Month: May 2021

ABCD of ICanCaRe Tobacco Cessation Intervention Program

Quitting Tobacco has been a challenge. Most do not plan to fail, but fail to plan! Planning and preparation is the most important step to being successful.

Any successful tobacco Cessation program has to incorporate these 4 things which I put as ABCD of the ICanCaRe Tobacco Cessation program. And this is the success mantra for achieving 100% success for our patients.

ABCD of our Cessation, how we will help you in this quitting journey.

  1. A – for ACTIVE MOTIVATION and FOLLOW UP in which quit coaches will give you follow-up calls to check your progress on this quit journey of yours. Keep you constantly motivated with encouraging words making your journey pleasant and happy.
  2. B – BEHAVIORAL INTERVENTION takes the form of advice, discussion, encouragement, and other activities designed to help quit attempts succeed. In this, we will give you the detail about 7D of coping with the urge of Tobacco. We will also explain to you to abstain from common trigger points and manage withdrawals.
  3. C – COMORBID CONDITIONS, to ensure those suffering from comorbidities of tobacco are appropriately recognized and treated to prevent Cancer, Cardiovascular, malnutrition and immunity deficiencies, and other chronic diseases.
  4. D – DRUGS OR MEDICATION which can be divided into Nicotine Replacement Therapy, non-nicotine medications, and supportive medications that have anti-craving effects. Certain other supplements as per the requirement would be added for the purpose.

An ICanCaRe-certified tobacco cessation specialist follows the ABCD Of tobacco cessation for a 100% quit rate.

Book your appointment today to start a healthy tobacco/smoke-free life with the best in class tobacco/smoking cessation experts at www.icancare.in/quittobacco or call 011-430-77695 for help. Download the ICanCaRe e-cessation app for quitting smoking and tobacco at https://app.icancare.in. 

(The Author – Dr. Pawan Gupta M.Ch. is Director of Surgical Oncology at Max Super Speciality Hospital, Vaishali. Patparganj and Noida. He is the author of the book – Win Over Tobacco Made Easy, Be Smart Do Not Start and is highly recognized for his work on Oral Cancer and Tobacco Cessation. He is the convenor for the Certified Course in Tobacco Cessation at Gujarat University)

What You Need for Successfully Quitting Tobacco Chew and Smoking – COMMITMENT (COMMIT TO QUIT)

Yes, this is the only thing that I need from you for a 100% quit rate. Full Commitment and I assure you my and my team’s full commitment to handhold you through your journey. Make your journey a pleasurable and happy one. Happy while actively quitting and happy ever after.

The preparation needs careful planning and would need modulation as we go on. We would need all the inputs from you to help you cope up with the different situations that would arise.

  • Will power – The willpower to quit is needed. The willpower would not be the same for everyone. The Will Power Index helps me understand your requirement for the type of intervention.
  • Motivation – Motivation will vex and vane. Some days you may be high and other days your motivation would dwindle. Our team would be there to support you and keep you motivated. Please feel free to discuss.
  • Slips – It may happen. It gives an opportunity to understand weaknesses and learn how to handle those weak points. Discussing the reason for the slip and finding out a solution to handle it next time makes you stronger and committed to staying quit
  • Friends – Two types – 1. encouraging talking positively about your commitment to quitting. 2. Discouraging – making fun of you for your decision to quit. They are generally the ones who themselves are diseased, better avoid them now and forever. No need to argue with them they are not worth your time.
  • Nagging – It may have negative effects but let us think positively about the person nagging. The fact is that the other person is so frustrated over the period of time. Your positive approach would convert these negative factors to positive ones and give you the respect that you deserve. The only people you need around you are the positive people.

Remember: WITH EVIDENCE BASED APPROACH it is easy to SUCCESSFULLY QUIT TOBACCO. You need to take the first step and give us your commitment to quit, leave the rest to us. ICanCaRe Team will make this quit journey smooth and easy for you.

Once we have your commitment, we would help you through the withdrawals, the cravings, and various situations that would arise during the journey, but finally, you would win and that is assured. Just need to follow the ABCD of Tobacco Cessation. 

All the best and wish you a clean green healthy and lively life ahead. Visit www.icancare.in/quittobacco or call 011-430-77695 to get professional assistance to quit the tobacco/smoking addiction. Download the ICanCaRe APP.

Oral cancers – King of all Cancers in India

Introduction

India the land of Chewing tobacco is also the land of Oral Cancer. India ranks the highest in the World in terms of both incidence and prevalence of Oral Cancers. And more than that we have the highest number of people harboring premalignant lesion in the mouth potential to turn malignant. Fortunately, oral cancers are the easily detectable, easily curable and more importantly easily preventable. But tragically most of the patients reach the health care facility in late stage with dismal anatomical, functional and life expectancy outcome.

April is designated as the oral cancer awareness month with a purpose to make all out efforts to reach out to public, physicians, surgeons and dental specialists so that they incorporate the knowledge in their practice which will make a huge difference in the incidence as well as outcome for these patients. Further the common problem of tobacco, Submucosal fibrosis and premalignant lesions needs to be handled by the primary doctors themselves to prevent and control at the primary level itself. For this it is important that the healthcare workers be updated with the knowledge. There is a huge gap and more of the primary health care specialists need to be trained.

For a common public and especially those into tobacco use both smoking or chewing have to practice self-examination of oral cavity as a routine.

In India, oral cavity cancer is among the three most common types of cancer. In India, the age standardized incidence rate of oral cancer is 12.6 per 100 000 population accounting for 30-40%of all malignancies in India.

Oral malignancies occur mostly as squamous cell carcinomas (SCCs) presenting as ulcers. They have a long period of premalignancy stage and mostly associated with a preventable cause. The treatment and outcome of these cancers depends on the stage at diagnosis. Early cancers 5 year survival can be 80% however most cancers present at late stage with a dismal 5 year survival of 20-30%. The only way to change the scenario in India is by early detection of these king of all cancers in India, and more importantly work for prevention of these cancers by stopping the cause- Tobacco

ICanCaRe understands the need of oral cancer screening in India and therefore have started Oral cancer screening and Tobacco Cessation Program in multiple hospitals including RSD Hospital Moradabad, Omaxe Green Valley Plaza Faridabad, Max Super Speciality Hospital Vaishali and more. 

Oral Cancer Prevention

The oral cavity starts from the lip upto the oral anterior pillar of the oropharynx. This consists of the following parts – the lips, the lining of the lips and cheeks, the teeth, the floor of the mouth under the tongue, the front two-thirds of the tongue, the glands that secrete saliva, the bony top of the mouth (hard palate), the gums, and the small area behind the wisdom teeth (retromolar trigone). Oral cancers can occur at any of these areas – the commonest areas being – sulcus between cheek and teeth, and the tongue, mostly related to the tobacco chewing habits the are where the quid is kept.

Oral cancer risk factors

Who have the higher chances of having these oral cancers? Risk factors determine the increase chance of having the cancers. Fortunately most of these risk factors are preventable or modifiable, unfortunately people are not ready to change!

  • Tobacco and Alcohol Use: Tobacco consumption both smoking (cigarettes, bidi, hookah, etc) form or non smoking form (gutka, zarda, mawa, kharra, khaini, etc) is the commonest factor causing oral cancer. Oral cancers are in the rise in the young as well as the adult Indian population. This is mostly related to tobacco habit being started at early age. Alcohol, any form increases the risk of developing oral cancer. Alcohol accentuates the permissiveness of tobacco substantially increasing the chance of cancers of oral cavity. Alcohol alone also increases the risk. Stopping the use of tobacco and/or alcohol will decrease the risk of oral cancer.
  • HPV:  The sexually transmitted human papillomavirus (specifically the HPV 16 type) has been linked to a subset of oral cancers, Although not common it is increasing in India.
  • Diet: A diet high in fruits, vegetables, and fiber may decrease the risk of oral cancer.
  • Age: The risk of developing oral cancer increases after 45 years of age. The age is rapidly decreasing in India due to starting of tobacco use at early age.
  • Dentures and sharp teeth: Ill-fitting dentures or sharp teeth causing chronic trauma and friction is a risk factor for developing oral cancers.
  • Sun Exposure: Sun avoidance or the use of sunscreen may decrease the risk of cancer of the lower lip. These cancers we commonly see in farmers exposed to sun for long duration.

Who are at risk of Oral Cancer?

  •  Tobacco smokers/chewers.
  • Drink excessive amounts of alcohol.
  • Feel difficulty in swallowing or chewing food.
  • Oral habits such as cheek or lip biting.
  • Wear dentures that are old or ill fitting.
  • Any swelling or lumps anywhere in the mouth.
  • White, red or dark patches anywhere in the mouth.
  • Repeated bleeding anywhere in the mouth.

Symptoms of oral cancer

  •  Ulcer in the mouth that is not healing for more than 2 weeks (most common symptom).
  • Any Non healing painless ulcer or growth anywhere in the mouth, which bleeds on touch.
  • White or red patches (leukoplakia or erythroplakia) in the oral cavity.
  • A lump or thickening in the cheek. 
  • Notice any tingling or numb feeling anywhere in the mouth, neck or facial regions.
  • Pain during swallowing.

Oral cancer early detection Quitting Tobacco

The oral cavity can be easily examined physically by self and by clinician. Many malignancies can be diagnosed at early stage and many lives saved

With awareness, self and clinical oral examination the number of new cases of oral cancer, as well as the number of deaths from oral cancer, has been decreasing.

Oral cavity examination – Once only once a month

The examination of the oral cavity is the best single modality that can detect oral abnormal lesions.  Self oral examination is easy to perform and is free. Mostly done self by standing in front of a mirror or by spouse or colleagues. Examine each and every area of oral cavity including by pushing the tongue to the opposite side. Look for any lesion – white, red patches, nodules, ulcers, swelling, bleeding points needs to be consulted by specialists. Self oral examination as an effective screening technique that includes extraoral and intraoral examination. A simple test of extent of mouth opening (by TrisCaRe) can detect the development of Submucosal fibrosis and the chance of harboring some Premalignant or frank malignancy in the oral cavity.

Each individual must self -examine the oral cavity atleast once a month and if they notice any of the symptoms mentioned above should immediately visit the doctor.

A clinical examination by a specialist is advised on a regular basis. For a tobacco user please get yourself examined every 6 monthly and continue this even after you quit tobacco. The health professional will examine your oral cavity and when needed with advise more tests.  

Clinical oral examination by a trained or certified specialist is a must every 6 months for those who consume tobacco and/or smoke.

Oral cancer prevention – Quitting Tobacco!

This is the single most important factor can change the outcome. Quitting Tobacco can help you prevent many other associated diseases as well. Quitting tobacco is possible through proper medical evidence intervention technique by medication,7D behavioral therapy, and co-morbidity management.

Please visit ORAL SCREENING AND TOBACCO CESSATION CENTRE at the nearest centre to you for early detection and treatment of oral cancer.

Visit www.icancare.in/quittobacco or call 011-430-77695 for seeking assistance in quitting tobacco and preventing oral cancers.

(The Author – Dr. Pawan Gupta M.Ch. is Director of Surgical Oncology at Max Super Speciality Hospital, Vaishali. Patparganj and Noida. He is author the book – Win Over Tobacco Made Easy, Be Smart Do Not Start and is highly recognized for his work on Oral Cancer and Tobacco Cessation. He is the convenor for Certified Course in Tobacco Cessation under the Gujarat University)