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Old 9th May 2009, 17:04   #1
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Default Oral cancer: How worried are you? (Please note : This thread contains Pictures)

Oral cancer has been in the spotlight for some years now, and everyone appears to understand the link between tobacco and 'gutkha' usage and oral cancer.

Of late, however, I have been observing an upswing in the number of cases which report to me, where people are apprehensive of lesions in the mouth and extraorally in the head and neck area. They want to put to rest their fear of developing oral cancer, and seek specialist opinion.

I specialize in the subject of oral pathology, which is a branch of dentistry dealing with the diagnosis, evaluation and management / treatment planning of oral diseases, including oral cancer. My work involves teaching undergraduate and post-graduate students, clinical evaluation of patients, running a biopsy service, and research.

This thread is being started with the hope that some misconceptions and fears about oral cancer can be put to rest, and some questions answered. You may post your queries on oral cancer on this thread.
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Old 9th May 2009, 17:09   #2
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Excellent Topic.

But I don't understand Cancer itself.
I do know that Cancer is a couple of cells gone crazy and growing bigger than they should. They tend to spread this tendency into other cells as well. And after a period of time all cells go crazy and big.

It would be very nice if you could explain Cancer itself.
What is it?
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Old 9th May 2009, 17:30   #3
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Originally Posted by bblost View Post
I don't understand Cancer itself.
I do know that Cancer is a couple of cells gone crazy and growing bigger than they should. They tend to spread this tendency into other cells as well. And after a period of time all cells go crazy and big.

It would be very nice if you could explain Cancer itself.
What is it?
Great question. What the common man calls 'cancer', is actually medically called a 'malignant neoplasm' or 'malignancy'. Our body is made up of cells which can grow in numbers (multiply) as well as increase in size. Such multiplication is normal, in that the body needs to replace cells which grow old or wear out, in a controlled manner. The problem starts when the process of multiplication of these cells goes out of control due to the effect of certain chemicals (like tobacco), or even without any known cause. That's when it's cancer.

Cancerous (or malignant) cells are those cells that keep multiplying, and refuse to stop. These cells not only create a lump (tumour) in the area where they started growing, they are also capable of invading, destroying and replacing the normal cells and tissues in the local area, as well as in distant places of the body. How do they do that? The neoplastic cells separate from the mother mass and float down (metastasize) through the blood vessels and lymphatic system to another place. Here, just a few cells can set up camp and start multiplying. As a result, a new tumour forms there, and starts to invade and destroy the contiguous structures. This process of migration is called metastasis.
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Old 9th May 2009, 17:34   #4
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What are the other causes of Oral cancer, other than the obvious ones - Chewing Tobacco/Gutka/Pan masala.
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Old 9th May 2009, 17:39   #5
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1. Smoking
2. Chemical abuse: Alcohol is a prime suspect.
3. Constant irritation: For example, an ulcer you ignored for a long time/teeth coming into constant contact with the tongue/cheek/lips and causing it trauma all the time, hence irritating the cells constantly, triggering an adverse reactory response by the cells.
4. VERY bad Gum conditions can sometimes also be a questionable cause of oral cancer!
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Old 9th May 2009, 17:41   #6
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What are the other causes of Oral cancer, other than the obvious ones - Chewing Tobacco/Gutka/Pan masala.
Any chronic irritation, like a sharp tooth, can, if ignored over a long enough period of time, lead to oral cancer. Alcohol helps the chemicals in tobacco to penetrate more easily into the cells, turning them cancerous. So drinking + smoking / chewing tobacco is 10 times more dangerous than just smoking or just drinking. Certain underlying diseases like lichen planus, submucous fibrosis or leukoplakia can also lead to oral cancer.

@ mods: Hope you won't delete this post for mentioning the 'A' word...

Last edited by SS-Traveller : 9th May 2009 at 17:42.
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Old 9th May 2009, 17:43   #7
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I read this somewhere a long time back.

Cancer cells are always present in the body. But the bodies immune system keeps them at bay. However sometimes a new element gets introduced which can tilt the balance in the favour of cancer cells. Such an element is called a carcinogen.

Common carcinogens are tobacco, heavy metal dust, asbestos and so on.
Sometimes even factors like a strong magnetic fields, EMI radiation, radioactivity can play the role of a carcinogen.

This is why we have people who smoke till 90's and die of other causes and on the other hand have 19 year olds dead from cancer in less than a year of smoking.

Since we cannot determine when the cancer cells are in a position to win, its best to not introduce carcinogens into our system.

Is my understand (as a layman) correct. Or am I way off the mark.
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Old 9th May 2009, 17:51   #8
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4. VERY bad Gum conditions can sometimes also be a questionable cause of oral cancer!
Frank, I wouldn't say that a severe chronic periodontitis due to poor toothbrushing habits per se would lead to a malignancy, but yes, if the very bad gum condition is due to activities like placing a tobacco quid (khaini or gurakhu) there, it can result in an oral cancer starting up. Or, bad gums can also be caused by an underlying disease process like oral lichen planus (desquamative gingivitis is what general dental practitioners would call it), then too, we can have oral cancer.
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Old 9th May 2009, 18:36   #9
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Cancer cells are always present in the body. But the bodies immune system keeps them at bay. However sometimes a new element gets introduced which can tilt the balance in the favour of cancer cells. Such an element is called a carcinogen.
Very true. The cells of the body are not all created normal. Like we have deformed babies, our body also develops deformed (mutant or mutated) cells. But there's a system in place which kills off these mutated cells. Current research says cancer starts if the controlled cell death mechanism fails.
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Old 9th May 2009, 18:55   #10
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Well, i had three cavities since 2000. Then about a year ago, i heard that age old cavities can cause oral cancer.

Not wanting to take any chances, got all 3 of them pulled out.

It was a good move since it has not only cleared up the infection but has also rid me of that nagging dental pain.

Shan2nu
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Old 9th May 2009, 19:19   #11
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Then about a year ago, i heard that age old cavities can cause oral cancer.
Cavities per se do not cause oral cancer. If the teeth break and end up having sharp edges which irritate your tongue or cheeks, then you can. If they weren't shaky teeth, you could have explored the option of a root canal treatment followed by a crown. That would have got rid of your pain too.
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Old 9th May 2009, 19:32   #12
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Quote:
Cavities per se do not cause oral cancer. If the teeth break and end up having sharp edges which irritate your tongue or cheeks, then you can. If they weren't shaky teeth, you could have explored the option of a root canal treatment followed by a crown. That would have got rid of your pain too.
I didn't have irritation in my cheek or tongue but the gum area around the tooth used to itch. Im guessing this itself could have been a good enough reason to get cancer if left untreated.

My dentist told me that they could not be saved and pulling them out was the only option. Frankly, after all these years, there was hardly any tooth left.

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Old 9th May 2009, 19:35   #13
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Nice thread Doc. My Uncles been a chain smoker since 25 years now. He is still in good health. I wish him the same. He started off with Panama without filter and now since 10 years hes settled for some filter. He has out lived his brothers too.
Another cousin of mine, was a chain drinker. He drank for 20 years non stop. Finally he stopped, but even today, he has a very normal life. I'm really confused regarding this medical stuff. When things are supposed to happen to someone due to some external trigger they do happen to some and do not for others.
My mother lived a clean life all her life and she got the dreaded cancer, ovarian, she survived and is still alive, but thats a different story. She was not involved in any kind of cancer creating activities.
Few questions: Please answer these.
If someone is involved in tobacco related habits or Alcohol related habits, how long do you think it'll take for the Cancer to show up.

What may be the reasons that my uncles still unaffected by the smoke he intakes?

Why do some get it why don't others?
Thanks doc for your time.
I hope to pay consulting fees once I come to Delhi. Thanks again.
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Old 9th May 2009, 19:59   #14
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Originally Posted by prince_pervez View Post
If someone is involved in tobacco related habits or Alcohol related habits, how long do you think it'll take for the Cancer to show up.

What may be the reasons that my uncles still unaffected by the smoke he intakes?

Why do some get it why don't others?
Thanks doc for your time.
I hope to pay consulting fees once I come to Delhi. Thanks again.
Maybe in a year. Maybe never. Cancer starting up does not totally depend on external circumstances like smoking or alcohol - they increase your susceptibility. Part of it could well be genetic. It could be the food you eat - how much of pesticides they contain... I had a grandfather who was a chest physician, smoked upto 50 cigarettes a day, and died at the ripe age of 88. He knew the risks. Never figured that smoking was affecting him on any way. Why didn't he get cancer? Medicine doesn't have an answer...

As to the consulting fees, Pervez, do you really think I'd have started this thread if I was looking for money from bhpians? Overtly or covertly?
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Old 9th May 2009, 20:02   #15
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Originally Posted by SS-Traveller View Post

As to the consulting fees, Pervez, do you really think I'd have started this thread if I was looking for money from bhpians? Overtly or covertly?
Hey thanks Doc. About the Consulting fees, I was just kidding . Forgot to add this --> in my last post.
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