Dr Mandeep Kaur
Our bodies are made up of many small units called cells. These cells have a limited lifespan. The process of forming new cells and dying of older or injured cells is a continuous one. This keeps a person in good health. For some reason, this process may get disturbed and cells can start to grow out of control. When this happens, it is called cancer. These cells either invade the surrounding areas or spread to distant parts of the body through the blood or lymph circulation (metastasis). Mouth cancer, also called oral cancer, is a major health concern in India. It is the most common cancer among men and the 3rd most common cancer among women and people are dying because of ignorance.
There are about 7, 00,000 new cases of cancers diagnosed every year in India out of which tobacco related cancers are about 3,00,000, cancer of uteri are 1,00,000 and 80,000 breast cancer. Cost of treatment of oral cancer is about 3.5 lakh. This can be completely prevented by simple changes in lifestyle and regular screening and even have health benefits that reach beyond cancer. About 2000 deaths a day in India is tobacco related.
According to the American Cancer Society, men face twice the risk of developing oral cancer as women, and men who are over age 50 face the greatest risk.
Risk factors
* Smoking . Cigarette, cigar, bidi, or pipe smokers are six times more likely than nonsmokers to develop oral cancers. Cheroot, napani tobacco and reverse smoking are other forms of smoking which cause oral cancer. Bidi smoke has a higher content of carbon monoxide, ammonia, hydrogen cyanide, phenol, and carcinogenic hydrocarbons than cigarette smoke.
* Smokeless tobacco users. Users of dip, snuff, or chewing tobacco products like gutkha, jarda, mava, betel leaf, pan, khaini shammah, toombak, naswar , marijuana (macerated flowers), hashish, hash oil, etc are 50 times more likely to develop cancers of the cheek, gums, and lining of the lips. The habit of keeping the tobacco quid against the cheek and gums has led to the high numbers of people with cancer of the gums, cheek, and inner side of the cheek. The chemicals that cause the cancer can also spread elsewhere inside the mouth via saliva, making the entire mouth prone to cancer. Tobacco contains potent carcinogens including Nitrosamines (nicotine), polycyclic aromatic hydrocarbons, nitrosodiethanolamine, Nitrosoproline, tarpenes, phenols, acids, and polonium. Tobacco smoke contains carbon monoxide, Thiocyanate, hydrogen cyanide, nicotine and metabolites of these constituents.
* Excessive consumption of alcohol. Oral cancers are about six times more common in drinkers than in nondrinkers. All forms of alcohol including hard liquor, beer, wine cause dehydrating effect on mucosa making it permeable for the easy passage of carcinogens resulting in oral cancer. It is important to note that over 25% of all oral cancers occur in people who do not smoke and who only drink alcohol occasionally.
* Dental factors. Constant irritation of the gums or cheeks by sharp teeth or ill fitting dentures, poor oral hygiene, rough restoration and low dentals status are contributing factors in oral cancer. One who smoked heavily, drank large quantities of alcohol, and had a poor dentition had an eight-fold higher risk than matched controls.
How to prevent Oral Cancer?
* Don’t smoke or use any tobacco products and drink alcohol in moderation (and refrain from binge drinking).
* Eat a well balanced diet.
* Limit your exposure to the sun. Repeated exposure increases the risk of cancer on the lip, especially the lower lip. When in the sun, use UV-A/B-blocking sun protective lotions on your skin, as well as your lips.
You can take an active role in detecting oral cancer early, should it occur, by doing the following:
* Conduct a self exam at least once a month. Using a bright light and a mirror, look and feel your lips and front of your gums. Tilt your head back and look at and feel the roof of your mouth. Pull your checks out to view the inside of your mouth, the lining of your cheeks, and the back gums. Pull out your tongue and look at all surfaces; examine the floor of your mouth. Look at the back of your throat. Feel for lumps or enlarged lymph nodes in both sides of your neck and under your lower jaw. Call your dentist’s office immediately if you notice any changes in the appearance of your mouth or any of the signs and symptoms mentioned above.
* See your dentist on a regular schedule. Even though you may be conducting frequent self exams, sometimes dangerous spots or sores in the mouth can be very tiny and difficult to see on your own. The American Cancer Society recommends oral cancer screening exams every 3 years for persons over age 20 and annually for those over age 40. During your next dental appointment, ask your dentist to perform an oral exam. Early detection can improve the chance of successful treatment.
(The author is Assistant Professor Department of oral Pathology & Microbiology Indira Gandhi Govt Dental College, Jammu)
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