I would like to quote an article of "greater kashmir" health page regarding oral cancer published yesterday on 21st June 2017.
Dr. Owais Gowhar:
"Notwithstanding tremendous advancement in scientific/medical research in present day world, cancer stares in our eyes as one of the most predominant causes of morbidity and mortality, thus are we confronted with it as a formidable challenge in our endeavor to ushering in a disease-free era, wholesomely.
It is estimated that around 43% of cancer deaths are due to tobacco use, unhealthy diets, alcohol consumption, stress, inactive/injurious lifestyles and infection at large. Oral cancer takes bigger chunk of the global burden of cancer. Tobacco and alcohol stand as the major risk factors for oral cancer. Studies bear testimony to the fact that heavy intake of alcoholic beverages is associated with nutrient deficiency, which appears to majorly contribute to oral carcinogenesis. Oral cancer is preventable through risk factors intervention. Prevention of HIV infection will also reduce the incidence of HIV/AIDS-related cancers such as Kaposi sarcoma and lymphoma.
Oral, or mouth cancer most commonly involves the tongue. It may also occur on the floor of the mouth, cheek lining, gingiva (gums), lips, palate (roof of the mouth), maxilla or mandible.
The precancerous conditions (Oral submucous fibrosis, Oral lichen planus) and the precancerous lesions (Leukoplakia,Erythroplakia, Palatal changes amongst reverse smokers) provide an opportunity for early detection and thus help prevent the malignant changes that may occur in them and thus end up in oral cancer. If diagnosed in the early phase, stopping the tobacco habit can reverse the condition. Thus, if appropriate measures for early detection with good public education are carried out, nipping the nuisance in the bud would be possible to a great extent.
Despite the fact that oral cancer and its consequences can be totally prevented, treated and controlled, there exists a significant dearth and complacence in the public's knowledge, attitudes and behaviors. Various preventive measures that can drastically reduce the oral cancer burden, contribute to minimising the effective gap between research/development and the public awareness.
It is indispensably required that we get knowledge disseminated in a way that will help people adopt desired behavior patterns, which in turn will improve their health and of those associated with them, and also help them make appropriate decisions. A strong and sound system of communication, which utilizes all the measures and methods for timely knowledge and information sharing, needs to be set-up throughout the populace, and more focally in the far- fetched /out-of-reach areas where it is most needed due to prevalent ignorance and lack of awareness. Communication efforts have to be so planned as to ensure that target audiences, which include health care providers, consumers, the research community, and other groups such as educators, policymakers, industry, and the media; all become informed, change behavior, and make decisions that will improve clinical care and health outcomes to meet the set goals.
The community intervention should mainly focus on protecting youth from tobacco, maintaining smoke free public places and promoting health literacy on tobacco related issues. Imparting health education through mass media, schools and community based education programs is most imperative step to increase the knowledge and awareness about the harmful effects of tobacco among the masses.
Also there needs to be strict legislation against smoking, by the Central as well as the state governments so that those who do not abide by the law incur heavy punishment. Smoking advertisements should be banned fully and strong anti-smoking campaigns should be launched. More awareness needs to be created amongst the public about smoking hazards and it should be strictly forbidden in all public places with the stricture that those found guilty of disobeying the law are fined.
Above all, the dental professionals should practice opportunistic oral cancer screening which is of great significance. Opportunistic screening is less systematic but very much cost-effective than population screening. If an opportunistic screening strategy is to be successful, all dentists should carry out the necessary soft tissue examination alongside hard tissue examinations. Screening for oral cancer and pre cancer should become a part of the routine examination and every dental surgeon must be aware of the most rapid and adequate referral pathway for the effective management of these lesions.
Oral health professionals can work at three levels for prevention of oral cancers; Primary, Secondary and tertiary level of Prevention. Primary prevention aims to change behaviors known to be related with oral cancer. Dental practices with staff trained to advise proactively against tobacco, alcohol and other substance abuse could make a real impact on oral cancer incidence. At Secondary level; oral health professionals need to identify the malignant or potentially malignant lesions at early stages through screening. The earlier lesions are found, the greater the chance of recovery and a better quality of life and function. In Tertiary prevention, dentists need to work as part of an oral cancer management team to prevent recurrence and further primary cancers in patients already treated for oral cancer.
In a nutshell, the goal of oral cancer prevention can be achieved only if all the individuals in the society be it the oral health professionals, general health professionals, patients, government (State/central), policy makers; all recognize their roles and participate in the oral health promotion strategies at individual as well as community levels to reduce this lethal disease burden."
