Friday, May 03, 2013

"Make a difference in the world of cancers" - specifically "head and neck cancers"


April was Oral Cancer Awareness month and awareness among the public is low. I hope to raise awareness in order to save lives in my blog. This was further strengthened by three patients who were misdiagnosed and luckily came to me at the right time. Patient1 was diagnosed as simple ulcer!!!! When in realty he had cancer, patient two came to me stating that he has a big ulcer in the tongue when in realty again it was cancer. The ultimate was patient 3 who was diagnosed as having a fungal disease and was being treated for the same when in realty he had cancer of palate!!! He is currently undergoing treatment.

Together, we have the opportunity to make a difference in the world of cancers specifically head and neck cancers.

Cancers of the head and neck are the most common malignancies seen in the country.  Every year about 20% of all cancer deaths in India are due to head and neck cancer which are primarily caused by tobacco consumption. While smoking is still a major risk factor, the fastest growing segments of oral cancer patients are young, healthy, non-smoking individuals due to the usage of tobacco in its various forms.

In India it is estimated that there are 7 lakh new cases coming every year and most present in advanced and incurable stage at the time of diagnosis. More of the patients are between the ages of 35 and 65 years.

"Despite improvements in diagnosis and local management the death rate associated with this cancer is particularly high not because it is hard to discover or diagnose, but due to the cancer being routinely discovered late in its development. It is much higher than that of cancers which we hear about routinely such as cervical cancer, breast cancer or skin cancer.
One of the real dangers of this cancer is that in its early stages, it can go unnoticed. It can be painless and by the time the cancer is discovered it would have spread to other areas namely the lymph nodes in the neck and invade deep into local structures.

Fortunately, most head and neck cancers produce early symptoms and ENT surgeons and Dentists can, in many cases see or feel the precursor tissue changes or the actual cancer while it is still very small, or in its earliest stages.


What you should do: You should know the potential warning signs. All of the symptoms and signs described here can occur with no cancer present. In fact, many times complaints of this type are due to some other condition. But you can’t tell without an examination. So if they do occur, see your doctor to be sure.

Remember—when found early, most cancers in the head and neck can be cured with few side effects. Cure rates for these cancers could be greatly improved if people would seek medical advice as soon as possible and practice health habits which help prevent these diseases. Remember—successful treatment of head and neck cancer depends on early detection. Knowing and recognizing its signs can save your life.

Symptoms of head and neck cancer

A lump in the neck. Cancers that begin in the head or neck usually spread to lymph nodes in the neck before they spread elsewhere. Not all lumps are cancer. But a lump (or lumps) in the neck that lasts more than two weeks should be seen by a specialist as soon as possible.
Change in the voice. Most cancers in the region of the voice box cause some change in voice. If you are hoarse or notice voice changes for more than two weeks, see your doctor.

A growth in the mouth. Most cancers of the mouth or tongue cause a sore or swelling that may be painless. If an ulcer or swelling is accompanied by lumps in the neck, you should be concerned. It may also appear as a white or red patch of tissue in the mouth, or a small indurated ulcer which looks like a common canker sore. Because there are so many benign tissue changes that occur normally in your mouth, and some things as simple as a bite on the inside of your cheek may mimic the look of a dangerous tissue change, it is important to have any sore or discolored area of your mouth, which does not heal within 14 days, looked at
Bringing up blood. If blood appears in your saliva or phlegm for more than a few days, you should see your physician.

Swallowing problems. Cancer of the throat or esophagus (swallowing tube) may make swallowing solid foods—and sometimes liquids—difficult. The food may “stick” at a certain point or come back up. If you have trouble almost every time you try to swallow something, you should be examined by a physician. Usually a barium swallow x-ray or a CT scan or an endoscopy will be performed to find the cause.

Changes in the skin. The most common head and neck cancer is basal cell cancer of the skin. Basal cell cancers appear most often on sun-exposed areas like the forehead, face, and ears, but can occur almost anywhere on the skin. Parts of the ulcer may heal, but the major portion remains ulcerated. Some basal cell cancers show color changes. Most squamous cell cancers occur on the lower lip and ear. They may look like basal cell cancers, and if caught early and properly treated, usually are not dangerous. However, any mole that changes size, color, or begins to bleed may mean trouble.

Persistent earache. Constant single sided ear pain lasting for more than 2 weeks can be a sign growth in the throat.


If your dentist or doctor decides that an area is suspicious, the only way to know for sure if it is something dangerous, is to do a biopsy of the area. This is not painful, is inexpensive, and takes little time. It is important to have a firm diagnosis as early as possible.