High consumption of tobacco, betel nuts (Supari), alcohol has led to an increase in prevalence of Head and Neck cancers in India, leading oncologist Dr. Anil K. D’Cruz said.
According to Dr. D’Cruz, 90 percent of the head and neck cancer are tobacco-related. “In areas where tobacco consumption is very high you will find a higher incidences of head and neck cancers. In certain parts of Uttar Pradesh, where it is consumed a lot, we see a lot of patients. Even in north-eastern states the consumption of tobacco is quite high. So, we see a lot of incidences there as well. The incidences of head and neck cancer depends on the pockets it is consumed most. Also, consumption of tobacco and alcohol is more harmful than tobacco alone,” he explained.
A new study from the International Agency for Research on Cancer (IARC), published in October this year, revealed that nearly 9 in 10 (88%) of all oral cancer cases caused by smokeless tobacco and areca nut use occurred in South-Central Asia and more than 95% (96.4%) occurred in low- and middle-income countries.
Globally, an estimated 300 million people use smokeless tobacco and 600 million people use areca nut. The highest rates of use are found in South-Central Asia, South-East Asia, and Melanesia. Smokeless tobacco products are consumed without burning and can be chewed, sucked, inhaled, applied locally, or ingested. Areca nut is the seed of the areca palm and is consumed in various forms, with or without smokeless tobacco, including in betel quid, or on its own, the health body said in a statement.
In a recent interaction with Financial Express.com at the Apollo Cancer Conclave 2024, Dr. D’Cruz revealed that Head and Neck cancers are complex as its comprises of 13-14 different types of cancers.
“When we look at cancer statistics, we look and individual sites. But head and neck cancer is a complex area which has at least 13-14 different types of cancer. For example, oral cancer. In the oral cancer, the cheek, tongue, the palate, the jaw, the base of the tongue, the voice box, the upper part of the food pipe, the nose…all this and more are head and neck cancers. When you take all this…in India, about one-fourth of all patients are head and neck cancer. It is the most common cancer in India. If you look at site wise…oral cancer is the most common one in our country and also the cause of the maximum number of deaths in our country. Head and neck is very important,” he told Financial Express.com.
Dr. D’Cruz is currently Oncology Director at the Apollo Cancer Centres. He is a well-recognised global leader, clinician, researcher and teacher in Head and Neck Oncology.
During the interaction, he also revealed that as the habit of tobacco consumption is more prevalent among men, oral cancer is more common in men. “…Around 5 percent of female cancers in our country are also tobacco-related as they also chew tobacco,” he added.
‘Early diagnosis is the key’
Head and neck cancers in its first stage has a 90 percent cure rate with single-modality treatment and very good outcomes and less problems in functioning and cosmesis, Dr. D’Cruz revealed.
“The unfortunate thing in our country is two-thirds to three-fourths of patients come with locally-advanced cancers…this requires more treatment and the functioning is affected…as these are all important areas of your body and the cost implications are more. So, the first challenge is late presentation. The second challenge is when the patients come with advance-stage cancer…they need multi-modality treatment like surgery, radiotherapy, chemotherapy etc. In our country, the challenge is that many people are from the lower socio-economic background and it gets difficult for them to afford the treatment. So, there are many persisting challenges,” he said.
He also revealed that globally Head and Neck cancers are 4-5 percent of all cancers whereas in India it is 25-30 percent of all cancers. “…the other south Asian countries like Bangladesh or Pakistan also have high incidences of head and neck cancer as the tobacco consumption in these areas are quite high,” he pointed out.
The oncologist also warned that increased adoption of sedentary and unhealthy lifestyle has led to a rise in cancer cases. “Also, its not just about cancers…our unhealthy lifestyle has made us more vulnerable to all non-communicable diseases. We are seeing a higher trend of cardiac diseases, diabetes, etc.,” he emphasised.
While highlighting India’s strength is medical innovation, Dr. D’Cruz said that although we have the best facilities and cancer care which is at par with the western world, accessibility and affordability continues to be a challenge.
“…the major issue is that these high-quality is not available to everyone. Improving access, equity, affordability are some of the critical areas. Earlier we use to treat these patients with surgeries…now we do organ preservation. For example, if we have to remove the voice box we can put an artificial speaking valve for our patients. We have all sorts of latest technology and our doctors are quite qualified to do these procedures. But the sad part is many patients are not able to access and afford these facilities,” he told Financial Express.com.
He also emphasised that Head and Neck cancers are largely preventable. “Those who consume tobacco and alcohol need to be watchful of their habit. If by chance, you get the cancer, you need to be aware of the warning signs. Early diagnosis and treatment is critical,” he added.