Cancer is the name given to a collection of diseases. In all types of cancers, some of the body cells begin to divide without stopping and spread into surrounding tissues. 10 million people around the world die each year. The common five leading sites are breast, lung, mouth, cervix, uterine, and tongue. Medicircle is conducting an exclusive series on cancer with eminent oncologist over the discussion to bring about awareness about cancer, its treatment, and myths related to it 

Dr.Kamlesh Desai is BDS and MDS from Nair Hospital Dental College in Mumbai. He is now a Private Practicing Dental Surgeon, Implantologist, General and Aesthetic Dentist, Senior Consultant at Bhatia Hospital and Asian Cancer Institute Cumballa Hill Hospital, Mumbai. He is also an Ex Lecturer at VDP College Sangli, Terna Dental College, and he was also a Chairman Examination Board for the final year BDS students at the University of Kolhapur. He has done scientific research in oral probiotics on behalf of Tenshi India Private Limited and their role in oral homeostasis as an Ex- Consultant at Hindustan Unilever Limited. Dr.Desai was instrumental in facilitating the incorporation of fluoride in toothpaste that has led to an improvement in “Dental Caries” status. His valuable inputs led to AIM Toothpaste, an affordable low-cost toothpaste, and the National Dental Insurance Scheme resulting in heightened awareness and improvement of oral hygiene status in the country. He works towards tobacco cessation and is keen to be at the forefront in the early diagnosis, intervention, and hence improve cure rates in oral precancer and cancer problems. As a student, he contributed to the oral health scenarios and WHO summit under Dr.David Barnes, The Chief Oral Health, WHO in the 80s. He is willing to take a public stand to help in the eradication of oral cancer in particular and others in general.   

Misconception and Myths about cancer 

Dr. Kamlesh Desai says, “It can't happen to me. That's the earliest misconception. The second misconception is Denial. When you are having a small lump in the mouth or ulcer oral cavity generally there is a denial. Many people think that sharp dentures, sharp teeth, broken teeth leading to ulcers will go away as it's minor. It is important to be examined by professionals and carefully assessed to rule out oral cancer. The third myth is that most people think that tobacco does not cause extensive damage. This is one of the greatest myths in the world because it does not cause any pain. So people continue to consume tobacco in different forms: smoke and smokeless. They leave it inside the oral cavity, in the cheek, or below the tongue as it does not hurt. It is generally discovered at a late stage in some situations. There is very little one can do to prevent this and sometimes often cause early death.” 

Cancer: Symptomatic or Asymptomatic 

Dr. Desai states, “It is a combination of both. It starts with some small little irritation. For example, If you talk about your palm, you might feel some thickening on your palm and it doesn’t bother you much. That's the first stage of pre-malignancy or the pre-cancer where the irritation in the oral cavity leads to thickening of the inner layer of cheek or thickening in the layer of the tongue with very mild discomfort which disappears and people continue tobacco, alcohol in their lives. All this results in the beginning and seeding of cancer where it is only on the surface and can be caught early. There are some which may start with slight pain and go on to be very painful if they hit the bone early and therefore affect the nerves. Some cancers are predominantly initially very painless as almost soft tissue cancers in the oral cavity. Unless a major nerve gets touched, it does not cause any pain. They are discovered in the routine examination and sometimes when a patient complains of a foul smell or odor or when somebody notices swelling.” 

Getting to the root of the problem is important rather than believing the tip of the iceberg in cancer patients

Dr. Desai clarifies, “At present, there are 8 lakh new cancer patients being admitted and diagnosed only in the pioneering Tata Memorial Hospital in Mumbai and its branches which are only of the hospitals. I think this is just the tip of the iceberg. There so many are not even being diagnosed or treated all across the country due to lack of economy and other reasons.” 

Tobacco is the main cause of oral cancer

Dr.Desai points out, “Tobacco is the singular large reason for these problems. Today, the prevalence of cancer among women has gone up by 12 % because women are bigger smokers than men today."

He further mentions, “Tobacco, alcohol, and betelnut that are placed inside the oral cavities are many causes of cancers. There was a time when there was ignorance by families and some parts of countries due to many old cultural habits. But now we need to spread the message that tobacco is dangerous to them and it can lead to loss of life, money, family, happiness, and everything.” 

Importance of “Banning Tobacco Campaigns”

Dr. Desai emphasizes the importance of campaigns and says,” We need bigger campaigns and proactive government stands. I am happy to talk about it. You need to look at banning tobacco in a much bigger way and bringing out the impact of tobacco and cancer in all forms to the general public at every socio-economic level. Apart from that, I must let you know that 25 % of cancer has no cause especially for non-smokers and non-tobacco users.”

The importance of oral health and dental check-up 

Dr. Desai mentions,” Healthy dental check-up by a professional doctor after 40 - 45 years of age is extremely important to rule out any problem. It is a five-minute check that costs very limited and spare people with lots of unwarranted unhappiness.”  

Spread awareness about tobacco to reduce the rate of oral cancer

Dr. Desai mentions,” Media is doing its job in ads and movie theaters but tobacco cessation as a method of amendment must become a big prominent way to help people. We need corporate and government specialist experts in creating synergy which will help eliminate tobacco which will reduce the rate of oral cancer along with the early diagnosis.”

Future and Dream for Easy diagnostic test for oral cancer. 

Dr.Desai states, “We need an early diagnostic test where you can take tissue from the oral cavity and put it under the microscope to predict the entire oral cancer sequence. This is probably going to be one of the easiest and best ways to catch cancer at early stages so that patients and people are sensitized and so that they can be motivated to give up tobacco. It's a part of my dream to prevent cancer and early death.”

(Edited by Dr.Rati Parwani)