How India’s chewing habit is fuelling a cancer crisis – Firstpost

Oral diseases, though largely preventable, remain one of the most widespread health challenges globally, affecting an estimated 3.7 billion people and often leading to pain, disfigurement and even death.

According to the Global Burden of Disease 2021 report, untreated dental caries in permanent teeth is the most common health condition worldwide. Yet, in many low- and middle-income countries, oral health remains a neglected part of national health agendas with prevention and treatment often excluded from universal health coverage, leaving millions vulnerable to avoidable complications.

Firstpost spoke to Dr. Amit Bhargava, Senior Director – Oncology at Fortis Hospital, Vasant Kunj to understand the growing threat of oral cancer in India.

Early signs of oral cancer

Dr Bhargava: In the oral cavity, even small lesions are visible and can be detected with the naked eye. An early sign of oral cancer is an ulcer or wound that does not heal with conventional medications and continues to grow or worsen over time. These ulcers are often painless. As the condition progresses, swelling or nodes may develop in the neck.

Tobacco use & alcohol consumption increase the risk?

Dr Bhargava: Tobacco gradually damages the mucosal lining of the mouth, altering it into dysplastic (abnormal) tissue, which can eventually become cancerous.

Alcohol enhances the absorption of tobacco, causing increased local damage and leading to genetic mutations that contribute to cancer. Additionally, alcohol depletes essential vitamins required for maintaining mucosal health. Prolonged alcohol use also causes liver damage, impairing its ability to clear toxins from the body.

Connection between HPV and oral cancer and how effective is the HPV vaccine in prevention?

Dr Bhargava: The Human Papillomavirus (HPV) is a surface virus that infects the oral cavity, damaging the inner lining of the mouth and leading to cancer. The HPV-16 strain is the most common type associated with oral cancers. Regular dental checkups and good oral hygiene can help prevent most HPV-related oral cancers.

Different stages & how each stage influences treatment and survival outcomes?

Dr Bhargava: Oral cancer is staged from 0 (localised) to IV (advanced spread). Early stages (I–II) are typically treated with surgery or radiation and have higher survival rates. Advanced stages (III–IV) often require a combination of surgery, radiation, and chemotherapy, with lower survival rates due to metastasis and the complexity of treatment.

Treatment options

Dr Bhargava: Treatment for oral cancer includes surgery, radiation, and chemotherapy. In advanced cases, newer options such as immunotherapy and targeted therapies are used to boost the immune system or specifically attack cancer cells. A combination of treatments is often most effective, depending on the stage of the cancer.

Are there any genetic or hereditary factors that increase oral cancer risk?

Dr Bhargava: Most oral cancers are not genetic and do not run in families. They are usually linked to identifiable risk factors such as tobacco and alcohol use, HPV infection, dental trauma, and poor oral hygiene.

Diet, oral hygiene and sun exposure, contribute to oral cancer risk?

Dr Bhargava: Oral cancer is largely a lifestyle-related disease. Risk is strongly associated with habits such as tobacco chewing, alcohol consumption and poor oral hygiene.

Regular dental checkups help in detecting oral cancer at an early stage?

Dr Bhargava: Regular checkups with a dental specialist or oncologist can help detect oral cancers early. A healthy oral cavity rarely develops cancer. Chewing tobacco often leads to its deposition on teeth, causing direct damage to the surrounding tissues. Simple changes in oral hygiene can significantly reduce the risk of developing oral cancer.