SHARE

The Centre for Research in Oral Cancer established in the Faculty of Dental Sciences, University of Peradeniya has planned a special program to mark the Head and Neck Cancer day on 27th of July. According to Professor WM Tilakaratne, Director of the Centre, several programs will be launched in order to educate and motivate medical and dental students, doctors and other health professionals in early diagnosis and preventive aspects of oral cancer in a seminar which will be held on 26th of July at the Faculty of Dental Sciences, University of Peradeniya. In addition a lecture will be delivered in most schools in Kandy area to educate schoolchildren and teachers on oral cancer and precancer.

Although oral cancer is the commonest cancer in males in Sri Lanka, it is considered as one of the most preventable cancers in the human body. Moreover, large majority oral cancers are preceded by a precancer. Two most common precancers in the oral cavity in Sri Lankan patients are leukoplakia which presents as a white patch and oral submucous fibrosis. A significant proportion of these patients develop oral cancer. Therefore, it is mandatory to identify these precancers early in order to prevent development of cancer. Late diagnosis of oral cancer will drastically reduce the survival. The patients with oral submucous fibrosis have numerous disabilities such as inability to open the mouth properly, restriction of tongue movements, leathery feeling of mucosa and difficulty in enjoying food, etc.

More than 70 percent of oral cancer patients in Sri Lanka present to clinicians at the advanced stage which will minimize their chances of survival. Therefore, early diagnosis is a must and awareness among the general public on this aspect should be highlighted by responsible health bodies.

Professor Tilakaratne further said that the aetiological factors for the deadly disease are well recognized. Tobacco and arecanut are the main culprits for the high incidence of oral cancer in the country. Although, tobacco has been identified as a cancer causing agent for many years, the role of arecanut as a carcinogen was recognized only recently. Therefore, it is a timely need for responsible parties to take immediate action to limit if not prevents the use of arecanut. He also reiterate the fact that this is not an easy task as betel chewing has become part of our culture for centuries and it is deeply embedded in South Asian culture.

Head Neck Squamous Cell Carcinoma (HNSCC) is the leading cause of death and disability in most parts of the world. The burden of HNSCC is putting much stress on the national healthcare systems and deprives individuals, families and society. The majority of HNSCC occur in the mouth. Mouth cancer is the commonest cancer in Sri Lankan males.

However, majority of the HNSCC can be prevented and cured, if detected early. Unfortunately, millions of victims suffer from delayed diagnosis, inadequate treatment, inappropriate rehabilitation and palliation. A multi-sectoral response is needed from the government, NGOO, health care professionals, civil society, academia to control the disease.

The purpose of celebrating HNSCC is to draw the attention of the entire world to effectively care and control of HNSCC, mainly mouth cancer. The International Federation of Head Neck Oncologic Society (IFHNOS) states that the global incidence of head and neck cancer is over 500,000 and annual deaths are over 200,000. It is the leading cause of mortality and disability in many parts of the world and mainly affects people in their productive age, though most of this mortality and morbidity is preventable.

The IFHNOS guarantees to motivate the governments in reducing the burden of H&N cancers by providing affordable facilities for prevention, early detection, diagnosis, treatment, rehabilitation, surveillance and palliative care.\ It also synergizes multiple sectors to plan, execute, monitor and evaluate national HNSCC control activities, strengthens primary healthcare system, introduce community-based approaches for raising awareness, prevention and early detection, enhances expertise of physicians through increase of education and knowledge, creating environment to reduce risk factors (tobacco, alcohol, areca nut, alcohol abuse), strengthening national cancer registry and maintain surveillance systems by giving emphasis on monitoring on related risk factors and promoting research on HNSCC regarding low cost alternatives, prevention and early detection management and quality of life.

The WHNCD targets two areas, viz. advocacy for strengthening healthcare system and introduce community based approaches for raising awareness, risks, prevention and early detection of HNSCC and enhance expertise of physicians by upgrading their knowledge skills through programs. During WHNCD priority is given on oral cavity, oropharynx, hypo pharynx, nasopharvnx and larynx cancers.

Educating physicians on early diagnosis, current treatment paradigms and frontiers in research in head and neck cancer, awareness programs for general public, free screening for H&N cancers, interaction with cancer survivors and their families, interaction with government and policy makers etc. are important initiatives to be taken in this regard.
The International Federation of Head and Neck Oncologic Societies invites everybody to observe July 27th, the World Head and Neck Cancer Day together with 51 H&NS societies, 53 countries, several governments agencies and The UICC by organizing programs of awareness, risk factors, cessation, prevention, public education, screening, early diagnosis, physician education, outcomes, survivorships, etc.
Manjari Peiris