Doctor points to link between tobacco consumption and oral cancer
Source: The Sangai Express

Imphal, December 28 2023: Citing high rate of tobacco consumption among both men and women in the North East, Dr Anil Ayekpam, Surgical Oncologist, Shija Hospital has urged people to take precautions against oral cancer.

Speaking to The Sangai Express, Dr Anil shared that cancer on the tongue, under the tongue, inside the cheek, adjoining area between the food pipe and the mouth, on the tissue lining the mouth and gums and tonsil cancer are some of the most common forms of oral cancer.

Stating that use of tobacco and other related products is the main cause of oral cancer, he added that it usually develops in adults beyond 40 years of age.

Doctor points to link between tobacco consumption and oral cancer

The Surgical Oncologist maintained that consumption of Khaini, all types of paan including "Kom Kwa", cigarettes and alcohol can cause oral cancer.

Consumption of paan causes chronic irritation in the mouth while the limestone (sunu) can tear the soft tissues in the mouth.

Consistent tearing and healing of this tissue can lead to oral cancer, he said.

He stated that 60% of oral cancer is caused by consumption of tobacco and other related products while 20% is caused by Human Papilloma Virus (HPV) .

Among the youth, oral cancer is commonly caused by HPV, which is also the virus that causes cervical cancer.

Doctors advise HPV vaccines to the public to protect themselves against cervical cancer, but this is not the case for oral cancer, said Dr Anil.

Further, he spoke about three common conditions that are non-cancerous but have the potential to progress into oral cancer, namely, Oral Submucous Fibrosis (OSF), Leukoplakia and Erythroplakia.

OSF is most commonly detected among paan consumers and its symptoms include inability to open one's mouth and throat.

Leukoplakia develops as a white patch or plaque in the oral cavity i.e on the gums, the insides of the cheek and beneath the tongue.

Lastly, Erythroplakia affects the soft tissue lining of the mouth and throat.

Without proper treatment, these conditions can develop into oral cancer, said Dr Anil Ayekpam.

Asserting that oral cancer is often detected early, he urged people to consult their doctors promptly if they find any lump in their tongue, mouth ulcer that do not heal, lumps on the neck causing difficulties in swallowing, bad breath and blood in spittle.

Describing some types of oral cancer, Dr Anil stated that cancer developed in the area adjacent to the gums is known as GB Sulcus.

This is the most common type of tumour that persists in the Indian subcontinet as well as Manipur.

Tongue cancer is the growth of a lump or an ulcer on the tongue that refuses to heal.

Such a condition that does heal within 2 or 3 weeks will need a biopsy as it has high chances of turning cancerous, he stated.

In the case of GB Sulcus, the cancer is treated through radiation therapy as surgery is inconvenient while for tongue cancer, surgeries are relatively simple, though complications can develop if the tumour spreads to the rest of the tongue instead of being localized in one spot.

In such cases, doctors are often unable to reconstruct the tongue to its original form.

Thus, many people succumb to cancer as such operations are rare, he pointed out.

To prevent the occurrence of oral cancer, Dr Anil advised against consumption of tobacco and related products stating that it will reduce one's chances of developing the disease by 50% to 60% .

His other recommendations include abstaining from consumption of both tobacco and alcohol, all types of paan, maintaining oral hygiene and seeking prompt treatment upon detection of premalignant (pre-cancerous/potentially cancerous) conditions.

Speaking about the treatment for oral cancer, Dr Anil Ayekpam shared that most forms of oral cancer are treated through surgery.

After surgery, chemoradiation (having chemotherapy at the same time as radiotherapy) is extremely vital.

Radiation therapy treatment is adopted in cases where surgery is not ideal.

Maintaining that oral cancer usually spreads to the neck, he added that after neck surgery, radiation treatment is needed.

Sharing an alarming detail, Dr Anil stated that once diagnosed with oral cancer, the chances of it recurring are very high.

Addressing the Manipur public, the Surgical Oncologist pointed out the high rate of tobacco consumption in the State but compared to other Indian States, the incidence of oral cancer is lower here.

Stressing on the importance of taking precautions, he urged people to consult their doctors if they discover any irregularities in their mouth.

He also called for complete avoidance of tobacco and all related products and suggested tobacco replacement therapy as a way to kick this dangerous habit.

Saying that surgical oncology is a brand new branch, he informed that including himself, there are only two persons with a degree in surgical oncology in the entire State.

He further shared that facilities for oral cancer surgery are available at Shija Hospital but not for radiation therapy.

So the hospital does not receive many patients with such conditions.

However, facilities for various types of cancer treatment are now available in Manipur.

There are three/four cancer surgeons and another three/four surgeons specializing in head, neck and oral cancer.

Adding that there is one radiation oncologist each at American Oncology Institute (AOI) at Babina Specialty Hospital and RIMS Hospital, he highlighted that this treatment also requires a plastic surgeon.

It wouldn't be too far-fetched to assert that all such cancer treatments are possible in Manipur.

However, as all the treatments are not available at one institution, people are often unaware and instead seek treatment outside the State, he said.