Mouth, Throat and Voice Box (laryngeal) Cancer             By Dr Bhiku Pattni

In this article I wish to bring to the fore an illness that seems to be increasingly diagnosed amongst the Asian community. The condition is Oro-pharyngeal Cancer. Its incidence (the rate at which new cases are diagnosed) is increasing. Worryingly, the increase is particularly high amongst younger members of the population.

Worldwide the incidence of mouth, throat and voice box (laryngeal) cancer is increasing. The increase is particularly worse in some south Asian countries including India, Bangladesh, and Sri Lanka. Worse still, the cancers are being diagnosed at a later stage when the disease has spread.

There is a general consensus by experts that while there is a genetic element that determines if an individual is susceptible, the risks of developing mouth and throat cancer increase substantially in those who smoke and drink alcohol. The risks are further increased in individual who smoke and drink alcohol at the same time. Many experts say that this is a disease linked to lifestyle.

Being of south Asian origin increases the risk. One of the reasons for this seems to be the habit of chewing paan and betel nuts. Betel nut (sopari) amongst others, contains a known group 1 carcinogen (substance which have been proven to be cancer causing).

Mouth and the throat area of the human body have many important and vital structures. So when this form of cancer spreads it can cause havoc and devastating results.

In this article my message is to try and prevent the cancer in the first place by adopting sensible lifestyle. If one is unfortunate, then the second message is to try and get early diagnoses so that the outcome from treatment is better. Because the mouth and the upper end of the throat is directly visible it is possible to be vigilant and by following the advise in the box below early professional opinion is recommended if you notice any of the symptoms mentioned.

The following lifestyle advice is particularly recommended to minimize the risk of getting oropharyngeal cancer:

1. Not smoking or chewing tobacco, gutkha or paan, particularly, not on a regular habitual daily use basis.

2. Limiting alcohol consumption and in particular not drinking alcohol at the same time as smoking.

3. Having a healthier, balanced, "low meat, low fat" diet, rich in vegetables and fruit with servings of cereals or beans everyday. Include nuts and seeds in your diet.

The table below lists symptoms that you should take particular notice and consult a health professional (i.e. your doctor or dentist).

1. A sore or ulcer in the mouth that does not heal within three weeks 2. A lump or overgrowth of tissue anywhere in the mouth 3. A white or red patch on the gums, tongue, or lining of the mouth 4. Difficulty in swallowing 5. Difficulty in chewing or moving the jaw or tongue? 6. Numbness of the tongue or other area of the mouth 7. A feeling that something is caught in the throat

8. A chronic sore throat or hoarseness that persists more than six weeks, particularly smokers over 50 years old and heavy drinkers 9. Swelling of the jaw that causes dentures to fit poorly or become uncomfortable 10. Neck swelling present for more than three weeks 11. Unexplained tooth mobility persisting for more than three weeks - see a dentist urgently 12. unilateral nasal mass / ulceration / obstruction, particularly associated with purulent or bloody discharge

Remember “Prevention is better than cure” and failing that unfortunately for some “Early detection is better for improved outcome”
                                                                   Dr Bhikhu Pattni

                                                                   General Medical Practitioner

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