Oral cancer poses a significant health challenge in India, ranking among the top three types of cancer in the country. With age-adjusted rates at 20 per 100,000 population, contributing to more than 30% of all cancers in the country.
Various factors contribute to the prevalence of oral cancer in India, including the ageing population and regional variations in disease-specific risk factors.
Tobacco and Alcohol Use:
Strong risk factors for head and neck cancers, including oral cavity and oropharyngeal cancer.
Smoking and other tobacco exposure significantly increase the risk, especially with prolonged use.
Oral tobacco products Also lead to high risks, affecting the cheek, gums, and inner lips.
Certain HPV types, especially HPV16, are linked to oropharyngeal cancers.
HPV-related cancers are more common in younger individuals with multiple sex partners.
Excess Body Weight: Being overweight increases the risk of oropharyngeal and laryngeal cancers.
UV Light Exposure: Prolonged exposure to sunlight, a source of UV light, increases the risk of lip cancers.
Poor Nutrition: Low intake of fruits and vegetables is also linked to an increased risk.
Genetic Syndromes: Syndromes like Fanconi anemia and Dyskeratosis congenita increase the risk of mouth and throat cancers.
Betel Quid and Gutka: Chewing betel quid and gutka increases the risk of mouth cancer.
Tobacco And Alcohol Limitation
Using tobacco and alcohol significantly increases the risk of oral cavity and oropharyngeal cancers. Quitting tobacco and moderating alcohol consumption are essential preventive measures.
Human papillomavirus (HPV) infection, linked to these cancers, can be reduced through vaccination. Early vaccination, ideally before sexual activity begins, helps lower the risk.
UV Light Protection:
Limiting exposure to ultraviolet (UV) light, a risk factor for lip and skin cancer, is crucial. Wearing protective clothing and using sunscreen with SPF 30 or higher can help minimize this risk.
Maintain Healthy Weight and Eating Pattern:
Adopting a healthy eating pattern with a focus on plant-based foods and maintaining a healthy weight lowers the risk of oral cancers. Following dietary guidelines contributes to overall cancer prevention.
Regular Dental Checkups:
Regular dental checkups are vital for detecting and monitoring precancerous growths like leukoplakia or erythroplakia. Early intervention and continued monitoring are essential for preventing cancer development.
Proper Denture Fit:
Ensuring dentures fit properly is crucial in preventing oral irritation and reducing the risk of oral cancer. Regular checkups and adjustments by a dentist are recommended for denture wearers.
Stage 0 (Carcinoma In Situ) Oral Cavity Cancer:
Treatment Approach: Surgery (Mohs surgery, surgical stripping, or thin resection) is the standard to remove surface-layer cancer. Regular follow-up is essential, with radiation therapy considered if carcinoma in situ recurs post-surgery.
Stages I and II Oral Cavity Cancer:
Preferred Treatments: Surgery and/or radiation therapy are effective for small cancers. Lip cancers may involve surgery or radiation alone. Surgical options include lymph node dissection if needed, and reconstructive surgery for large or deep cancers.
Stages III and IVA Oral Cavity Cancer:
Comprehensive Treatment: Surgery, including lymph node dissection, is typically the first step for larger cancers. Follow-up with radiation alone or chemoradiation is common to address residual or potentially recurring cancer.
Stages IVB and IVC Oral Cavity Cancer:
Advanced Stages: Surgery may not be viable for IVB; radiation, chemoradiation, or chemotherapy is considered. Stage IVC involves treatments like chemo, cetuximab, or immunotherapy, with a focus on symptom relief and preventing complications.
Recurrent Oral Cavity Cancer:
Addressing Recurrence: Treatment options vary based on the cancer’s location, prior treatments, and overall health. Surgery is often considered if radiation was the initial treatment. Lymph node dissection, radiation, chemoradiation, and systemic therapies like chemo or immunotherapy are tailored to the individual’s situation.
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