Oral Cancer Awareness Month

According to the latest report by the Global Cancer Observatory, new cases of cancers of lip & oral cavity were the second highest in Pakistan for both sexes and all ages in 2020. With over 11,000 new cases in males last year, it ranks as the commonest cancer seen amongst men in our country.  Only last year, over 10,000 people died of cancers of lips and oral cavity. Even though there are no screening tests for this type of cancer but there are measures that you can take to reduce your risk of getting oral cancer and to detect it early when it is most treatable.

Working at a cancer hospital, we see thousands of examples of the devastation caused by cancer every day but certain patients present perfect example of how early detection of cancer can save lives and livelihoods. Khursheed used to work in a brick-kiln until his declining health left him unable to continue. He was diagnosed with a type of oral cavity cancer involving his tongue. A critical source of income for the family stopped and the heart-wrenching circumstances forced his thirteen-year old son to work as a cleaner at a local clinic to be able to put food on the family’s table. The family consists of four children who all live with their parents in a three-marla house in Swabi. His children used to study but due to difficult financial situation, he could no longer afford to send them to school. It was not only one life that was threatened by cancer but the sustenance of the entire family rested on a very thin thread of hope—which was linked with Khursheed’s chance to fight cancer. Fortunately, his cancer was detected early when it was still treatable. In this month of April, which is oral cancer awareness month, you can pledge to fight oral cavity cancers by committing to a self-exam of your mouth.

As part of primary prevention of oral cavity cancer, you should avoid smoking and stay away from tobacco in any form, including niswaar, chhaalia/supaari, paan or gutka. Limiting exposure to UV radiation is also recommended, as it can lead to cancers of lips and skin. There has been some evidence of reduced risk of oral cavity cancers by adopting a healthy diet which should include plenty of fruits, vegetables, and whole grains while avoiding highly processed foods and sugary drinks.

For early detection, you should have a professional examination for early signs of mouth cancer, at least once a year, by your dentist. Due to limited access to primary healthcare professionals in Pakistan, you can commit to the alternative option of regular self-exams and check your mouth for changes every month, especially if you are using or have used any type of tobacco related products.

A self-exam of the mouth may take less than two minutes and it can save your life. You can start with your neck and check for swellings. Moving on to the lips, check insides for any non-healing wound/ulcer, changes in colour or texture. Then check your gums and both your cheeks. Look for any red or white patches and feel for any lumps or bumps. Check the sides of your tongue and then the underside for any swelling, ulcers or change in colour. Examine the floor of your mouth for any visual changes and feel for any lumps. Similarly, check the roof of the mouth for any unusual changes.

In addition to the above-mentioned signs, there are certain symptoms indicative of oral cavity cancer including pain in the mouth, difficulty in swallowing, trouble in moving your jaw or tongue, numbness of tongue or other areas in the mouth, and changes in voice. You should familiarize yourself with these signs and symptoms of lip and oral cavity cancer and then make an effort not to succumb to the culture of ignoring symptoms. It is essential that in case of any unusual signs and symptoms, you visit your nearest doctor.

Aside from deaths, long-term effects of lip and oral cavity cancers can significantly impact the quality of life of survivors due to functional impairment and disfigurement, which makes treatment in a timely manner even more important. At the Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC), multidisciplinary care is provided with a focus on the quality of life of patients. The treatment for oral cavity cancer varies depending on the stage and location of the tumour however, surgery is often the first line of treatment followed by radiation therapy or combined chemotherapy and radiation therapy. At SKMCH&RC, the speciality of Head and Neck Surgery provides extensive treatment in the cancers of skin, orbit, oral cavity, jaws, nose, sinuses, neck, pharynx and larynx. This requires not just the removal of cancer but also functional rehabilitation by appropriate reconstruction according the recommended gold standards.

In this month of April, pledge to stay away from tobacco/betel nut and all the related products, practice sun safety and adopt a healthy lifestyle to lower your risk of getting oral cavity cancer. Committing to a regular self-exam of your mouth and seeking medical attention in case of any unusual signs and symptoms will help in early detection of oral cavity cancer and can save your life.

– Dr. Raza Hussain

Consultant Oro-Maxillo-Facial Surgeon at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore.