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Doctors at Mumbai's Tata Memorial Hospital find way to reduce risk of oral cancer

Times of India:  June, 2015

Mumbai: Tata Memorial Hospital, the cancer hub in Parel, announced a breakthrough on Tuesday that could not only reduce the risk of death for oral cancer patients by 36% but also prevent recurrence of the disease by 55%.

The innovation is an 'extra cut' - a dissection in medical parlance - along the neck to detect if the patient's cancer had spread from his/her oral cavity to the neck. The cut would be a prophylaxis - a preventive medicine - against aggressive cancer forms and prevent the need for chemotherapy or radiation.

The findings were announced by Tata Memorial Centre's Dr Anil D'Cruz at an ongoing meeting of American Society of Clinical Oncology at Chicago on May 31. The findings were also published in the latest edition of New England Journal of Medicine.

The study assumes significance because India carries the highest burden of oral cancer in the world, with around 1 lakh new patients detected every year. It is the most common cancer among Indian men and third most common among Indian women. Worse, almost half of them die within 12 months of diagnosis, because of the delay in seeking treatment.

At a press conference held in the Parel hospital on Tuesday, one of the other investigators Dr Pankaj Chaturvedi said, "When a patient comes with a lesion in his oral cavity, be it his\her tongue or jaw bone, it's not possible to say whether the cancer has progressed beyond to the neck region. This is especially in the early stages of oral cancer.'' At present, patients may choose to not undergo neck dissection and wait until some cancerous bulge - basically, a recurrence - appears in his/her neck.

It has been one of medicine's long standing ethical debate on whether or not early stage oral cancer patients should undergo a neck dissection. On one hand, the dissection is a delicate operation because the cut is made near important nerves (for facial expression and spine), veins and arteries running along the neck.

On the other hand, if patients choose to not undergo a neck dissection, they may be at the risk of not diagnosing the cancer's complete spread early enough. This could impact their quality of life and, more importantly, their survival.

"But this research has put an end to this debate. A neck detection can save more lives. All it requires is 30 minutes extra on the operation table,'' added Dr Chaturvedi. Dr Richa Vaish, another researcher in the study, said that one death could be prevented for every eight patients who undergoes a neck dissection.