Oral cancer awareness

#CAP2020 Oral cancer is a significant health problem to the country due to widespread use of tobacco. • There is a rising incidence of tongue cancers in the country and the problem is as acute as those with gingivo-buccal cancers. • Early diagnosis is imperative in improving outcomes and preserving quality of life. • Biopsy is easily established in oral cancers but a high index of suspicion is required for submucosal lesions. • Tongue is a high risk site for premalignant lesions converting to cancer and clinician should be very vigilant in following these lesions. • MRI is the investigation of choice for visualizing the primary when available. CT scan is optional. • In very early lesions where the primary does not require visualization, ultrasound may help guide the management of neck. • Early stage patients (stage I&II) require single modality treatment – surgery preferred. • Locally advanced tumors require combined multimodality treatment - surgery + adjuvant treatment. • Radiotherapy as an adjuvant is used for all T3/T4 cancers or when there are high risk features (LVE, PNI, PD, node +, close margins). • Adjuvant CTRT is indicated for positive margins and extranodal disease. • The role of neoadjuvant chemotherapy is not well established in oral tongue cancers. • A multidisciplinary approach on emphasis on proper rehabilitation (appropriate reconstruction) is necessary. • Unresectable advanced cancers should be treated with a goal for palliation. CELL TARGETTED DRUGS:- • Sempervivum tectorum • Gallium aparine • Kalium cynatum • Antimony chloridum ➢ GALLIUM APARINE Around more than 14 major phytochemicals are identified which are cytotoxic for CA Tongue as they do arrest G1 phase of cancer cells which inhibits growth of cells. In cancer of the tongue GA is the drug when it has the appearance of scirrhous formation with a nodulated lesion embedded in the tongue. There is more or less induration of the tongue. ➢ SEMPERVIVUM T. When the tongue has ulcers, bleeds easily especially at night patient complains of much soreness of the tongue with stabbing pains, this remedy should be given. CA Tongue near root, purple color lesion. Active component of ST is 5D-5-methyl-pyrroline-N-oxide which acts as anti oxidant and helps decrease free radical activity in liposomal system leading to tumor lysis and growth inhibition in CA Tongue. ➢ KALIUM CYNATUM In the last stage of cancer of the tongue when the pain is very severe and very little nourishment can be taken, we can give the patient some relief by this remedy for palliative purposes. Active component of KC is Benzaldehyde and Hydrogen Cyanide which acts as targeted poison for CA Tongue cells. ➢ ANTIMONY CHLORIDE This medicine is yet not proved but has shown clinical cytotoxic effects on CA Tongue with quick regression of lesions, non bleeding and hard to touch. Proved to cause autophagy in A549 cells of epitheal and squamous cell CA cells in CA Tongue . Cancer of the oral cavity is predominantly seen among those who chew tobacco. The red and white coloured patches, non healing ulcers of long duration, ulcers caused by sharp tooth. Inability to tolerate spices along with glistening appearance of the tongue and lining of cheeks especially in tobacco habituates. REFERENCE(S): 1. https://www.cancerresearchuk.org/about-cancer/mouth-cancer/stages-types-grades/tongue-cancer/about 2. https://oralcancerfoundation.org/facts/whats-new-oral-cancer-research/

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Nice explanation
Thank you doctor
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