Oral cancer: treatment and management

New Delhi [India]: Oral cancer is one of the most common forms of cancer in India. India has one of the highest rates of oral cancer in the world with more than 80,000 new cases reported every year across the country.

As per the WHO, in India, the age standardized incidence rate of oral cancer is 12.6 per 100 000 population. Cancer that occurs in the tissues of oral cavity or oropharynx (upper part of the throat) is called oral cancer.

There are a number of factors that can lead to oral cancer including consumption of alcohol, smoking, lack of a proper diet, and infection (Human Papilloma Virus), says Dr M Udaya Kumar Maiya, Medical Director, Portea Medical.

Statistics indicate that more than five million children in India are addicted to gutkha, a smokeless tobacco product, which is a key driver behind the country’s soaring oral cancer rates.

People at risk for oral cancers should get annual checkup done for prevention, or for early detection.

The treatment plan for oral cancer varies from person to person and is decided depending on the following main factors.

•Patient’s age, general health, and past medical history

•Cancer type, size, and location

•Treatment tolerance

•Risk for hidden disease

•Need to save certain functions/tissues.

It is imperative to get diagnosed for this cancer in the early stages for better treatment outcomes. There is extensive research on oral cancer today as it is an eminently curable form of cancer and amenable for early detection. Much work is being carried out in the field of gene and DNA analysis with respect to carcinogenesis and diagnosis.

There is a large body of work on the Human Papilloma Virus (HPV) and its effect on oral cancer. Giant strides have been made in immuno-histo-chemistry for pathological diagnosis, good imaging modalities with MRI and PET scans, excellent organ preserving surgeries without much damage to the functioning of speaking and swallowing using lasers, etc., as also good precision radiation therapy by way of IMRT, IGRT, and Brachytherapy.

There new and less toxic chemotherapy and targeted therapies available which act by themselves or in tandem with surgery and radiation for optimal outcomes.

Managing the issue

-At the workplace

Industries should promote healthy habits among employees by way of periodic health checks and increasing awareness on prevention and early detection of oral cancer.

They also must have a strict ‘No smoking and chewing’ policy at work as per industrial norms and enforce it effectively. This can go a long way in dissuading people from acquiring illness.

-In hospitals

An effective oral screening policy for all oral and dental patients visiting a hospital can help detect early disease even if the patient is not symptomatic.

There should be a trained medical team that can detect the disease early and treat it accordingly. Hospitals should also aim at generating awareness among its patients, attendants, and the general public.

-Government

Smoking and Chewing restrictions in public places are an urgent need of the hour. Smoking, chewing, and spitting of paan, gutka, betel, and tobacco should be banned on a war footing in public places. The government should also take steps to ensure that the sale and distribution of these products around schools and colleges is stopped.

Although there are existing rules for controlling the consumption of tobacco, the enforcement is poor as it is not accorded much priority. The need of the hour is sensitization of police and other agencies in this regard and making the punishment of offenders exemplary.

Mass awareness and screening programmes at all governmental and aided hospitals should be encouraged. Television and print media should highlight the ills of chewing and smoking tobacco extensively.

Advertisements on oral cancers should be made more imaginative and catchy. It is also imperative to encourage tobacco farmers to switch to other cash crops in a phased and practical manner. All these measures will definitely bring about a reduction in the incidence of oral cancer in India. (ANI)