Quiting tobacco products & early diagnosis critical for controlling Head & Neck Cancer cases in India

About Author: Dr. Vineet Kaul, Associate Consultant, The Oncology Centre, CK Birla Hospital Gurugram. Dr Vineet Kaul is a versatile and experienced Head and Neck Surgical Oncologist. Having completed his fellowship training at IFHNOS-MSKCC, New York, he later completed his clinical observership at the prestigious head and neck DMG, Tata Memorial Centre, Mumbai. Dr Vineet has numerous publications in national and international journals to his credit. He is a life member of the Foundation for Head and Neck Oncology, India and the Association of Otolaryngologists of India.

The numbers presented by the national cancer registry based on the ICMR study in the Indian parliament in January this year projected a bleak picture of the country’s contribution to cancer cases, which is expected to add 15.69 lakh new cancer patients by 2025.

Among some of the most common cancers in the Indian population, besides lung cancer, prostate cancer, stomach cancer, breast cancer, and cervical cancer, head and neck cancer numbers are often undermined. Going by the multiple studies conducted by some of the most prestigious research institutes in India, the country roughly adds 1,40,000 new head and neck cancer patients every year.

The alarming trend creates an urgent need to advance the prevention, detection, treatment, and rehabilitation processes of head and neck cancer through public awareness, research and advocacy and propagating stories of survivorship.

A reality check

World Head and Neck Cancer Day is observed on July 27 every year. It’s an opportunity to assess and improve the collective efforts made by the medical fraternity, policy makers, public health experts and other stakeholders.

As per the data of national communicable disease monitoring survey report 2017-18, India has 32.8% population which is a regular tobacco smoke/smokeless user, and the trend is increasing. As a result, India’s global contribution of Head and Neck Cancer patients is around 57 %.

The reports suggest that the number is expected to double by 2030. The use of alcohol and tobacco in any form are the most prominent risk factors for head and neck cancer, especially the cancer of the oral cavity, oropharynx, hypopharynx, and larynx.

The studies and the years of diagnosis have proven that at least 75% of the head and neck cancers have tobacco at the root cause. The general trend has shown that most of these cancer cases reach us in the advanced stages. While it is important for the government to curb the sale of tobacco, the users also share the responsibility of trying to quit the habit and examine themselves regularly.

We always recommended the tobacco users to self-examine their oral cavity regularly in the mirror as it could help in the early diagnosis or prevention of these cancers.

Some of the most alarming signs that a tobacco user must never overlook are non-healing ulcers in the mouth, sore throat, persistent pain, difficulty in swallowing, and a change in the voice.

However, in some conditions, the symptoms could also be caused by other, non-cancerous conditions; hence, it is important to get them checked with the doctors.

Other than self-examination and early diagnosis, the course of treatment is determined by various factors, including the specific location of the tumour, the stage of the cancer, the patient’s age, and other risk factors.

Among the treatment options for head and neck cancer, depending on the condition of the patient, there are options like surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of treatments. Surgery has remained the mainstay treatment option for most head and neck cancers, followed by other treatment methods.

Road ahead

Regular follow-up is very important after cancer treatment to make sure that it has not relapsed or that a second primary cancer has not developed. Apart from the doctors, support from the family expedites the recovery journey. The patients who come to us in the initial stage have a survival rate of 90–100%, but in the advanced stages, the rate of survival is reduced to half.

*The views expressed by the author are his own.