Cancer

Oral Cancer: What you must know a #CancerAwareness

By Dr.Amrita Basu(MBBS,MS) on February 4, 2020 1

Oral cancer or mouth cancer has a very high incidence in India.

Key Highlights about Oral Cancer:

Prevention for oral cancer is possible
Gutkha and tobacco chewing are harmful to your body and can cause many cancers. This information needs to reach the masses.
Early diagnosis and effective treatment are possible with oral cancer.
Punitive damages for selling and producing addictive substances should be seriously considered if we want to lower the deaths and suffering due to oral cancer.
Awareness is crucial.

Did you know India has a large percentage of oral cancer sufferers?

Risk factors for Oral cavity malignancy

Smoking: The incidence of oral cancer occurs six times more often in smokers than in nonsmokers.

Smoking and alcohol consumption account for risk factors in more than 70% of those affected.

Tobacco chewing: Did you know tobacco chewing and the use of tobacco-related products have a strong correlation to oral cancer?

Betel leaf, supari, powdered tobacco, and lime are often a favorite for many. They keep this quid in the vestibule of the mouth and often cancer develops at that site.

Did you know more than 30% of cancer affected in India have oral cancer

Did you know children as young as 10 starts using tobacco called gul in the small towns and villages? Before I worked in small-town India, I didn’t realize the extent of the problem. But now it’s shocking what can occur. Both economically well to do and economically backward males and females in small towns and villages are fond of these addictions.

Smokeless tobacco

Alcohol: Did you know cancers of the aerodigestive tract , that is the airways and food pipe occurs six times more commonly in association with alcohol addiction?

Human papillomavirus 16 is also associated with this cancer.

Dental caries, alcohol mouthwashes, hot spicy food, leukoplakia, avitaminosis, malnutrition, syphilis, cirrhosis, Plummer Vinson syndrome, lichen planus, chronic hyperplastic candidiasis, Human immunodeficiency syndrome, xeroderma pigmentosa.Dyskeratosis congenita .

Submucosal fibrosis, ulcers, malignancies and burning sensation of tongue and mouth which is so bad, that even sweet food gives a tingling sensation. It is a spectrum that is hard to miss with these addictions.

On this Cancer awareness day, I want to let you know ., that it’s not okay to try it even once.

The younger you start abusing tobacco paste and tobacco products, the stronger and higher is the damage to your body.

Which are the definitive premalignant lesions causing mouth cancer?

Leukoplakia(white patch) & erythroplakia (red patch )are the definitive premalignant lesions causing mouth cancer.

Melanosis/Mucosal hyperpigmentation: While one-fourth of mucosal melanoma may present like benign melanosis, the exact incidence of melanosis turning malignant is not documented.

HPV infection may cause oral or oropharyngeal cancer if a person engages in oral sex.

What is oral cancer?

Oral or mouth cancer is malignancy affecting lip, commissures, the floor of the mouth, cheek lining, gingiva, alveolus, soft palate hard palate, the tongue, retromolar region.

Symptoms & early signs of mouth cancer you should watch out for!

This cancer can appear anywhere inside your mouth and is a part of the head -neck malignancy spectrum. The symptoms to watch out for include most ulcers, nodules, discoloration not healing after two weeks.

Ulcer or nodule not healing even after two weeks. Swelling, thickened patches, reddish areas, whitish areas, raw areas, eroded patches on the lips gums and anywhere else in the mouth.

Pain may or may not be present.

Bleeding areas may or may not be present.

Difficulty opening mouth or moving tongue.

The feeling of something stuck in the throat.

Ill-fitting dentures, dentures falling off repeatedly when they used to fit before.

Neck lump on one or both sides may be the presenting feature in advanced cases.

Significant weight loss: More than five percent weight loss from previous body weight over the last three months

The good news is early diagnosis is possible since it’s a visible part of the body most of the time.

The bad news is it can spread rapidly and if its too big surgical excision is often disfiguring and needs extensive reconstruction.

Where to get Treated?

Most of the Government Medical colleges in India provide cancer surgery, radiotherapy, and chemotherapy at free or fraction of costs of private hospitals. You have to remember the surgery requires considerable expertise and a long follow up period. Radiotherapy and chemotherapy are expensive but often needed for comprehensive treatment
In West Bengal among the private players Tata Medical centre and Apollo Hospital provide comprehensive Cancer treatment.

What country has the highest rate of oral cancer?

Papua New Guinea had the highest rate of cancer of the lip and oral cavity in 2018, followed by Pakistan.

India is third in position.

What is the most common type of oral cancer?

Lip cancer, the most common form of oral cancer, affects mostly men.

Two main types of oral cancer

Squamous cell cancer 85-90%[1]
Basal cell cancer

More Resources:

The truth about Mouth Cancer treatment FAQ(part2)

World Cancer Day 2022 Theme: Where India Stands #WorldCancerDay
Cancer prevention:Living life meaningfully
Cancer prevention diet
Ovarian cancer
Oral cancer
Tongue Cancer
Difficulty Swallowing in Cancer
Throat Cancer
Truth about mouth cancer
Head Neck Cancer treatment in India
Life after Radiotherapy
Truth about Chewing tobacco
Say no to tobacco
Air pollution a noncontrollable risk factor for NCD
Apollo Hospital Proton Therapy
How is the Health of the Nation

VITAMIN D Deficiency:Is it a Myth?

By Dr.Amrita Basu(MBBS,MS) on February 11, 2019 56

The Vitamin D deficiency: What could be the story?

Many of my busy cousins in their thirties are having a variety of old age problems.

Hypertension, diabetes, deranged lipid profile, nothing seems to be left.But is chronic stress the only culprit? While reading the many research papers, I found a surprising answer.

Lifestyle and your diet really do decide your health. Vitamin D is suspected to have a role. Vitamin D is the miracle vitamin which has a range of goodness. This sunshine vitamin can bring the sunshine into your life.

Not only physical health but your mental health is also influenced by Vitamin D.

Shocked ?I was too.Do you know anybody with hypertension?

Anybody with diabetes?What about somebody who is having a weight issue.

You must be knowing someone who has depression. It’s another chronic problem of our times.

They might need to check their vitamin D level in blood.Do you have Vitamin D deficiency?

Have you ever tested for your blood level of Vitamin D?

Are you overweight?All over theworld, in both developed and developing nations VitaminD deficiency is a highly researched topic.Undernutrition and deficiencies of micronutrient is not surprising.What is surprising is that Vitamin D deficiency is present even in overweight, obese people.This has created the shocking nutritional state known as ‘Malnutrition of Obesity”.

The USA , as well as worldwide Vitamin D, ppears to be a micronutrient which is largely deficient in most.

Who is at risk of Vitamin D deficiency?

50% of world population.Yes the rate is that high.

1 billion people worldwide suspected to be suffering.

There’s a pandemic of vitamin D deficiency worldwide.

The cause is suspected to be environmental pollution, that’s preventing synthesis of Vitamin D by your skin.
Dietary deficiency
Sunscreen(with SPF more than 30) use is another reason which decreases vitamin.
Obesity decreases vitamin D .Decreased Vitamin D makes it difficult for you to lose weight.Vicious cycle.

Source of Vitamin D

Vitamin D is a very special fat soluble hormone. You can synthesize this vitamin in your skin.

Most oil-rich fish such as salmon, mackerel, and herring contain vitamin D.95% of vitamin D can be synthesized by exposure of the skin to sunlight(UVB). Ideally between 10.00 hours and 15.00 hours in the spring, summer, and fall.Sunscreen(with SPF more than 30) use is another reason which decreases vitamin

Population at risk

- Children
- Young and middle-aged adults
- Breast fed infants (If mother is deficient baby will be deficient.
- People of Australia, India, Middle East, Africa, and South America.
Darker the skin, more is the melanin, less is the Vitamin D production in the skin

What the right level of Vitamin D?

VITAMIN D Normal :30ng/ml

Vitamin D insufficiency: 25(OH)D of 21–29 ng/mL

How can Vitamin D protect you?

Protects your heart

Maintains the health of your heart and blood vessels.

Bones and Muscles

Keeps your bones strong
Keeps your muscles strong
Protects against fall related injuries
Prevents fatigue

Cancer protective

Protects against cancer. Most significantly colorectal cancer.
Maybe protecting against breast cancer too

Obesity

Auto immune disease and immunity

Less risk of type 2 Diabetes.
Vitamin D protects against autoimmune diseases(multiple sclerosis,Type 1 diabetes, rheumatoid arthritis, and autoimmune thyroid disease.)
It also has a role in protection against influenza during winter

Mental health

Vitamin D helps prevent cognitive problems associated with aging.
It helps in depression by preventing relapse.
Helps in decreasing the dose of medicines in depression.
Helps in weaning off medicines

How much can Vitamin D be given?

After measuring your serum Vitamin D level the right dose can be calculated.

The Mega dose may need to be given to get the deficiency corrected.

Takeaway:

Measure your vitamin D level.

Have a diet rich in Vitamin D.

Don’t forget to start vitamin D supplement if you are deficient.

Design your own healthy lifestyle. Be strong live healthy.

What’s your Vitamin D status? Have you ever tested? Let me know in the comments below.

Disclaimer :

This article is meant to spread awareness about health. It is not a substitute for a professional medical consultation. Read my full disclaimer.

Updated Feb2018

Throat Cancer : 8 Things you should know (Bonus Download)

By Dr.Amrita Basu(MBBS,MS) on January 11, 2019 7

Rakesh Roshan, Hrithik Roshan’s father, underwent surgery for throat cancer.Hrithik Roshan shared on Social Media, that his father was suffering from squamous cell carcinoma involving his throat. It’s important to appreciate that Hrithik Roshan has shared not only about his father’s disease but also that he has undergone surgery and doing well. Celebrities help by sharing their stories and our work is to help them share.

And he’s up and about😊
Power of love!
Thank you all for being with him and helping him power through.
Today was a great day. pic.twitter.com/p4DPNokTgO
— Hrithik Roshan (@iHrithik) January 10, 2019

What should you know about throat cancer or Laryngeal malignancy

Symptoms of Laryngeal Cancer.

Signs of Laryngeal Cancer.

What investigations your doctor may suggest?.

Modalities of Treatment available for Laryngeal Malignancy.

What are the factors affecting Treatment choice?.

Types of Malignancy of Larynx according to pathology.

What is the incidence of Laryngeal Malignancy in India.

Some demographic factors.

Symptoms of Laryngeal Cancer

Initial complaints may vary from hoarseness, that is mild to severe change of your voice
The onset, duration, progression and whether it improves with voice rest is seen.
In case of cancer starting in the vocal cord, this is the first symptom.
Noisy breathing, shortness of breath difficult breathing may occur with the change of position at rest or with increases activity.
In some cases of laryngeal cancer like subglottic cancer, the first sign may be stridor or noisy breathing
Foreign body sensation of the throat or something stuck in the throat is a common complaint of supraglottic or subglottic cancer.
Difficulty swallowing or dysphagia is a rare symptom of laryngeal cancer and is seen to involve the food pipe often.
Odynophagia
Haemoptysis
Hot potato voice
An associated symptom of referred earache can happen with laryngeal malignancy.
A cough during eating may be a warning sign of nerve palsy causing aspiration into lungs

Throat cancer signs

Signs of Laryngeal Cancer

There may be a swelling in the neck as the first warning which is seen from outside. There may be a mass or ulcer involving the different parts of the vocal cord and voice box. This mass may also spread to the food pipe. The extent of disease determines symptoms, signs, treatment, and prognosis.

The laryngeal examination will show the growth and extension to some extent.

What investigations your doctor may suggest?

Fibreoptic laryngoscopy
Upper GI endoscopy
Contrast-enhanced computerized tomography from the base of skull till die from direct laryngoscopy and biopsy after the CECT reports are available
Fine fine Needle Aspiration Cytology from the from the neck swelling for assessment
Blood work up

Modalities of Treatment available for Laryngeal/Throat Malignancy

Radiotherapy
Laser surgery
Cold surgery with or without post-op Radiotherapy
Chemotherapy
Rehabilitation
Palliation

What are the factors affecting Treatment choice of throat cancer?

Age
General health and lung function
Treatment preference by the patient
Ability to follow up Very important
Distance from the treatment facility
Any previous treatment
Stage of tumor of the larynx and involvement of surrounding structures.
Status of neck node
The site of the laryngeal tumor

If the patient has noisy breathing or stridor, then a preoperative tracheostomy will be needed for stabilizing the person’s respiration

Types of Malignancy of Larynx according to pathology

Squamous cell cancer 85%
Carcinoma in situ
Verrucous
Undifferentiated
Adenocarcinoma
Sarcoma
Others

What is the incidence of Laryngeal Malignancy in India

More than 10 per 100,000.

Some demographic factors

Urban more than rural Male more than female
Risk factors for Laryngeal Malignancy are
Geography
Smoking (Images on cigarette packs should give you an idea about the nature of disease)
Alcoholism (Together smoking and alcoholism is has a stronger effect than either alone)
Radiation exposure
Exposure to Asbestos and formaldehyde
Family history
Infection of HPV 16

While any malignancy is a challenge, laryngeal malignancy if diagnosed on time, has a good prognosis. You should never give up and get help as soon as possible.

Most Government Hospitals in big cities have facilities for all modes of treatment and medical colleges are centers of excellence. When in doubt you can always go for a second or third opinion but never delay treatment. Every second count. The important thing to remember is while genetics cannot be controlled, you can control risk factors like smoking and alcoholism. May the almighty help Rakesh Roshan and his family while they go through this difficult time.

Disclaimer: This is meant for spreading awareness and not be taken as medical advice. Kindly consult a qualified doctor for consultation. We update articles regularly, but since medical science is fast evolving, the author and the website disclaims all claims of completeness of this article.

References:

Stell & Maran
Scott Brown

Cancer

Key Highlights about Oral Cancer:

Risk factors for Oral cavity malignancy

Which are the definitive premalignant lesions causing mouth cancer?

What is oral cancer?

Symptoms & early signs of mouth cancer you should watch out for!

Where to get Treated?

What country has the highest rate of oral cancer?

What is the most common type of oral cancer?

More Resources:

Featured post

References:

Sharing is good Karma!

The Vitamin D deficiency: What could be the story?

Who is at risk of Vitamin D deficiency?

Source of Vitamin D

Population at risk

What the right level of Vitamin D?

How can Vitamin D protect you?

Protects your heart

Bones and Muscles

Cancer protective

Obesity

Auto immune disease and immunity

Mental health

How much can Vitamin D be given?

Takeaway:

Sharing is good Karma!

What should you know about throat cancer or Laryngeal malignancy

Symptoms of Laryngeal Cancer

Signs of Laryngeal Cancer

What investigations your doctor may suggest?

Modalities of Treatment available for Laryngeal/Throat Malignancy

What are the factors affecting Treatment choice of throat cancer?

Types of Malignancy of Larynx according to pathology

What is the incidence of Laryngeal Malignancy in India

Some demographic factors

Featured post

Sharing is good Karma!

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