Tobacco and Oral Cancer: The Warning Signs Inside Your Mouth
India has among the highest rates of oral cancer in the world, driven by gutka, khaini and pan masala. It is one of the few cancers you can see developing in a mirror.
Read articleCancer of the mouth and tongue is strongly linked to tobacco chewing, gutka, betel quid and smoking, and it is one of the most common cancers seen in this part of Andhra Pradesh. It is visible and reachable, which means it can be caught early by simply looking.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- A mouth ulcer that has not healed within three weeks
- A white or red patch inside the mouth that does not rub off
- A lump or thickening in the cheek, tongue or floor of the mouth
- Difficulty or pain on opening the mouth fully
- Loose teeth, ill-fitting dentures or bleeding from the mouth
- Persistent pain in the ear on one side, or difficulty swallowing
- A lump in the neck
When to see a doctor
Do not wait these out
If any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- Any mouth ulcer, patch or lump present for more than three weeks
- Progressive difficulty in opening the mouth
- A neck lump that persists, with or without pain
- Any of the above in a person who chews tobacco, gutka or betel quid, or smokes
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- Clinical examination of the mouth, tongue and neck
- Biopsy of the ulcer or patch — the definitive test
- CT or MRI of the face and neck for staging
- Ultrasound of the neck with needle aspiration of any lymph node
- Chest imaging and dental assessment before treatment
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- Surgery to remove the tumour with clear margins, with neck node dissection where indicated
- Reconstruction with flaps to restore speech, swallowing and appearance
- Radiotherapy or chemoradiotherapy, coordinated through referral where required
- Complete and permanent stopping of tobacco, gutka and alcohol
- Speech, swallowing and nutritional rehabilitation after treatment
- Regular surveillance, since a second cancer can develop in the same mouth
This page is general information, not a diagnosis
Oral Cancer can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the Surgical Oncology department. If a symptom is sudden or severe, call 9281862028.
