The word cancer elicits an emotional response like no other disease does. This 4000 year old disease which has been the scar on the face of mankind, continues to elicit a fear no other disease can match.
Oral Cancer is one of the most common cancers in our country, accounting for more than 80% of oral cancer burden of the world. Unsurprisingly, its incidence continues to rise. But even more worrisome trend is its occurrence in the younger subset of population.
To a large extent, oral cancer is a result of an improper lifestyle. India continues to be an accelerating market for one of mankind’s worst enemy – tobacco. Large scale acceptance of this addiction, peer pressure and ease of availability has resulted in a spiralling trend of craving for this weed. Compounding this is the unwillingness of the national policy to curb this menace, as it is a vital source of national income, only to come at the cost of national health. Millions are spend to undo the debility caused by tobacco not only to the addict, but also to those passively exposed to its harmful fumes.
Unfortunately, India’s young population has misguidedly elevated smoking and chewing tobacco to a status symbol. It is being associated with ‘manliness’ and ‘cool’ness, with a very disturbing trend of increasing women smokers and chewers. India continues to be the largest market for chewable tobacco in its varied and diverse forms. Accelerating the detrimental effect of tobacco is alcohol, whose consumption is on the rise. The new-age India, flush with increasing buying power is on the rise in alcohol intake. Again, a skewed view of what is ‘fun’ is responsible for this disturbing trend. More needs to be done on this front.
The most bewildering aspect of these addictions is – the awareness about its harmful potential is also on the rise. Tobacco addicts are very much aware about its misadventurous journey but probably are too dependent, or too imprudent, or both.
Regrettably, majority of cancer victims present late for treatment. While efforts are made to popularise prevention of cancer, not much is done to promote its early presentation and cure. Compounding it are widespread misconceptions regarding cancer amongst general public and even among untrained health facilitators. A very pertinent example is the fear of biopsy which is erroneously believed to abet its aggressiveness. Nothing can be further from truth!
The immense psychological fear of cancer has often led to delay in seeking medical aid, with victims denying obvious signs and hiding facts from family and caregivers. Many early lesions are thus willingly ignored, only to regret later.
Fortunately, the treatment of oral and head-neck cancer has improved tremendously. Insights into its pattern of growth and spread, and population based scientific studies about prognosis have changed the very concepts of treatment. New modalities of imaging, multidisciplinary treatment, evidence-based treatment protocols and improved methods of rehabilitation and reconstruction with superior surgical and medical facilities have made a sea-change in outcomes in oral cancers.
The cornerstone of cancer-care is the development of centres where multidisciplinary care is available. This would include experts in pathology, imaging, surgery, reconstruction, anaesthesia and critical care, radiation, chemotherapy, nursing and lastly but importantly, rehabilitation. Such centres also help in training of care-givers. Unfortunately, such centres of excellence are far and few in India.
A great achievement has been standardisation of treatment protocol for the various stages of cancer, leading to uniformity in treatment at various “Onco-centres” and thus improving treatment outcomes at all such centres. This has also made comparison of treatment outcomes more meaningful and has made possible clinical trials to improve morbidity and mortality across the globe a reality. Although far from perfect, things are definitely improving at a rapid pace in the correct direction.
But the greatest support a cancer victim has is his circle of family and friends. They are the most vital link to accept the diagnosis, fight the disease, and help in overcoming the obstacles to lead a fruitful life. Life is a journey, and has a start and a finish. But it’s the companionship which makes the journey worthwhile, isn’t it?
To conclude, cancer is a disease like any other. Oral cancer is curable if presented early. It can be prevented by adopting a healthy lifestyle and regular exercise. And, with help, it can be defeated!
Dr Rajdeep P. Guha,
MS (ENT), DNB (ENT)
Consultant, ENT and Head-Neck Surgery