In their teens and already staring at the ‘Big C’

KUALA LUMPUR: A person who starts smoking in his teens risks getting cancer at a younger age, even before he turns 40.

Hospital Kuala Lumpur oncologist Dr Vaishnavi Jeyasingam said with the increased number of years of smoking, the risk of developing cancer dramatically increases.

“We are seeing patients as young as their early 20s having oral cancer,” she said.

“In the past, most patients with oral cancer were aged above 40.”

This cancer rate is alarming considering that 14.2% of Malaysian youngsters between the ages of 10 and 19 have been found to be smokers.

According to the Tobacco and E- Cigarette Survey Among Malaysian Adolescents (TECMA) 2016, a study by the Health Ministry, the prevalence was significantly higher in males with 24.3% compared to females, who made up only 3.7% of the total surveyed.

What is worse, 78.7% of cigarette smokers tried their first stick before the age of 14. Perlis recorded the highest precentage of smokers with 22.9% while Terengganu has the lowest with only 10%.

Almost 15% of adolescents aged between 13 and 15 are no snokers. The legal age for buying cigarettes in Malaysia is 18 years and above.

However, most smokers can buy cigarettes from supermarkets, grocery stores or roadside stalls.

The report also noted that one in 10 non-smoking adolescents was susceptible to start smoking in the future and many were still exposed to cigarette smoke at home and in public places.

Dr Vaishnavi expressed concern that those who started smoking early might end up as heavy or chronic smokers.

Most of those with head and neck cancer, which includes oral cancer, were patients who had smoked for many years.

“It’s rarely a one-off thing. It’s usually chronic exposure,” she said.

“A biopsy should be taken if a painless ulcer in the oral cavity does not heal after two weeks,” she said.

Asked why some smokers get cancer and some do not, she said there were many factors, including genetics and environmental exposure.

Dr Vaishnavi said smokers increased the risk of cancer not only in the aero-digestive tract, but in many other organs.

They include cancer of the nasal cavity, pharynx, oral cavity, lungs, oesophagus, stomach, pancreas, colon and bladder, among others.

She said the hospital saw 10 to 20 oral cancer cases a month, including referrals from hospitals in Perak, Pahang, Malacca, Selangor and Kuala Lumpur.

Of these patients, about 60% of patients were chronic smokers.

Among non-smokers, betel nut chewing was noted to be a major risk factor in the development of oral cancer, she said.

Dr Vaishnavi said the survival rate of up to five years for Stage 1 oral cancer was 60% to 70% and with each higher stage, the survival rate dropped by 10 precentage points.

“Oral cancer has relatively poor outcomes and frequently recur even after surgery, chemotherapy and radiation,” she said.