Dr.Gautam Sharma
Rise in fresh cases of oral cancer is a cause of concern in the country.  Approximately 130000 people die of oral cancer in India in a year. Chewable tobacco which includes gutkha, snuff, zarda, quid, areca nut, paan (betel chewing), etc. and smoking are the main cause of this kind of cancer. Other factors include irritation caused by ill-fitting dentures, poor oral hygiene, sharp surfaces on the teeth causing injury to mucosa, and some chronic infections caused by bacteria, viruses and fungus.
The International Agency for Research on Cancer (IARC) and the World Health Organization (WHO) accept the scientific evidence that chewing betel quids and areca nut is carcinogenic to humans.  The main carcinogenic factor is believed to be areca nut.
Cancer is an uncontrollable growth of cells that invade and cause damage to adjoining tissues. Oral cancer appears as a growth or raw area in the mouth that does not go away. Oral cancer, which includes cancers of the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and throat can be life threatening if not diagnosed and treated early.
The most common symptoms of oral cancer include swellings, lumps , eroded areas on the lips, gums, or other areas inside the mouth; white and red patches in the mouth; Unexplained bleeding from mouth; numbness and tenderness in any area of the face, mouth, or neck; difficulty in chewing or swallowing, speaking, or moving the jaw or tongue; hoarseness, chronic sore throat, or change in voice and unexplained weight loss.
Dental quacks also pose the threat of oral cancer by providing ill fitting and faulty prosthesis to the public in addition to spread of various blood borne infections like HIV, Hapatitis-B etc.
For early diagnosis of oral cancer, one must visit the dentist every six months who conducts an oral cancer screening. Dentist can feel for any lumps and tissue changes in the neck, head, face, and oral cavity and any kind of sores or discolored tissue as well as check for any signs and symptoms mentioned above.
Many precancerous conditions like leukoplakia, erythroplak, erythroleukoplakia, proliferative verrucous leukoplakia (PVL) and oral submucous fibrosis if diagnosed at an early stage, can be managed by avoiding the known causative factors and minimal surgical intervention. These lesions can become cancerous if diagnosis and treatment is delayed.
Cancer cells have the potential to spread from the oral cavity to other parts of the body where they can grow into new tumors. This process is called metastasis. The most common sites where oral cavity cancer spreads are muscles and bones surrounding the oral cavity, lymph nodes in the neck, lungs, liver, bone. Oral cavity cancer may spread locally or to distant sites through the lymphatic system.
Treatment options for oral cancer includes surgery, radiation therapy and chemotherapy. Surgery is performed to remove the tissue that has been affected by cancer along with some healthy tissue margins. Radiation therapy may be given as the primary treatment and after surgery to reduce the risk of the cancer recurrence or as palliative care to reduce signs and symptoms. Chemotherapy drugs may be used to make cancer cells more sensitive to radiation and to relieve pain or control the symptoms of advanced oral cavity cancer.

world cancer day

Supportive care which is an important part of cancer care helps in meeting the physical, practical and emotional challenges after the cancer treatment.
Reconstructive surgery is done to restore the physical appearance and physiological functions like chewing, speaking etc. Sometimes dental implants are recommended in patients after the surgery where tooth or teeth were extracted.
(The writer is Dental Surgeon, University of              Jammu and President, Indian Dental   Association.)
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