Betel and oral tobacco ban

Regardless of one’s political affiliations, one has to be a sport and welcome the recently imposed ban on chewing betel and tobacco in government offices. Several states governed by different political parties (Sikkim and Maharashtra were early ones) have restricted their use, and the results on health and cancer have been quite positive.

Mahadev, a 35 year old father of 3, who worked in our endoscopy department as an attendant, had consulted me 5 years ago for an ulcer on one side of his tongue that was refusing to heal. Fortunately, the stage of his cancer was early and surgical removal offered hopes of a cure.

When we called on him after surgery, he was in some pain, with one half of his toungue chopped off and stiched. He had difficulty articulating, but seemed relieved that the cancer was gone. Subsequently, he had to undergo radiation therapy to kill any possible remaining cancer cells in the vicinity of his mouth. Several years later, he seems fine except of the asymmetry of his mouth, but fearful whether the disease might return. He has resolutely kicked his Gutkha habit and wishes that he had done it much earlier before the cancer had struck.

A grateful lady whose daughter had got well under my treatment and who used to send me gujias during Holi and Diwali for almost 20 years, recently came to me with a mouth cancer. She had always responded to my advice to stop tobacco-chewing with “I will do it soon, whenever my present stressful phase ends”, the day that never came. She came to seek advice on who would be the best surgeon in the city for the operation.

India leads the world in mouth cancer with 65,000 people getting it each year, almost 90% of which are due to tobacco. Chewing tobacco either as Gutka or rolled in betel leaf with areca nut, is the primary cause in the majority, smoking, bad oral hygiene or a sharp tooth being the others.

The syptoms of mouth cancer could be any of the fllowing:

A sore on the lips, gums, or inside of your mouth that bleeds easily and doesn’t heal

■A lump or thickening in the cheek that you can feel with your tongue

■Loss of feeling or numbness in any part of your mouth

■White or red patches on the gums, tongue or inside of mouth

■Difficulty chewing or swallowing food, or a constant sticky feeling in the throat

It is only in the last 2 decades that tobacco companies have started selling tobacco ready-packaged in small sachets, called Gutkha in various flavours. It is marketed and offered by many as a sweet - bright colours and children’s faces decorating the wrappers.

Mr Sharad Pawar, who was a tobacco and Gutkha addict, had contracted mouth cancer in 2004 for which he underwent surgery, and subsequently converted to an avid ant-Gutkha campaigner.