Zee Media Bureau/Salome Phelamei
Smoking and other tobacco use are associated with about 75% of oral cancer cases. Cancer of the mouth and throat are also very common among paan users. In India, where such practices are very common, oral cancer represents up to 40% of all cancer cases against just 4% in the UK.
Thus, cancer of the mouth and throat are the most common cancers in Indian males, because of the high incidence of smoking and chewing tobacco and the widespread use of pan masala.
Cancer of the mouth usually presents as an ulcer on the cheek, gums or tongue and any blister/ulcer in these areas persisting for more than three weeks should see a doctor.
The symptoms of throat cancer are a foreign body sensation in the throat, change in voice, painful swallowing persisting for three weeks. Both mouth and throat cancer may also manifest simply as a lump in the throat.
Radiotherapy is the treatment of cancers using X rays or other forms of electromagnetic rays that have the ability to destroy tissue by damaging the DNA of cells.
Radiotherapy is an integral part of the treatment of head and neck cancer, having the ability to destroy cancer in this site, thus curing cancer of the mouth and throat. The probability of cure is excellent, with more than 90% early vocal cord cancer patients getting cured and up to 70% stage III and IV patients getting cured.
Modern radiation techniques have led to a dramatic improvement in the quality of life of cancer patients undergoing radiotherapy. A technique called Intensity Modulated Radiotherapy (IMRT), in use for a little more than a decade, has resulted in this dramatic change. This technique allows the radiation oncologist to target the cancer accurately and yet reduce the radiation dose to normal structures adjacent to the cancer.
Patients treated for head and neck cancer without using IMRT have to change their diet to a liquid or porridge like diet often, also losing the ability to taste food forever. They also develop a permanently dry wood like mouth, being troubled by oral blisters and bad teeth.
Dr. Sapna Nangia, Cancer specialist at the Indraprastha Apollo Hospital, New Delhi, who has been working in the field of IMRT in mouth and throat cancer for more than a decade and has vast experience in this field, says that in contrast, patients treated with IMRT quickly regain normal taste and salivary function and have a good quality of life. They are also less likely to have dental problems following radiotherapy. Since dose to all normal structures is reduced with this treatment, there are fewer blisters during treatment, and less chance of scarring or damage to the jaw bone.
Dr. Nangia feels strongly that in the interest of patients suffering from mouth and throat cancer, radiotherapy, whether being used alone or in combination with surgery or chemotherapy, should always be in the form of Intensity Modulated Radiotherapy.
She feels that primary physicians, dental surgeon and ENT surgeons, who are often the people who first diagnose cancer of the mouth and throat, need to be aware of this advanced form of radiotherapy, so that they can guide their patients correctly.
The general public, too, should be aware of the latest advances in the field of cancer treatment, a field in which rapid advances are taking place and which are available in India at the same time as they are in the western hemisphere.
