Oral cancer: A silent culprit taking its toll on India

Oral cancer, a sinister disease silently wreaking havoc within the oral cavity, is becoming an imminent threat worldwide. The situation is particularly alarming in India, where it is the most prevalent form of cancer among males. India also bears the highest burden of lip, oral cavity cancer worldwide.

According to the latest data from GLOBOCAN 2022, in India, the incidence of oral cancer is 143,759, which is expected to double by 2050, raising concerns about the well-being of individuals, families, and communities. The mortality rates due to oral cancer in India are also alarming, with predicted increases from 20359.7 deaths in 2022 to 147300 deaths by 2050. These statistics highlight the urgent need for action and support. The global incidence of oral cancer was 389,800 in 2022, which is also expected to double by 2025, emphasizing that this is a global challenge requiring collective action.

Behind these statistics lie the heart-wrenching stories of individuals and families grappling with the devastating impact of this disease. The effects of oral cancer extend far beyond the physical suffering endured by patients. The emotional strain, financial burdens, and shattered dreams that accompany this disease are immeasurable. In a study conducted by Tata Memorial Hospital, it was estimated that premature oral cancer deaths cost India a staggering $5.6 billion in terms of productivity losses in 2022. One of the key findings stated that 91% of the fatalities or terminal stages were among patients with a median age of 41.5 years. The monetary value of the losses for men exceeded Rs 57 lakh and that for women Rs 71 lakh. This loss affects the economy and tears at the very fabric of families, pushing them into the depths of poverty.

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Chronic tobacco consumption is the leading cause of oral cancer, responsible for 90% of cases. India suffers the most, with around 200,000 deaths annually from smokeless tobacco products. Shockingly, over 30% of Indians, including 14.6% of children, use tobacco. This could also be a contributing factor to the presentation of oral cancer in a younger population in our OPDs, some of whom are as young as in their 20s.

Under the aegis of Tata Cancer Care Foundation by Tata Trusts, Ranchi Cancer Hospital and Research Centre (RCHRC) emphasizes the importance of preventive measures through a school-based initiative. In line with the National Tobacco Control Programme, RCHRC educates school students about the hazards of tobacco and the laws under the Cigarettes and Other Tobacco Products Act (COTPA). To date, RCHRC has sensitized over 28,000 young individuals about the dangers of tobacco use.

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One of the challenges in combating oral cancer lies in its silent progression during its early stages, often without noticeable symptoms. It is imperative for individuals to seek medical attention if they have an ulcer that persists for more than two to three weeks. Additionally, white or red patches in the mouth, known as leukoplakia and erythroplakia, may indicate precancerous conditions that warrant immediate evaluation. Early detection through regular screenings, which can be as simple as a thorough examination under good lighting, can significantly improve prognosis and treatment outcomes.

Several misconceptions and myths surrounding cancer, particularly regarding biopsies, impede prompt diagnosis and treatment. It is crucial to address these misconceptions head-on. Biopsies are safe and necessary for accurate diagnosis, contrary to the belief that they enhance the spread of cancer. A unified effort by government bodies and medical associations to dispel such misconceptions is vital in encouraging patients to seek necessary treatments. Although oral cancer can indeed be treated successfully, it is important to understand that no treatment can guarantee a 100% cure rate. Nevertheless, early-stage cancers have a promising prognosis of around 90%, highlighting the significance of awareness and early screening to save lives. The crucial step is to consult a specialist promptly and not get duped by those who give faux claims of a 100% cure.

Cancer patients face more than just physical suffering; they bear the burden of social stigma as well. These patients are often judged by the community and neglected by their own. Most of the time, underprivileged patients cannot even afford an autorickshaw, let alone travel comfortably to distant cities for treatment, resulting in exorbitant expenses. While the establishment of cancer centres, like RCHRC in Ranchi, is commendable, there is a pressing need to expand such facilities in peripheral regions. By embracing new surgical techniques and treating cancer in its early stages, we can alleviate the fears of disfigurement and functional impairment that deter some patients from seeking treatment.

Preventing oral cancer requires awareness, regulation of tobacco usage and educating children. Healthcare systems must prepare for the increase in cases by increasing capacity, while rehabilitation services need improvement. Comprehensive care is essential for patients’ quality of life. Collaboration between the government, medical professionals, and society is crucial in battling oral cancer. By fostering awareness, dispelling myths, promoting early detection, and supporting rehabilitation, and prevention, we can protect countless lives and families from the devastating effects of oral cancer in India.

Authored by Dr. Sachender Pal Singh – Consultant, Surgical Oncology Head & Neck Ranchi Cancer Hospital & Research Centre – Ranchi, Jharkhand