Oral cancers – Importance of Self Oral Examination: Identifying Chota Daana

April is recognized as Oral Cancer Awareness Month.

Head and Neck experts from multiple specialties’ unite together across the country to create sensitization about the importance of oral examination and hold oral screening camps for early detection and prevention of oral cancer. Experts always recommend to perform self examination once every month to detect the chota dana – the pre-malignant lesions that are curable, less dangerous and do not cause financial losses.

Importance of Self Oral examination Cannot be Underestimated

Any one with the habit of tobacco – chewing or smoking in any form is at a higher risk of cancers of oral cavity and it can happen anytime in life. But luckily oral cancer does not happen in just one day it takes few years of this habit to establish the changes required to get oral cancers. There is a long incubation period and you can take steps to rectify your life style.

Two things that is important for all tobacco users:

  1. Prevention
  2. Early detection

Prevention – Cancer can be prevented easily by quitting tobacco use and smoking. Most of the early mucosal changes can regress with quitting of smoking and tobacco. But if more advanced changes have taken place – like dysplasia and submucosal fibrosis they are likely to progress. The best thing any tobacco user can do is take help of the experts and quit tobacco and alcohol completely. This may halt or decrease the progression of the mucosal changes. Quitting tobacco is now easy with specialist care providing specific medicines, behavioral therapy, co-morbidity management and follow up by quit coaches. Download the ICanCaRe app (http://app.icancare.in). You can get your own book ‘WIN OVER TOBACCO – MADE EASY’. Or just call 011-43077695

Early Detection – Oral Cancers just do not happen in one day. If you had few smoking or chewing tobacco in your lifetime maybe you are at a low risk, but for those who had regular tobacco products and especially started as a teen, are at high risk throughout life even after quitting tobacco. Luckily the oral lesions can be self-examined and early changes detected easily by just self-examining the mouth and checking all the areas inside the mouth – inner walls of the cheeks, upper palate, below the tongue, on the gums, towards the epiglottis, etc. Just notice for occurrence of red patches, white patches or small white ulcer like lesions in the mouth. If such changes are noticed, medical assistance should be immediately taken to detect any malignant lesions early and treat them in the early stage itself. Checking the mouth once every month is advised by the experts. Following points should be notices again:

For all who are at high risk of oral cancers (all smokers and tobacco chewers) must examine their mouth at least once a month.

Steps of Oral Examination:

  • Rinse your mouth with plain water to remove all the removable stains from the paan masala
  • Wash your hands with soap, Stand in front of the mirror.
  • Look for any swelling or puckering on the face or neck.
  • Feel with your fingers for any hardness or lumpy areas on face or neck.
  • Check for any lesions on the lips both upper and lower.
  • Check your mouth opening
  • Measure mouth opening with TrisCaRe instrument or otherwise a rough estimate with the vertically placed number of fingers that can easily pass with the mouth open. Normally more than 3.5 cm on TrisCaRe or 4 fingers (atleast 3 fingers) will be considered as adequate.
Self-check for Trismus

TriCaRe for Mouth Opening Measurement and Jaw Motion Rehab System

Now open your mouth and in a clockwise direction visualize all the areas in the mirror for any lesion. Take help of your fingers to push the cheek and tongue. The cheek, both the sulcus, alveolus, Floor of mouth, hard palate and soft palate. Look for any restrictions of tongue movement. Protrude the tongue out and look at all the areas for any lesions. With the fingers feel for any lump, hardness in any area of the oral cavity.

If you find any abnormality please report to a specialist (trained for the purpose).

If you have decreased mouth opening it may be start of the submucosual fibrosis which would immediately require intervention to halt the progress. This would warrant regular use of TrisCaRe through out life.

Oral Cancer king of all cancers in India, the land of Chewing tobacco is also the land of Oral Cancer. India ranks the highest in the World in terms of both incidence and prevalence of Oral Cancers. And more than that we have the highest number of people harboring premalignant lesion in the mouth potential to turn malignant. Fortunately, oral cancers are the easily detectable, easily curable and more importantly easily preventable. To control the disease you are important. Be the Tobacco Marshal  in the society, and crusade the change to save the youth from tobacco and cancer.

With awareness, self and clinical oral examination the number of new cases of oral cancer, as well as the number of deaths from oral cancer, has been decreasing.

Max Super Specialty Hospital understands the need of oral cancer screening in India and therefore have started Oral cancer screening program in association with ICanCaRe at Max Noida and Vaishali.

(The Author – Dr.Pawan Gupta M.Ch. is Director of Surgical Oncology at Max Super Speciality Hospital, Vaishali. Patparganj and Noida. He is author the book – Win Over Tobacco Made Easy, Be Smart Do Not Start and is highly recognized for his work on Oral Cancer and Tobacco Cessation. He is the convener for Certified Courses in Tobacco Cessation under the Gujarat University. Launched the campaign #SAVEtheyouth #winovertobacco)

Make quitting tobacco a pleasure journey. Talk to the experts. Call ICanCaRe Quitline 011-43077695  or visit www.icancare.in/quittobacco to join the tobacco/smoking quit program today.

Make your appointment today for ORALSCREENING at MAX HOSPITAL  – Noida and Vaishali.

Most Important Reasons to Quit Smoking and Tobacco

Any tobacco consumer or smoker is always encouraged to define 3 most important reasons to quit their habit so that it can remind them why they are quitting and keep them motivated in their journey to quit smoking successfully. This blog is an attempt to define some very common and important reasons why one would want to quit smoking. Pick out your reasons to quit and I’m sure many reasons will inspire you to stay quit and self control from smoking and chewing in vulnerable times.

Some common health reasons to quit smoking are:

  • Higher risk of getting infected with covid-19
  • Fear of suffering from cancer, CVD, CRD, Stroke, COPD and other chronic diseases
  • Early wrinkles on skin
  • Stains on teeth, skin and nails
  • Loss of smell, taste, hearing and vision
  • Increased risk of diabetes, dementia, Alzheimer’s disease, etc.
  • Loss of fertility in both men and women
  • Painful menstruation for women
  • Tooth loss from periodontal diseases which wears the gums from chronic inflammation
  • Increased gastrointestinal problems such as bowel disorders, stomach ulcers, diarrhea, rectal bleeding etc.
  • Loss of bone density causing quick fractures, osteoporosis, etc.
  • Weakening of immune system making a person prone to infections and diseases

There are many more health impacts of smoking and tobacco use and we will discuss about it in other blogs in detail. There’s a misconception that smoking causes only cancer. However the fact is smoking causes more of CVDs and CRDs than cancer. More than 200 illnesses and chronic diseases occur in a person from tobacco consumption and smoking. On the contrary a tobacco consumer never believes that their tobacco habit or smoking is the root cause of their illnesses and diseases. Only when the chronic diseases start appearing does the consumer believe that tobacco has caused them irrevocable damages.

Other reasons to quit smoking and tobacco are:

  • Push from the family because the immediate family member, child or friends may be affected from second hand and third hand smoke
  • Financial losses from high expenditures of tobacco and its related products
  • Self-realization to quit habit on time before the damages cannot be undone
  • Ensuring safety of children and the near and dear ones like preventing burns, accidental fires, etc.
  • Negative social consequences like unacceptability in the non smoking group, feeling isolated at family parties or functions, difficulty in mingling with people around, etc.
  • Loss of productivity due to constant smoke breaks
  • Bad smell in clothes, hair, etc.
  • Self-realization to stop polluting the environment

The above are some of the common and most important reasons to quit smoking and tobacco forever. A person can have their own reasons to quit the habit and should always identify them before quitting. Constant reminder of 3 major reasons keeps the person motivated at all times to stay quit and firm on their decision quit the habit successfully.

Quitting tobacco and smoking, has been made very simple and easy at ICanCaRe with the scientific, medically validated and digitized tobacco cessation program. To register one can visit www.icancare.in/quittobacco or call helpline 011-430-77695 for assistance.

Spouse’s Role in Tobacco Cessation

SPOUSE’S ROLE IN TOBACCO CESSATION
Your Spouse is Your World!

Spouse has a very important role to play for tobacco cessation. Here I am only addressing the wife! There would be conflicts I have patients where the husband came to know about his wife’s habit post marriage. Traditionally Indians do not ask about the tobacco habits and even if they do the husbands would usually lie, or say “I will Quit-I promise”. A promise which is hard to keep.

Sufferings of an Indian Lady whose husband smokes –

  • Have to manage with foul smelling husband
  • Keep cleaning the washrooms, bedrooms etc.
  • Cleaning the stains on his clothes (In India it is wife’s job!)
  • Infertility and dis-balanced sexual life
  • Finance and economic dis balance
  • Caretaker when the husband who is often ill because of his tobacco habit
  • Taking care of family when husband is no more or crippled because of illness
  • Passive smoking or tobacco chewing affects
    • Suffer illness (hypertension, COPD, Wrinkling of skin etc)
    • Infective disease – Tuberculosis
    • Complicated diseases like cancer, cardiac, stroke
  • The Future generation may be crippled

A LADY SUFFERS FOR NO MISTAKE OF HERS

Different type of wives when it comes to the tobacco habit of their husband

  1. Helpless and suffering – the Indian traditional wives. She is aware of the harms of tobacco but cannot get the husband to understand or quit.
  2. Ignorant and accepts as it is. Not aware of the harms of tobacco as because it has been used traditionally in her family too
  3. Partners – starts using tobacco along with him.
  4. Firm – She is aware of the harms and firm with her husband and pushes him to rectify his habit
  5. Quarreling – keeps scolding  but does nothing about his tobacco use
  6. Helping – learns the various methods of quitting and takes the husband to doctors, help him quit

NAGGING – because of frustration and suffering at some point of time this would show up and become a part of the relationship. This may have a negative affect and the husband may become more adamant.

TAKE ACTION

A newly wed wife has to take immediate action once she comes to know about the spouse’s disease. If it is accepted in the beginning, but slowly it becomes a chronic issue and gets more difficult to treat as time passes.

The challenge is getting support, tobacco use is so rampant and accepted in the society that she does not get family support. But being firm and knowledgeable helps.

How to know:

There are tell-tale signs of tobacco use whether smoking or chewing

  • Stains on teeth and /or lips
  • Bad foul smelly breaths
  • Constant coughing
  • Stains on nail beds, fingers
  • Foul smelly hairs and cloths

Some behavioral aspects that one needs to notice

  • Chewing gums – constant use
  • Frequently disappearing
  • Going for a walk avoiding you
  • Friend circle

Laboratory and Qualitative assessment

  • Laboratory tests are available for confirmation of tobacco use (Cotinine Test)
  • Qualitative assessment of present health assessment

It is important that one should know and decide before tying the knot. Tobacco is a disease and you do not want to be wedded to a diseased person. Either he takes treatment and is cured for at least 6 months or he is not the right choice for you.

Help is available. Tobacco as a disease needs intensive treatment. ICanCaRe Tobacco Wellness Centers and Online Tobacco Wellness program are just a call away. ICanCaRe team of Certified tobacco Cessation Specialists and Quit Coaches work with you to make your journey smooth, easy, interesting and achievable.

The ICanCaRe Tobacco Wellness Program incorporates evidence-based protocol digitalized intervention program which is both medically validated and scientific in its nature. It is data driven and has given a success rate of 92%.

ICanCaRe Tobacco Wellness Centres with its India’s first digital protocol-based assessment process guide intervention as per requirements.

Do visit the ICanCaRe Tobacco Wellness Centres or register online by visiting our page or call ICanCaRe quit line 011-430-77695.