My limited experience working as a house officer in Dow University Hospital has given me enough chances to witness patients with oral cancer. They are easy to identify among the hordes of patients visiting the Government funded dental hospital. An outgrowth on one side of the face, mouth completely locked, not even able to talk and fragile, thin body. The reason behind their condition if asked, is something that they do know already, Oral cancer.
Current situation in Pakistan: According to the World Health Organisation, there are more than 640,000 cases of mouth cancer diagnosed each year worldwide and it is the eleventh most common cancer. World Cancer Research Fund International stated that Pakistan stood first in the prevalence of oral cancer among the South Asian countries. The city of Karachi itself, stands at an alarming rate of 30%.
The reasons of oral cancer are many. The sole cause in Pakistan is the use of manpuri, gutka, paan and naswar consumption. It is more like a habit of putting these carcinogenic agents in mouth cavity or at times sleeping with them and sucking on its liquid.
Why oral cancer is increasing in country? In third world country like Pakistan, the availability of basic health care is a farfetched dream. In such hopeless conditions, dental health care seems to be not on priority for many people in the country. The carcinogenic products are generally consumed by low income working class, who are already struggling to make both their ends meet. Most people have to go to quacks, who most of the time worsens patients’ dental health conditions. The chemicals released from these agents cause loss of appetite leading to malnutrition, a sense of elation and euphoria, and causing addiction.
Lack of awareness: With the general awareness of cancer, many people still don’t know much about oral cancer. Most of the time, patients don’t identify the initial symptoms of cancer. Instead of going to the doctor with the persistence of symptoms for 3 weeks, patients generally ignored. Though, it is verified by health experts that the early diagnosis of the disease can improve the survival rate. But the lack of awareness regarding the disease, worsens the situation of patient.
Fighting oral cancer: The fight against cancer, one must have strong will and determined. The effect of cancer doesn’t limited to just one’s self. The setbacks of cancer is equally felt by people related to the cancer patient. The expensive treatment available for cancer, is another debate. Hence the addiction of carcinogenic products doesn’t only limit to physical disable person, but also affect on financial and emotional level.
The warning notes printed on cigarette packets are not seen on other causative products of cancer like paan, betel nuts. Though such warning notes hardly make an impact to the consumers to give up their habits. Conducting a crackdown and coming up with more strong policies by Government might help people in this regard.
Ironically, more than 90 per cent of cases are preventable as the main causative factors are manpuri, gutka, and paan chewing. But in Pakistan, there are far more assistances available for smokers or drug addicts as compared to betel nut chewers. Currently there is not a single rehabilitation center working on addiction of betel nuts etc. Users of both substances show similar patterns of dependence but lack plans of how and when to quit.
Oral cancer, a war against time: It is expected that this burden will increase in the times to come due to growth and aging of the population, and because of adopting such behaviours and lifestyle factors which leads to cancer. Dental healthcare professionals and the non-profit organizations can jointly make this possible.
-written by Dr Muattar Hanif