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Cancer of Oral cavity is the most critical issue among cancers of Head & Neck (HNC) in India. It is nothing but the 'Atrocity of the Monster called Tobacco primarily. Tobacco chewing habit is deeply rooted in our social system to an extent that whosoever attempts anti-tobacco initiative fails on most of the occasions. We as cancer physicians are compelled/conditioned to accept it as a reality and yet do the best treatment for patients presenting with Oral Cavity cancer.

Most of the pre-cancerous symptoms of oral cavity are ignored therefore patients present to us in relatively advanced stage. Cancer of tongue for example, if presented in second or third stage will invite surgical treatment i.e. removal of cancerous part or whole of tongue. Having said that, we as doctors envisage the poor quality of life for patient after such a surgery because of loss of important organ like tongue and thereby loss of function.

Thanks to Chemotherapy supported by radiotherapy, I would say that such stage 2 & 3 cases can be given chemotherapy upfront so that cancer is downsized to disappear partly or fully while tongue can be preserved. Such a treatment is termed as 'Organ Preservation Strategy'. It is offered to patient after due consultation and risk assessment by Cancer Surgeon, Radiation therapists and Chemotherapy specialist.

To conclude, oral cavity cancers can be prevented by exclusion of Tobacco. But those deeply engrossed into the habit should at least proactively look for early symptoms & report them to doctors. Early the presentation, better are the chances for 'Organ Preservation' in HNC.

Dr.Kshitij Joshi

M.B.B.S, M.D. (Medicine). D.M.(Medical Oncology), D.N.B.(Medical Oncology), ECMO (European Society Certification in Medical Oncology)

Medical &Pediatric Oncologist &Hematologist