Twenty-one-year-old Naveen, who is battling tongue cancer, has come to terms with the fact that he may lose his ability to speak clearly after doctors remove half his tongue in a bid to save his life.
   About 85% of oral cancer occur due to abuse of tobacco (smoke and smokeless\chewing) or alcohol. But what is alarming the doctors about India’s tobacco-mouth cancer graph is that now youngsters below 30 years of age form 20% of the patient pool.
   “The youngest boy whose tongue was operated was 13 years old,’’ says Dr Pankaj Chaturvedi, head and neck cancer surgeon at Tata Memorial Hospital. He remembers a 28-year-old woman who started using gutka as a pain killer during a toothache at 15 years of age.
   While people below 25 years of age being afflicted by the disease is rare, Dr Chaturvedi is worried that as the youth get increasingly addicted to the cheap tobacco-based products, the cancer numbers too will increase. Incidentally, in 1999, the Journal of Indian Medical Association reported an unusually high incidence of oral submucous fibrosis—a stage that predates cancer by five years—among younger individuals.
   The article’s author, Dr P C Gupta, then with the epidemiology research unit of the Tata Institute of Fundamental Research in Colaba, wrote that “there are several recent reports in the literature predicting an increase in mouth cancer incidence in India. This prediction is based upon observation of an increasing prevalence of oral submucous fibrosis, especially in younger individuals, caused by gutka, an industrially manufactured food item’’.
   A walk through the wards and the out-patients department of Tata Memorial Hospital tells the story of an ignored epidemic. In the ICU lies 32-year-old Manish, an imitation jewellery worker from Santa Cruz, who cannot talk as his whole tongue has been removed.
   “He has stage IV cancer. He has been chewing gutka for 12 years,’’ says a resident doctor after pursuing his file. On the next bed, a smoker with tongue cancer is awaiting discharge.
   In the Tata Memorial Hospital’s OPD, every patient has a similar story to tell: years of consuming gutka, khaini, areca-nut or smoking cigarettes or bidis. “Almost all the patients in the OPD have mouth cancer caused due to tobacco abuse,’’ says the doctor.
   It is not as if Naveen didn’t know about gutka and its carcinogenic qualities. “I just didn’t think it would affect me, or so soon,’’ he adds.
   “But my parents would rather have me alive than dead right now,” he says. His father’s liver has been affected by Hepatitis B, his brother is handicapped and the family spent Rs 2 lakh to get his sister married last year.
   “We have been facing some terrible problems ever since,’’ says the boy, who questions the doctors about every diagnosis and treatment. “I have to know,
don’t I?’’ he asks. (Names of patients have been changed to protect their identities)

Head And Neck Cancers
They encompasses a wide range of tumours that occur in the head and neck region, including the nasal passages, sinuses, mouth, throat, larynx, swallowing passages, salivary glands and the thyroid gland. People who use tobacco or drink alcohol excessively are much more likely than others to develop the disease
Oral Cancer arises in the mouth. It includes the lips, the gums and the area behind the wisdom teeth, the inside of the lips and cheeks, the floor and roof of the mouth, and the front two-thirds of the tongue
Laryngeal Cancer begins in the larynx or the voice box. It sits at the top of the trachea, the tract that leads to the lungs
Nasal Cavity & Paranasal Sinus Cancers are found in the tissues that line these hollow structures. The paranasal sinuses are hollow areas in the bones of the face near the nose that produce mucus
Nasopharyngeal Cancer is found in the nasopharynx, the uppermost portion of the throat
Oropharyngeal Cancer is found in the section of the throat (oropharynx) located just beyond the mouth. The region includes the base of the tongue, the soft palate (the soft area just beyond the roof of the mouth), and the area around the tonsils
Hypopharyngeal Cancer is found in the hypopharynx, the uppermost portion of the oesophagus (the tube through which food travels to the stomach)
Salivary Gland Cancer is found in the salivary glands, the structures that produce saliva to keep the mouth from drying, and aid in digestion of food

Treatment |
It may include surgery, radiation therapy, or chemotherapy. When surgery is extensive, reconstruction of the area is often possible. For example, in cases where the jaw bone is removed, a surgeon can fashion a new jaw using bone from the patient’s own leg. Dental implants can be used to replace teeth

Death Clock

According to Smokefree Mumbai Campaign, an endeavour of the BMC along with NGOs. Since Thursday, January 01, ’09 15,668 Mumbaikars have died due to smoking related causes

Rising Numbers    

The excess number of deaths among adult smokers in 2010 will be about 930,000
   That includes 580,000 deaths among men and 90,000 deaths among women between the ages of 30 and 69 years
- Projections Based on Study in India and Canada

Bidi Menace

6,00,000
lives are lost in India every year due to the bidi habit says the Bidi Monograph entitled, Bidi Smoking and Public health, released by the government of India in May 2008