Common form of tobacco consumption in India
Gutka is a mixture of betel nut and chewing tobacco. It is extremely addictive and is apparently targeted at youngsters.
Quid is the mixture of tobacco and lime and extensively consumed in India.
The tobacco when kept in mouth leaches out carcinogens, which act on the mucosa causing precancerous lesions, which lead to cancer.
According to the B.B.C "4 in 10 of all cancers in India are oral cancers".
This is because of extensive use of tobacco and betel quid.
There are three most common precancerous lesions seen in the mouth and they are
The most common sites of the oral cancer are the tongue and the floor of the mouth. The other common sites are buccal vestibule, buccal mucosa, gingiva and rarely hard and soft palate. Cancer of bucco-pharyngeal mucosa is common in smokers.
This cancer is extremely malignant and even if there is slight delay it spreads to lymph nodes of the neck. Once it spreads the prognosis becomes poor and death is inevitable and is because of erosion of major blood vessels and erosion of the base of the skull, Cachexia and secondary infection of the respiratory tract.
N0 is no lymph node
N1 is single ipsilateral node < 3 cm
N2a single ipsilateral node > 3 cm but < 6 cm
N2b multiple ipsilateral node < 6 cm.
N2c bilateral or contra lateral nodes < 6 cm
N3a ipsilateral node > 6 cm
N3b bilateral nodes > 6 cm
M0 is no metastasis and M1 is metastasis present.