term snuff(a form of tobacco) users. The surgery for this could lead to removal of parts of your face, tounge, cheek or lip.
Effects of Chewing Betel Nut
  • It can cause Oral Submucous Fibrosis (OSF), a pre - malignant condition associated with oral cancer.OSF refers to the permanent thickening and hardening of the inner lining of the mouth, stiffening of the oral mucosa and development of fibrous bands, resulting in the person being unable to open the mouth at all. The tounge loses its roughness and becomes smooth and white. The sensation of taste is gradually lost and the ability to tolerate spicy foods diminishes. The condition is not reversible, nor does it have an effective cure.
  • In the presence of salivary nitrates, areca nut alkaloids can form nitrosamines that can cause cancer.
  • Betel nut chewing is also a risk factor for cardiovascular diseases and asthma.

8 Preventive Measures
The earlier, lesions caused by oral cancer are found, the greater the chance of recovery and a good quality of life and function. This is what makes the early detection of malignant or potentially malignant lesions through screening so important - only half of those diagnosed with the disease will survive more than five years.
  1. The best way to prevent oral cancer is to avoid tobacco and alcohol use.
  2. Cut down on chewing betel leaves (paan with areca nut) and avoid using tobacco. Discourage children and young adults from chewing betel leaves.
  3. If you are going to chew betel leaves, do not keep it in the mouth for long periods of time.
  4. Regular check-ups, including an examination of the entire mouth, are essential in the early detection of cancerous and pre-cancerous conditions.
  5. Many types of abnormalities can develop in the oral cavity in the form of red or white spots. Some are harmless and benign, some are cancerous, others are pre-cancerous, meaning they can develop into cancer if not detected early and removed.
  6. Finding and removing tissues before they become cancerous can be one of the most effective methods for reducing the incidence of the disease.
  7. Recently, the Academy of General Dentistry reported that simply swishing green tea around the mouth halts the growth of new oral cancer cells and kills existing oral cancer cells without harming normal ones.
14 Symptoms of Oral Cancer
An early indication of oral, head and neck cancer is one or more changes in the way the soft tissues of your mouth usually look or feel. These signs and symptoms may be indicative of cancer or other, less serious conditions.
  1. A sore in the mouth that doesn’t heal or increases in size
  2. Persistent pain in the mouth
  3. Lumps or white, red or dark patches inside the mouth
  4. Thickening of cheek
  5. Unusual bleeding, pain or numbness in the mouth
  6. Difficulty in chewing or swallowing or moving the tongue
  7. Difficulty in moving the jaw, or swelling or pain in the jaw
  8. Soreness in the throat or feeling that something is caught in the throat
  9. Pain around the teeth, or loosening of teeth
  10. Numbness of tongue or elsewhere in the mouth
  11. Changes in voice
  12. Pain in the ear without evidence of local ear problems
  13. A lump in the neck
  14. Bad breath
Dr. Kumaresh Krishnamoorthy is Senior Consultant in ENT - Head and Neck Surgeon and Neurologist at Apollo Hospitals, Bangalore,India


    
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