• Amid COVID-19 those who are addicted to tobacco or smoking are at a very high risk as the oral cancer screening has taken a hit and not being done as earlier due to high risk associated with the examination of the oral cavity

Life is a roller coaster ride once the patient is diagnosed with cancer, has its multitude of implications on the patient and family, physically, financially and emotionally. It spares no one, young or old. On the occasion of the World No Tobacco Day ( May 31) experts have urged people especially youth to quit tobacco and nicotine and do not allow these life-threatening habits to swipe out youthfulness. Precious lives can be saved by avoiding tobacco in all forms.

India has one-third of oral cancer cases in the world According to Globocan, oral cancer accounts for around 30% of all cancers in the country. Every year 1.19 lakh new cases are registered which indicates its severity. Over 72,000 deaths are caused by it. People who smoke or consume tobacco in any form are at higher risk for oral and lung cancers. 

One can take an active role in detecting oral cancer early, should it occur, by conducting a self-exam at least once a month and see the dentist/doctor on a regular schedule. But COVID-19 has come as a setback for early screening. 

“Screening or early detection, and time detection are the keys to combating cancers. Amid COVID-19 people, who are addicted to tobacco or smoking, are at a very high risk as the oral cancer screening under government-run National Cancer Screening Programme has been temporarily suspended due to high risk associated with the examination of the oral cavity as saliva is high in Sars-Cov- 2load that causes coronavirus disease. We can easily realize the gravity of the situation,” said Dr Surendra K Dabas, Senior Director & HOD-Surgical Oncology & Robotic Surgery, BLK Super Specialty Hospital. 

“A growth or sore in the mouth that does not go away is suspected as oral cancer. It can occur in the lips, cheeks, tongue, hard & soft palate, and pharynx (throat).  Oral cancers can be life-threatening if not diagnosed and treated early. Oral Cancer is diagnosed by clinical examination and a biopsy may be needed to determine the makeup of a suspicious-looking area and requires further radiological evaluation before treatment commences,” said Dr Ashwani Sharma, Associate Director, Surgical Oncology, BLK Super Specialty Hospital.   

“Oral cancer is treated the same way many other cancers are treated – with surgery to remove the cancerous growth, followed by radiotherapy and chemotherapy, if required, to destroy any remaining cancer cells,” Dr Dabas added.

Risk factors for the development of oral cancer include smoking, consumption of tobacco such as Gutkha and Pan masala , infections such as Human papillomavirus (HPV) among others. According to experts, the overall 5-year survival rate for patients with an early diagnosis of oral cavity and pharynx cancers is around 75-80%. If cancer has spread to nearby tissues, organs, or lymph nodes, the 5-year survival rate drops to 55-60%

To prevent oral cancer, experts strongly recommend youth to start a quit tobacco journey and avoid it in any form. Eating a well-balanced diet, limit exposure to environmental carcinogens and pollutants, and regular exercise would help a lot maintaining youthfulness. Experts also urged the youth to enhance their resolve to fail the tobacco industry’s strong strategies to attract them for the use of tobacco or smoking.

On the occasion of World No Tobacco Day, the young generation should come forward to derail the tobacco industry’s aggressive and well-resourced tactics to attract youth to tobacco and nicotine products. Youth needs to stand up against the tobacco industries’ systematic and aggressive strategies to attract a new generation of tobacco users. No Tobacco Day will provide a counter-marketing campaign and empower young people to engage in the fight against Big Tobacco.

On its part, the World Health Organisation (WHO) has urged influencers – in pop culture, on social media, in the home, or in the classroom – who reach and connect with youth to expose the industries’ manipulative tactics to create a new generation of tobacco users. There is a need to empower youth to stand up to Big Tobacco by dispelling its lies and refusing to use its products

Case Study: Saving Life of a 43-years-old Oral Cancer Patient amid COVID-19 Crisis  

Pawan(Name Changed) , a 43-years-old resident of Delhi had an ulcer on the right side of the tongue for six months, and after running from pillar to post for a cure, he finally got an oncologist and timely surgical intervention saved his life which was threatened by a tongue cancer. At BLK Super Specialty Hospital, Pawan  was diagnosed as suffering from tongue cancer. 

On further examination and radiological evaluation, he was found to have extensive disease involving the almost entire oral tongue. Surgery was the only curative option available for him which involved excision of the cancerous lesion with wide margins, draining neck nodal basin dissection along with plastic reconstructive surgery to make a new tongue in the same sitting. Surgery without reconstruction would have meant functional impairment, loss of speech and swallowing function.