Oral Cancer — a Global Challenge

Oral cancer, a daunting ailment that affects the lining of the lips, mouth, or upper throat, often begins subtly. It might start as a painless white patch in the mouth, gradually thickening, developing red patches, and eventually evolving into a persistent, unhealing ulcer. This stealthy progression makes early detection difficult, but this challenge doesn't have to equate to a death sentence.

In the battle against oral cancer, late detection is a recurring theme healthcare professional have encountered in their interactions with patients. This common narrative is regrettable and calls for a change.

The knowledge of early diagnosis of Oral Cancer has the potential to dismantle healthcare barriers is phenomenal, facilitating screening to extend even to the world's remotest corners. Armed with this knowledge, we gain the ability to detect oral cancer at its nascent stages, significantly amplifying the chances of successful treatment and saving precious lives.

As we teeter on the edge of this technological revolution in oral healthcare, let's keep our objective clear – our mission isn't just to combat oral cancer but to prevent it. This journey of prevention starts with early detection. Let's seize the potential of knowledge of oral premalignant disorders and, united, alter the course in the battle against oral cancer.

What are oral premalignant disorders? Oral Cancers do not arise de novo. They are preceded by changes in the lining of the oral cavity (known as oral mucosa). These alterations in the oral mucosa are known as oral premalignant disorders. In the simplest terms oral premalignant disorders are described as:

[1] White Lesions: (leukoplakia)

[2] Red Lesions (Erythroplakia)

[3] Red and white mixed lesions (Erythro-leukoplakia)

[4] Fibrotic Condition (Oral Submucous Fibrosis)

The causative factors responsible for the development of these oral premalignant disorders are tobacco (Both, smoked and smokeless tobacco), Areca Nut (Supari), Alcohol and Virus infections (HPV).

Regarding the subject of oral premalignant disorders and oral cancer, the healthcare professionals, and the challenges they face in educating and directing patients with positive oral cancer test results. It is crucial for them to have the knowledge and confidence to guide their patients effectively.

An ideal roadmap for a patient in this situation, with no visual symptoms or lesions and no risk factors, it would be important to focus on early detection and prevention. Regular follow-ups and monitoring, along with educating the patient about potential risk factors and lifestyle modifications that can reduce the chances of developing oral cancer are recommended. This roadmap could also include referrals to specialists for further evaluation and treatment if necessary.

Oral cancer constitutes one-third of head and neck cancers in the U.S. and half of worldwide cases. The unseen threat of Oral Cancer is on the rise.

1] Worldwide, an estimated 476,125 people were diagnosed with oral cancer in 2020

2] It will cause over 9,750 deaths, killing roughly 1 person per hour, 24 hours per day.

3] UK Cancer registry data demonstrate that the majority of Head and Neck Cancers are diagnosed at an advanced stage, with 58.5% at stage III or IV.

4] In USA, 54,000 Americans were diagnosed with oral / oropharyngeal cancer in the year 2020.

5] and tobacco killed 500,000 Americans in the year 2020.

6] Incidence of Oral Cancer in India was 143, 759 in the year 2022, and 79,979 people died because of oral cancer.

The need for early diagnosis of oral precancerous diseases, including Oral Submucous Fibrosis, cannot be overemphasized. Time and again, it is proved that early diagnosis of precancerous and cancerous lesions extends the patients' life span. It is important for healthcare professionals to study basic diagnostic techniques like Conventional Oral Examination to the most advanced diagnostic techniques like the point of care dual-mode mobile-based diagnosis. Some of these advanced techniques are still under the investigative stage and have not reached the clinical levels; their knowledge is necessary for the clinicians to understand what lies ahead in "Cancer Diagnosis" in the future.


About the Author

Dr. Subodh Nanavati is a dynamic and innovative Oral and Maxillofacial Surgeon with a proven track record of helping patients achieve optimal Oral Health and overcome complex Oral Diseases. Adept in the management of Oral Premalignant and Malignant Disorders and providing patients with guidance on preventive, diagnostic and management strategies. Acknowledged for the development of new surgical techniques for the treatment of trismus associated with Oral Submucous Fibrosis. Recognized as a Dental Specialist, Author, Consultant, Researcher and Educator.

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