I have tried to make my own little mark in this world. My career as a Medical Educator and Clinician in Gastroenterology (see www.gastroindia.net) and my flirtations with Health Promotion, especially amongst school children (see www.hope.org.in) are shown elsewhere.This blog contains my attempts at creative writing, most being write-ups for Health Adda column of HT City of Hindustan Times (also see www.healthaddaindia.blogspot.com) as well as a few others, and some reflections and thoughts that have struck me from time to time on my life journey.Please leave your footprint on this blog with your comment.


Wednesday, July 14, 2010

Gutkha Blitz

When Mahadev, a 35 year old father of 3, who works in our department as an attendant, had consulted me 2 years ago for an ulcer on one side of his tongue that was refusing to heal, I recall how sad and worried I had felt telling his family that he was suffering from cancer. Fortunately, the stage was early and surgical removal offered hopes of a cure.
When we called on him after surgery, he was in some pain, with one half of his toungue chopped off and stiched. He had difficulty articulating, but seemed relieved that the cancer was gone. Subsequently, he had to undergo radiation therapy to kill any possible remaining cancer cells in the vicinity of his mouth. Two years later, he seems fine except of the asymmetry of his mouth, but fearful whether the disease might return. He has resolutely kicked his Gutkha habit and wishes that he had done it much earlier before the cancer had struck.
India leads the world in mouth cancer with 65,000 people getting it each year, almost 90% of which are due to tobacco. Chewing tobacco either as Gutka or rolled in betel leaf with areca nut, is the primary cause in the majority, smoking, bad oral hygiene or a sharp tooth being the others.
The syptoms of mouth cancer could be any of the fllowing:
  • A sore on the lips, gums, or inside of your mouth that bleeds easily and doesn't heal
  • A lump or thickening in the cheek that you can feel with your tongue
  • Loss of feeling or numbness in any part of your mouth
  • White or red patches on the gums, tongue or inside of mouth
  • Difficulty chewing or swallowing food, or a constant sticky feeling in the throat
Dentists and doctors can often spot pre-cancerous changes in the mouth such as leucoplakia (a whitish discoloured patch) or submucosal fibrosis (thickening of the inside of cheeks that restrict full opening of the mouth) before cancer actually develops during a routine check-up
With the popularity of chewable tobacco, particularly among the young, doctors are already reporting a rise in this disease. But what is the reason for this?
 It is only in the last 2 decades that tobacco companies have started selling tobacco ready-packaged in small sachets, called Gutkha. It can cost as little as half a rupee - which means one could buy 90 sachets for the price of US$1.One brand of Gutkha does not say it contains tobacco. Some Gutkha are chocolate flavoured; others are sold as mouth fresheners. In addition, some manufacturers package Gutkha as if it were a sweet - bright colours and children's faces decorate the wrappers.
Mr Sharad Pawar, who was a tobacco and Gutkha addict, had contracted mouth cancer in 2004 for which he underwent surgery, and subsequently converted to an avid ant-Gutkha campaigner. His face tells it all. It would do us well to learn from his experience.
As published in HT City ( Hindustan Times) dated 11 july, 2010.

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