Head and neck cancer, which is highly prevalent in India, is the second most common cancer in men and the third most common in women.
These include a variety of cancers that occur in the mouth, neck, throat, nose, sinuses, ears, larynx, salivary glands, thyroid, and skin.
Symptoms vary depending on the location: oral cancer often presents as a painful ulcer that doesn't heal within 2-3 weeks, while laryngeal cancer usually causes a change in the voice.
Common symptoms include mouth sores that do not heal, teeth that loosen spontaneously, pain when swallowing, changes in voice, difficulty swallowing food, difficulty breathing, a lump in the neck, and bleeding from the nose or mouth.
Doctors from Amrita Hospital, Faridabad, found that the incidence of cancer in India varies from region to region due to local practices and exposure to carcinogens.
Oral cancer is more prevalent in Uttar Pradesh, Bihar, Gujarat and Maharashtra due to high rates of smoking. Pharyngeal cancer is most prevalent in the northeastern states.
In rural Andhra Pradesh, a unique smoking technique known as reverse smoking has been linked to a rise in the incidence of palate cancer.
These regional differences highlight the impact of lifestyle and environmental factors on cancer incidence rates across the country.
Risk factors include alcohol use, HPV (human papillomavirus) infection, chronic irritation from sharp teeth, and ill-fitting dentures.
According to Dr Harshveer Singh Malhi, Medical Head, Oncology, Merck Healthcare, these factors are insignificant compared to the main impact of tobacco products in our country.
This includes both smoked and smokeless tobacco. Examples of smokeless tobacco include bread, Zarda, Gutka, Kara, Mawa, and Kainni It contains a dry mixture of areca nut flakes, lime and tobacco powder.
“Since 90 per cent of head and neck cancers are lifestyle related, limiting exposure to these causes can go a long way in preventing these cancers. Cancer is curable if detected early. The importance of early diagnosis and appropriate treatment cannot be overemphasized. It is probably the most important factor that determines the outcome,” said Dr Subramanian Iyer, head and neck cancer specialist, Amrita Hospital, Faridabad.
Recent estimates suggest that India will experience 2.1 million new cases of cancer by 2040, with head and neck cancer accounting for 30% of all cancer-related cases.
Early diagnosis not only significantly increases cure rates but also significantly reduces the side effects and toxicity of cancer treatment.
For example, in the case of oral cancer, the success rate of cure is 70-80 percent in early stages (stages 1 and 2), but drops to 40-50 percent in stages 3 and 4, Dr. Iyer said.
“The rising number of cases will put strain on healthcare resources like diagnostic facilities, treatment centres and healthcare workers. The emotional and financial burden on patients and their families will also be considerable,” said Dr Sanjay Deshmukh, head of surgical oncology at Ruby Hall Clinic, Pune.
Dr Rishab Kumar, senior consultant, Radiation Oncology Department, Amrita Hospital, Faridabad, said cancer treatments include surgery, radiotherapy and chemotherapy and are selected based on the type of cancer, its stage and the patient's health condition.
Advanced technologies such as robotic surgery, IMRT, IGRT, proton therapy, and new drugs (immunotherapy, targeted therapy) have greatly improved precision and significantly reduced side effects over the past decade.
On the occasion of World Head and Neck Cancer Day, Dr Deshmukh said a multifaceted approach is essential to effectively combat the rising incidence of head and neck cancer.
- It is important to educate the public about the risks associated with tobacco and alcohol use, and the benefits of HPV vaccination.
- Promoting smoking cessation programs, encouraging alcohol moderation, and promoting diets rich in fruits and vegetables can reduce the risk of cancer.
- Regular screening and check-ups facilitate earlier diagnosis, leading to more effective treatment. Improved access to dental care and regular check-ups are key components of an early detection strategy.
- Expanding HPV vaccination programs, especially among adolescents, can help prevent HPV-related cancers.
- Implementing policies to regulate tobacco and alcohol use and controlling occupational exposure to hazardous substances can play an important role in reducing cancer incidence.
