Mapping Oral Cancer [In Conversation with Dr. Veejay Deshpandey]
Oral cancer is a heterogeneous group of cancers, which arises from different parts of the oral cavity. Sixth in the most globally reported cancers worldwide, oral cancer numbers are on the rise in India. According to a study conducted by National Institute of Public Health in Feb 2011, India accounts for 86% of the world’s oral cancer cases and the main reasons behind this are tobacco chewing and smoking. To talk more about the diseases, how tobacco is linked to oral cancer, its susceptibility, prevention and treatments, today we have with us Dr. Veejay Deshpandey - Consultant Dental Surgeon and Implantologist, Mumbai.
Here are the excerpts from the interview:
Mansi Kohli: How is tobacco linked to oral health?
Dr. Deshpandey: In India, over 700,000 to one million Indians die every year due to consumption of tobacco, mostly due to mouth cancer (Food Safety and Standards Authority of India). India has the highest number of oral cancer cases in the world out of which 90 per cent are due to tobacco consumption (World Health Organization Survey Report). When it comes to oral health problems, tobacco use becomes a primary cause. The increase in the use of tobacco in various forms like lime, raw with betel leaf, betel nut, pan masala, gutka and smoking has led to a rise in the cancer cases. Smokers or smokeless tobacco users are also at a much higher risk of developing cancers of the lips, mouth, cheeks, tongue and throat as well as problems relating to periodontal, or gum, diseases. Tobacco also affects your calculus, deep pockets between your teeth and gums and also results into a loss of the bone and tissue that support your teeth. Intake of tobacco not only affects your oral health but it affects your posture and looks, heart, and lungs.
Mansi Kohli: Is tobacco the only cause of oral cancer?
Dr. Deshpandey: Though tobacco is the leading cause of oral cancer it is not the only one that causes it. Many cases of oral cancer are linked to cigarette smoking, heavy alcohol use, or the use of both tobacco and alcohol together. HPV is also an increasing cause of oral cancer cases. It is caused due to the Infection with the sexually transmitted human papillomavirus. HPV is the cause of concern among men as compared to women says a recent study. It’s not just your habits and life style that will affect your health but your genes also play an important role here. Your hereditary problems make you more vulnerable to various types of cancers including oral.
Apart from this, too much exposure to the sun might increase the risk of lip cancer affecting the mouth. One's poor oral hygiene, chronic trauma from sharp tooth or ill fitting dentures can also be linked to cancer. Age and your diet also play an important role when it comes to cancer. So I suggest one to follow a proper balanced diet and visit your doctor frequently if you are above 40 years of age.
Mansi Kohli: Who is more susceptible to oral cancer?
Dr. Deshpandey: Anyone consuming tobacco is vulnerable to oral cancer. People who smoke and chew tobacco and drink alcohol frequently will be highly susceptible. Tobacco is also a risk factor for oral cancer, periodontal disease, and congenital defects in children whose mothers smoke during pregnancy. Hence, pregnant women should keep themselves away from active as well as passive smoking. Those who also have cancer patients in their families should see to it that they stay away from any forms that might lead them to cancer as they are highly susceptible.
Mansi Kohli: How does oral cancer develop and what are its risk factors?
Dr. Deshpandey: Oral Cancer can be detected at an early stage but unfortunately it is usually detected very late. This happens because people generally tend to ignore their dental related problems. I have come across many such cases that had come to me with dental problems but were diagnosed with oral cancer.
Research has also shown that people who use tobacco have to face the following problems often: Bad breath, stained teeth, tooth loss, bone loss, loss of taste, less success with periodontal treatment, less success with dental implants, gum recession, mouth sores and facial wrinkling.
Mansi Kohli: What are the signs and symptoms of oral cancer?
Dr. Deshpandey: Some signs and symptoms that could indicate oral cancer include: Sign of irritation, like tenderness, burning or a sore throat; pain, tenderness or numbness in the mouth or lips; development of a lump, wrinkled or patch inside your mouth; color changes like grey, red or white spots or patches in mouth; if one has difficulty chewing, swallowing, speaking or moving the jaw or tongue; or any change in the way your teeth fit together. I would suggest you to see your dentist or physician if you notice any of these changes.
Mansi Kohli: What are the treatment options available for oral cancer?
Dr. Deshpandey: The main treatment is surgery. The advanced cases surgery is mainly followed by radiation therapy. But only 70% of the cases after treatment are successful as they are diagnosed at a very late stage of cancer. This leads to relapse and the result is death. The treatment is successful only if the symptoms are detected and diagnosed early, but sadly many times, it is ignored and the patient reports it has spread to the extent that the treatment is impossible. The treatment totally depends upon the studies and diagnosis of surgeons, oncologists and radiation specialists.
Mansi Kohli: If one is feeling depressed after quitting tobacco, what should he or she do?
Dr. Deshpandey: Every person has their own way to handle situations. Some overcome their situations easily and some take time. Everyone has their own stress busters too. If they are too depressed then a visit to a psychologist or psychiatrist can help them overcome these episodes. What one needs is proper support and guidance and counseling can help them.
Mansi Kohli: Kindly throw some light on the de-addiction program of oral cancer?
Dr. Deshpandey: Various institutes conduct de-addiction programs. Psychologists and psychiatrists also help in the process of de-addiction. Some de-addiction programs involve a detailed assessment procedure that also includes psychometric testing and physiological testing. They also conduct interventions with a mix of motivation enhancement therapy, cognitive therapy, behavioural skills training and relapse prevention.
About Dr. Veejay Deshpandey: He is a Consultant Dental Surgeon and Implantologist, practising in Thane/Mumbai for the last 28 years and Muscat for 8 years. After completing his Bachelor of Dental Surgery from Mumbai University, he completed his Post Doctorate in Oral Implantology - D.U. (Oral Implantology) from Lille University in France. He has been awarded the Fellowship of American Academy of Implant Dentistry in USA. He is the first Indian to have this honour for which he was felicitated by the then Governor of Maharashtra Mr. P.C.Alexander.
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