Oral cancer in India

Oral cancer in India.
Every year, April is celebrated as ‘Oral cancer awareness month’. India is regarded as the capitol of oral cancer in the world, a distinction we certainly do not cherish. Every year about 10000 patients are registered in apex cancer centres in India and many more are either treated outside these centres or they simply do not reach a cancer treating unit. Several thousand patients die of oral cancer in India every year.
Oral cancer is a major public health problem but the `noise level’ against oral cancer seems very low. I wonder why. Most people are aware of the harmful effects of tobacco. The pictorial warnings on cigarette and tobacco pouches are gory and graphic enough. Absence of an established screening modality may be a reason. Some people wrongly believe that only some forms of tobacco such as gutkha or cigarette/beedis are harmful; chewing tobacco as such or with betel leaves is harmless. Tobacco addiction is one of the toughest to quit, only 8% or so can do it successfully. Given the fact that the addiction is so deeply settled even culturally, bringing about de-addiction on a mass scale to reduce the incidence of oral cancer is a long journey which has not even begun. Thus early detection is the only reasonable option to improve results and reduce mortality from oral cancer. Oral cancer being a native problem, the solution will have to come from within. It is a well known fact that gastric cancer (cancer of the stomach) is more prevalent in Japan due to their peculiar eating habits. The Japanese have devised their protocols for early detection and adequate treatment and hence their success rates of treating gastric cancer are very high. Similarly, we Indians cannot rely on the Western world to provide us with guidelines for screening and treatment but will have to devise our own guidelines.
Oral cancer screening has been a topic of discussion in many meetings but unfortunately has never caught on. There were studies about ‘Mouth-Self-examination’ which were published some time ago but it has not been tested widely throughout the country. If one thinks of it, simple oral examination under adequate illumination is not a difficult thing to perform at all. If performed regularly on all tobacco abusers, we may be able to detect oral cancer in a very early stage. It would require no sophisticated gadgets but only some training to identify lesions. We may end up doing additional procedure in the beginning but that happens with every screening modality. Eventually, with experience and training, it would be possible to tell the potentially carcinogenic lesions from the benign ones.

- Oncologist in Pune | Cancer Specialist | Dr. Chetan Deshmukh