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Aug 16

Tobacco and oral cancer situation in Bangladesh

Oral Cancer: One defining feature of cancer is the uncontrollable growth of abnormal cells which grow beyond their usual boundaries and which can invade and cause damage to adjoining parts of the body and spread to other organs (a process referred to as metastasis). Metastases are the major cause of death from cancer. Oral cancer appears as a growth or sore in the mouth that does not go away. Oral cancer, which includes cancers of the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx (throat), can be life threatening if not diagnosed and treated early.
Cancer situation in Bangladesh: Cancer has been appearing as an important public health problem in Bangladesh. Due to the lack of reporting system and under-diagnosis of cancer, the real situation is unknown yet. A recent WHO study estimated that there are 49,000 oral cancer, 71,000 laryngeal cancer and 196,000 lung cancer cases in Bangladesh among those aged 30 years or above in Bangladesh (as of 2004).
Tobacco as a cause of major cancers: There are many external factors either cause or facilitate the development of cancers. Tobacco use is the single most important cause of large variety of cancers such as lung, larynx, oesophagus (food pipe), stomach, bladder, oral cavity and others. Dietary factors such as inadequate fruit and vegetables intake play important role in causing cancer. Excessive alcohol causes several types of cancer such as oesophagus, pharynx, larynx, liver, breast, and others.
Tobacco, through its various forms of exposure, constitutes the main cause of cancer-related deaths worldwide among men, and increasingly among women. Forms of exposure include active smoking, breathing secondhand tobacco smoke (passive or involuntary smoking) and smokeless tobacco (e.g., zarda, sada pata, gul, etc.).
The total death toll in 2005 from tobacco use was estimated at 5.4 million people, including about 1.5 million cancer deaths. If present usage patterns continue, the overall number of tobacco-related deaths is projected to rise to about 6.4 million in 2015, including 2.1 million cancer deaths. In 2030, the projected overall death toll will amount to 8.3 million. Tobacco poses a double burden to Bangladesh because of high production and high consumption. According to 2005 estimate 30.9 million people aged 15 years and above consume tobacco in any form. Unlike developed countries, smokeless tobacco in various forms adds an extra dimension to tobacco control. Bangladesh is among the world’s 20 largest producers of tobacco and tobacco products.
Tobacco control is the key to cancer control: At least 40% cancers can be prevented. Tobacco is the main culprit that should targeted for cancer prevention. You can help yourself. Just say “NO TO TOBACCO”. If you are a non-user “NEVER TRY IT”. If you are a tobacco user “QIUT IT NOW”. You definitely can do it.
Screening for oral cancer: Early detection of oral cancer using visual inspection of the mouth is being considered in countries where incidence is high, such as Bangladesh. The oral cavity is easily accessible for routine examination, and medical personnel can readily detect lesions that are the precursors of carcinoma. Furthermore, there are indications that precursor lesions may regress if tobacco use ceases and that surgical treatment of early oral cancer is very effective. Detection of precancerous lesions or early cancers can reduce mortality from the disease.
Treatment of oral cancer: Early detection of cancers can reduce mortality. If reconstruction is possible surgery is the first option then after healing give radiotherapy and chemotherapy

Dr. Abdullah Al Masud

Dr Abdullah Al Masud completed his BDS (Bachelor of Dental Surgery) in 2001 from Dhaka Dental College. In 2010 he completed FCPS in Oral & Maxillofacial Surgery from BCPS (Bangladesh College Of Physicians & Surgeons). He is trained in Orthognathic Surgery under Professor J.P.Reyneke from South Africa who is the author of the book “Essentials of Orthognathic Surgery”. He also took training in Dental Implantology from Dr.Wynand Van der Linden. American consultant Dr. David C Labber gave him special training in microtia surgery/ replacement of total external ear.

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