Dr. Dilip Murarka
Onco 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 nuts
Tobacco is used for the teeth- as masheri & tobacco toothpaste
Tobacco is used as a snuff & in paan masalas
All these forms of Intake are harmful & causes an Increase
incidence of tobacco related cancers
DO YOU KNOW?
DO YOU KNOW?
Atmaram has more chances of developing
cancer and other diseases in comparison to
Sakharam. Why is this so?
ATMARAM
SAKHARAM
• Smokes Beedi since 18 yrs of age
• Does not use tobacco in any
form
• Chews Gutkha since the last 5
years
• Keeps his mouth clean
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
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:
a. Cigarette Smoking
b. Beedi Smoking
COMMON CAUSES OF HEAD
AND NECK CANCERS
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
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
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
COMMON CAUSES OF HEAD
AND NECK CANCERS
i. 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
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
WHITE PATCH
RED 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.
a. 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.
b. 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
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
OTHER HARMFUL EFFECTS
OF TOBACCO
Unfortunately, besides cancer, tobacco use causes a number of
other diseases also.
a. 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.
b. 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
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
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.
a. 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
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 OF HEAD AND
NECK CANCERS
Treatment Modalities:
a. Surgery
b.Radiation
c. Chemotherapy
CORRECT YOUR MISCONCEPTIONS
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
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
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.
YOU CAN HELP YOURSELF
AND YOUR LOVED ONES
YOU CAN HELP YOURSELF
AND YOUR LOVED ONES
• Do something else when you feel the urge to smoke or chew
tobacco. This will help you keep your mind off tobacco.
• Delay the act, Count to 100 and think pleasant thoughts
because the urge to use tobacco will pass in 5-10 minutes
whether you have tobacco or not.
• Collect the money saved from each pack of cigarette or Pan
masala. You can buy a gift for your family with all that money.
It is not very simple but we can do it. Surprisingly 85% of tobacco users wish to give a try.
1.
Decide positively that you want to quit.Educate yourself to the harmful effect of tobacco.
2.
Stop tobacco use totally Gradual reduction in tobacco consumption usually fails
3.
Avoid Situation that increase your urge for tobacco
4.
Get health conscious –walk, jog, exercise, swim
5.
Collect the money that you save as it multiplies you will realize what you have lost all these
years.
The urge to use tobacco is very strong in the first few days after stopping. Once you get past
this the rest is easy STAY STOPPED!Even a simple cigarette/ paan can take you into
the habit all over again
•Avoid prolonged placement of the paan in your mouth.The longer the contact the
greater is the risk.
•Maintain meticulous oral hygiene.
•Examine your mouth in a mirror at least once a month, look for cleanliness of your
mouth, condition of your teeth and gums, any red and white patches on the tongue or
cheeks. These are the warning signs should not be ignored.
•A change in once voice persistence cough, hoarseness, pain and difficulty in
swallowing should look into it.
•A chronic smoker should undergo a periodical X_Ray chest and check up by
competent doctor at least once in a year.
1 cigarette: loss of 2 breaths
1 beedi : loss of 3 breaths
1 packet of gutka : loss of 4 breaths
One life- yours
Recipes of death - multiple
Tobacco does not affect only your health, but also the health of
people who love you and who you care about.
• Passive smoking harms your family’s health
• Children & elders & follow their bad habits of tobacco use.
Do you want them to pay the
price of love – by death?
Save for a Better life or
Spend to end your Life
Expenses
Savings
Diseases
Health
Pain
Happiness
Death
Life
Choice is yours
A Saving of Rs 5 every day, amounts to Rs. 1825 every year.
Just think how much you save in your life time?
Live Life King Size
And died a slow & painful death
Its your Choice. Its your life
OR
Tobacco has many forms, but the
end is one- Disease and Death
With friends like these who needs enemies?
Are they truly your friends? Do they really care?
If they care, then would they give you tobacco, the ingredient of death?
Think about it?
When a loved one dies the heart of a family bleeds.
Don’t make your family suffer the consequences of your friendship
Dr. Dilip Murarka