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Towards a tobacco free World. Dr. Dilip Murarka Onco Surgeon. Consultant: KOHINOOR HOSPITALS Kohinoor City, Kirol Road, Opp LBS marg, Kurla , Mumbai-70 Tel:- 67556755/30553055.
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Towards a tobacco free World Dr. Dilip MurarkaOnco Surgeon • Consultant: • KOHINOOR HOSPITALS • Kohinoor City, Kirol Road, Opp LBS marg, Kurla , Mumbai-70 • Tel:- 67556755/30553055
* One third of all cancers in India are tobacco related, 2 lacs cases per year.* 14.2 cr man & 7.2 cr women above the age 15 consumes tobacco in India* The government spends 1000 Cr. Of Rs on the treatment of tobacco related cancers every 5 years
Tobacco is smoked- in cigarettes, beedis, chutta, dhumti, clay pipes & Hokas.Tobacco is chewed- in paans with or Without lime & betel nutsTobacco is used for the teeth- as masheri & tobacco toothpasteTobacco is used as a snuff & in paan masalasAll these forms of Intake are harmful & causes an Increase incidence of tobacco related cancers
Atmaram has more chances of developing cancer and other diseases in comparison to Sakharam. Why is this so? DO YOU KNOW? • SAKHARAM • Does not use tobacco in any form • Keeps his mouth clean • ATMARAM • Smokes Beedi since 18 yrs of age • Chews Gutkha since the last 5 years Nearly 40% of cancers detected in India are because of tobacco use. Tobacco contains Nicotine which is an addictive agent. This addiction makes the user a slave to tobacco
COMMON CAUSES OF HEAD AND NECK CANCERS • There are a number of reasons why these • cancers occur. The most common cause is use • of tobacco in any form. Tobacco contains over • a 1000 chemicals many of which play a role in • the initiation of cancer. Tobacco can be used as: • Cigarette Smoking • b. Beedi Smoking
COMMON CAUSES OF HEAD AND NECK CANCERS c. Hookah: Cut, shredded tobacco moistened with molasses is kept in the bowl and is burnt with charcoal. The smoke is drawn through the water, which cools and filters it. This form of smoking is common in North India. d. Paan: Consists of betel leaf, catechu, slaked lime and betel nut. It may not contain tobacco. Pan chewing is a socially accepted habit in our country especially in the northern and eastern parts. Unfortunately each of the ingredients used in paan affect oral health
Two thirds of the smoke from burning cigarette does not reach the smokers lung but instead goes directly into the air. The effects of this smoke are similar to tobacco smoke inhaled by active smokers. An increased the risk of lung cancer has been shown in wives of husbands who smoke. Inhaling of air containing tobacco smoke is called passive smoking.
The risk of passive smoking does not stop with cancer. There is increase incidence of heart disease in a passive smokers. Children of parents who smoke has an increase incidence of cough, bronchitis, ear infection & pneumonia. Children exposed to their parent cigarette smoke have six times the number of respiratory infection. If a pregnant women chew or smoke tobacco it will have an adverse effect on foetus.
COMMON CAUSES OF HEAD AND NECK CANCERS e. Pan Masala: is a commercial preparation containing areca nut, slaked lime, catechu. Many brands of pan masala contains tobacco (Gutkha). Pan masala has all the ingredients of a paan but it is not perishable. The Indian market is being flooded by this form and it is becoming very popular due to aggressive advertising. f. Mava: is sold as a mixture containing areca, tobacco & Lime.
COMMON CAUSES OF HEAD AND NECK CANCERS g. Khaini: contains dried tobacco and slaked lime. These are carried separately in a metal container. When required, a little bit of tobacco an lime are taken in the palm and mixed thoroughly and then placed in the mouth. h. Creamy snuff: is a tobacco paste marketed in toothpaste like tubes.
COMMON CAUSES OF HEAD AND NECK CANCERS • Masheri: is prepared by roasting tobacco on a hot metal plate till it is uniformly black. It is then powdered before using for brushing teeth. This is very common in Maharashtra, especially in women. • Alcohol: Besides tobacco another important cause of head and neck cancers is alcohol.
COMMON SITES FOR HEAD AND NECK CANCERS • Oral cavity cancer refers to cancer of the lips, floor of the mouth, gums, tongue, cheeks and palate. • Use of tobacco in any form can cause cancer of the oral cavity, voice box, food pipe, lungs and many other organs.
PRECANCER CHANGES IN ORAL CAVITY RED PATCH WHITE PATCH
PRECANCER CHANGES IN ORAL CAVITY • Luckily for us, before oral cancer develops, the body will give certain warning signals. These are also known as precancer lesions. Most oral cancers develop from these precancer lesions. Therefore it is important to look for these signs. • Leucoplakia/ white patch in mouth: This white patch normally develops at the site where the person places the tobacco in the mouth. However it may be seen in non tobacco users also. • Erythroplakia/ red patch in mouth: This red patch can develop anywhere in the oral cavity. These colour changes of white/ red/ black patches are seen usually on the tongue, gums, angle of the mouth, cheeks and floor of the mouth.
PRECANCER CHANGES IN ORAL CAVITY • c. Submucous fibrosis: there is a uniform whitish discolouration of the oral cavity with: • Difficulty in opening mouth fully • There is intolerance to spicy food • It is usually seen with chewing tobacco/ Pan masala • d. Non- healing ulcer: This ulcer is usually painless, keeps increasing in size, does not show signs of healing.
OTHER HARMFUL EFFECTS OF TOBACCO • Unfortunately, besides cancer, tobacco use causes a number of other diseases also. • Chronic Bronchitis: This is infection of the lining of the breathing tubes in the lungs. Infection occurs because of damage to delicate cells. The damage results from prolonged exposure to irritants from cigarette smoke. • Peripheral vascular diseases: There is narrowing of blood vessels that carry blood to the leg and arm muscles. This is dangerous because if a blood clot blocks a narrow artery, it can result in damage or loss of the limb. Smoking is a major risk factor for this disease.
OTHER HARMFUL EFFECTS OF TOBACCO c. Heart attack: Cigarette smoke, high blood pressure, high cholesterol levels and physical inactivity are the four major risk factors for heart attack. The more cigarettes a person smokes the greater the risk of a heart attack. d. Babies born to mothers who smoke can be more sickly. Smoking can cause a pregnant woman to lose her baby and children of parents who smoke have more health problems than children of non-smokers.
Early stages of almost all tobacco related cancers can be cured with 80% success. Advanced stages however required extensive treatment, at times with disfiguring surgery. Ignoring the sign and symptoms in the belief that they will go away can be a fatal mistake. The sooner cancer is diagnosed, the earlier the treatment can be gained and with the favorable outcome.
INVESTIGATIONS TO HELP DIAGNOSE HEAD & NECK CANCERS • A number of investigations help in diagnosing cancer of head and neck region. Some of the routine investigations used are as follows. • Biopsy: Here the doctor collects a small sample of the suspected tumor and this specimen is then examined under a microscope to confirm the presence of cancer cells. • b. Indirect laryngoscopy: Here the doctor use the laryngeal mirror to examine for cancer in the voice box. The mirror resembles the dentist’s mirror and has a long handle. If the cancer is suspected then further investigations can be done.
INVESTIGATIONS TO HELP DIAGNOSE HEAD & NECK CANCERS c. Chest X- Ray: Chest X- Rays are important in detecting lung cancer. Besides this there are a number of other procedures which can be used for diagnosing lung cancer. d. Barium Sallow: Barium Sulphate is a radio opaque dye used for taking special X- Rays where the patient swallows the dye and X- Ray is taken. This helps in identifying any lesion in the food pipe.
TREATMENT OF HEAD AND NECK CANCERS • Treatment Modalities: • Surgery • Radiation • Chemotherapy
CORRECT YOUR MISCONCEPTIONS a. “Cigarette smoking is more harmful than Beedi.” No! Both cigarettes and beedi are harmful to the body. Infact, one puff of a beedi is as harmful as two puffs of a cigarette. b. “Smoking tobacco is harmful to the body but other forms of tobacco are not so harmful.” No! Both smoking and smokeless tobacco are similarly addictive and carcinogenic though the sites of damage may differ. Infact in our country, the habit of chewing tobacco is increasing in all sections of the society. c. “Some cigarettes are less harmful than others” No! There is no such thing as a safe cigarette.
CORRECT YOUR MISCONCEPTIONS d. “I can get cancer only if I am a heavy smoker.” No! the very fact that you use tobacco increases your risk of getting cancer. The quantity of tobacco smoked or chewed only determines the degree of risk e. “I am harming only myself by smoking.” No! Passive smoking is exposure of non smokers to air polluted by tobacco smoke. It can be considered as a form of smoking because the non-smoker is exposed to many of the harmful substances in this smoke. The non-smoker inhales this polluted air as a part of the necessary act of breathing. It is not by choice.
YOU CAN HELP YOURSELF AND YOUR LOVED ONES • It’s never too late to quit this addiction. No matter how long you have used tobacco but the body repairs much of the damage when you give up tobacco. Your circulation will improve and your lungs will begin to repair themselves. You will stop harming those you love and whats more, you can save all that money! So. • Stop using tobacco in any form • Select a quit day to put your Promise into Practice. • Deep breathing makes you calm and helps you cope with the urge to use tobacco.
