Tobacco Use and Oral Cancer

Tobacco causes a host of disorders and diseases. However, among these, the most prevalent ones – and certainly the gravest – are oral and lung cancer. The rising oral cancer rates in India are among the highest in the world, and 90% of these can be attributed to tobacco. Tobacco- related cancers represented 42% of male and 18.3 % of female cancer deaths and there were twice as many deaths from oral cancers as lung cancers.Oral cancer is the most common cancer in males in India.

Tobacco products have cancer causing agents:

Tobacco products contain different kinds of carcinogens: tobacco-specific nitrosamines, benzo[a]pyrene and other polycyclic aromatic carcinogens, etc which are responsible for development of cancer. All forms of tobacco and nicotine either smoking or smokeless forms, are harmful. Many studies have shown high rates of leukoplakia (white or gray patch that develops on the tongue and in the cheek) at the place in the mouth where users place their chew or dip. The longer a person uses smokeless tobacco, the more likely they are to have leukoplakia. Tobacco products causes chronic irritation and repeated mucosal injury which leads to precancerous changes in the form of leukoplakia or erythroplakia (fiery red patch in the check or the tongue).

With more and more use of gutkha, khaini, paan masala,etc, lot of young people are coming with submucous fibrosis and oral cancer. Not all patients who use tobacco, develop leukoplakia or erythroplakia before developing cancer. Many patients directly present as ulcer or growth and being diagnosed as oral cancer. For oral cancers, men who smoke have a 27-times higher rate of oral cancer than men who do not smoke.

Signs and Symptoms of Oral Cancer:

Signs and symptoms include white or red patches, decreased mouth opening, ulcer or growth that persists for more than 2 weeks, difficulty in chewing and swallowing, loose teeth, ill-fitting dentures, etc. oral cavity is easily visible from naked eyes and this aspect can be utilized for screening and early detection when treatment results are excellent.

Screening for Oral Cancer:

Screening includes self-examination of all areas of oral cavity at least once a month especially who use tobacco, especially of the areas where tobacco is kept. In case of white or red patches or other signs or symptoms, patient should be examined by a doctor who is familiar with the oral cancer symptoms and signs to detect cancer in the early stage. In case of any suspicion, biopsy should be done to confirm diagnosis. Treatment includes surgery and postop radiation or chemoradiation.

Quit the bad habit that harms you:

Today, there is more need for awareness campaigns about ill effects of tobacco use. There’s no proof that smokeless tobacco products can actually help smokers quit. But there are proven treatments for tobacco addiction, such as nicotine replacement products like the nicotine patch or gum, prescription drugs, and behavioral therapies.The most important thing is the willingness and will-power required for quitting tobacco.