Oral Cancer

Oral cancer (mouth, tongue, cheek, lip, floor of mouth) has the highest burden in the world in India, driven by tobacco — particularly chewed forms (gutka, pan masala with tobacco, khaini, zarda, mawa), betel-quid chewing with or without tobacco, and smoking. Alcohol multiplies the risk. It is one of the most preventable cancers.

Early warning signs — any of these, for more than 2-3 weeks

• Non-healing ulcer or sore in the mouth.
• Red or white patch on the tongue, cheek, gum.
• Lump, hard area, or thickening.
• Unexplained bleeding from the mouth.
• Pain or difficulty chewing, swallowing, opening the mouth, or moving the tongue.
• Numbness of tongue or other mouth part.
• Loose teeth not explained by dental disease.
• Voice change, a lump in the neck.

Pre-cancerous conditions to take seriously

• Leukoplakia — white patch.
• Erythroplakia — red patch (higher cancer risk).
• Oral submucous fibrosis (OSMF) — stiffening of mouth tissues from areca-nut / gutka use. Very common in India; difficulty opening the mouth. Markedly raises cancer risk. Stop chewing immediately.

Who should be examined

• Every tobacco user should have a thorough oral examination at least once a year — by a dentist or a Health Expert.
• Opportunistic screening by dentists, ENTs, family doctors reduces late-stage presentation.
• Simple "mouth self-exam" in front of a mirror — check all surfaces in good light.

Diagnosis

Suspicious lesions are biopsied. Further evaluation includes CT or MRI for staging, endoscopy to rule out other tobacco-related cancers, dental evaluation.

Treatment

• Surgery — primary treatment for most; reconstructive surgery where needed.
• Radiation +/- chemotherapy — for locally advanced disease.
• Targeted and immunotherapy — newer options.
• Rehabilitation — speech, swallowing, nutrition, prosthetic dentistry — central to quality of life.
• Best done at a cancer centre with a head-and-neck specialty team.

The single biggest thing — quitting tobacco

Stopping tobacco use (smoked or chewed) starts reducing cancer risk within weeks. India's Tobacco-Cessation programme (through government hospitals and the national helpline 1800-11-2356) provides free counselling and support. Nicotine replacement therapy and medicines are affordable and available. It is one of the highest-impact health decisions anyone in India can make.