Tag: Tobacco

Dilemma of a Doctor – Advise to Quit or Not?

Dilemma of a doctor – A 44 year old tobacco chewer with advance stage of cancer – should he be asked to quit tobacco???

Author – Dr. Monalee Prasad, BDS(2007), PGD in Aesthetic Dentistry (2009),TII -IDA(2020) ,OCTC (2021), CTCS (2021).

This is a case of a 44 year-old male patient suffering from Stage IV recurrent oral cancer with extensive neck and systemic metastasis. He was being treated somewhere in Uttarakhand. He attended OPD for treatment. He has been a chronic chewer and smoker for years and he continues to do so even after being diagnosed with advanced cancer with a short life expectancy. Besides the palliative treatment, the big question is about his tobacco – Should we ask him to quit? Or should we not ask him to quit?

How should we plan his treatment with regards to tobacco cessation?

The case was put for discussion during the tutorial for Certified Tobacco Cessation Specialists were – different difficult cases that we come across in Tobacco Cessation practice and their treatment are planned. It was a mixed opinion with more suggesting  that the patient should be told to quit tobacco.

The same question was put in the group who are actively working for tobacco control and the majority said that the above patient needs to quit so that the treatment will be helpful and the organs will respond better to treatment.

Now opinion from group of oncologists was seeked, unanimously they said there is no need for him to quit tobacco.

The argument put forth by was that with Stage IV cancer there is no hope of his long survival and it will not be of much help at this juncture to force him to quit. Also the handling of withdrawal symptoms is more difficult in this case along with the Palliative care that has to be provided. It will not improve the quality of life of this already dying patient.

Hence, it wouldn’t matter whether we advise him to quit or not. It would be his wish.

Also, in case we are able to convince him to quit; there are two case scenarios which were discussed and how we can use it as a positive messaging for the next generation.

One scenario is where he is able to quit completely and then the message that can be conveyed through him that even though he suffered from taking tobacco and has reached the last stage of his life, he could quit his habit with the help of our esteemed doctors. And if he can do it, anyone at any stage can do it and the sooner one quits, the better it is for health.

Second case scenario is when he is unable to quit despite all the efforts by the doctors and himself and he continues to smoke till his last breath. The message that we can pass on in this situation is that Tobacco is a deadly disease and really addictive one. Message is clear for the youngsters and family members – never to start such a habit and quit as early as possible. BE SMART DO NOT START and if you have then please QUIT.

So, an important learning was shared via this case by Dr. Pawan as to how to choose the messaging we need to convey to the society at large and always choose the treatment keeping the patient’s overall benefit in mind.

Medical treatment is available to quit tobacco and treatment from the cessation specialists should be seeked.

Do share your thoughts on this in the comments below? What would be your choice of treatment?

Pledge to Advice Quit Tobacco – Interaction with Doctors And Paramedics Of Bhardwaj Hospital

PLEDGE TO ADVICE QUIT TOBACCO – Interaction with doctors and paramedics of Bhardwaj Hospital

Schedule: 18th February 2023 Time: 2:30 pm onwards

An interactive session with enthusiastic members staff of Bhardwaj Hospital Sector 29, Noida as part of #oraloncologyconnect CME and #advisequittobacco was conducted

The program was arranged by Mr. Kunwar Chauhan and his team of MAX Vaishali Sales.

The program was coordinated by Dr. Saurabh Gupta  administrator of the Hospital and Dr. Abhishek Kumar, a Physician with a special interest in tobacco related diseases.

The Interactive oral oncology connects sessions were attended by 53 doctors and paramedics.

Dr. Pawan Gupta M.Ch. Director HN MAX Hospital, Founder of ICanCaRe, and MASTER trainer convenor for Tobacco Courses interacted with the participant and gave the following messages to them

  • ORAL CANCER IS A PUBLIC HEALTH PROBLEM and all MEDICAL PROFESSIONALS TSHOULD JOIN HANDS TO CONTROL THIS EVER INCREASING DISEASE
  • Tobacco is a disease and not just an habit, it has to be treated as a disease.
  • Tobacco cessation is possible – Medical Treatment is available
  • SPECIALISED TOBACCO CESSATION SPECIALIST are now available and they should be consulted for cessation.
  • Courses are available and delivered by ICanCaRe for the doctors and paramedics.
  • Every hospital should have ORAL CARE and TOBACCO CESSATION CENTRE at prominent visible location.

Dr Pawan Gupta emphasized that it is a moral duty of all health care professionals to ADVISE QUIT TOBACCO to all their patients and others also.

There was special interest in knowing about tobacco-related cancers and how to control the same. especially in chewing tobacco which is so rampant in India. Dr. Pawan Gupta M.Ch. Director of Cancer Surgeons, MAX Hospital, Patparganj, and Vaishali, made them aware that quitting tobacco is possible and that one can quit tobacco with proper intervention by a Tobacco Cessation Specialist. TRISCaRe the innovative mouth opener device was also demonstrated. Dr. Pawan apprised that besides being a fine surgeon he is also the MASTER TRAINER of Tobacco Cessation courses run by Gujarat University and conducted by ICanCaRe.

The main emphasis was on involving the first echelon doctors for controlling the biggest killer cancer of India which is head and neck cancers and prevention with tobacco cessation and early detection by regular examination.

#MAX #oraloncologyconnect #icancare #icancareacademy #pawangupta #tobaccomarshal #advisequittobacco #savetheyouth

 

Oral Care and Tobacco Camp by Rotary Club of Aligarh Rudra

at Varshney Mandir, Aligarh

ORAL CARE AND TOBACCO CAMP at Varshney Mandir, Aligarh by Rotary Club of Aligarh Rudra

Event Date: 25th January 2023 Time: 11:00 AM – 3:00 pm

In association with –MAX Hospital, Patparganj and ICanCaRe

An Oral Care and Tobacco Users Camp was conducted under the leadership of Mr. Saket Varshney, President of Rotary Club of Aligarh Rudra as part of SAVE the youth Campaign of ICanCaRe.

The focus was specially on Tobacco Users. Chewing tobacco use is unique in India. India has the highest tobacco chewers in the WORLD and also the highest Oral cancers related to tobacco use in the world. Aligarh is dominated by tobacco users. With this in mind Mr. Saket and his team organised this unique camp for the tobacco users. The camp was inaugurated by Rotary District 3110 Assistant Governor Mr. Harvansh Sahay.

Dr. Pawan Gupta M.Ch. a highly recommended Oncosurgeon, Director MAX Hospital and Founder of ICanCaRe made the participants aware on the following:

  1. Tobacco is a disease and needs to be treated as a disease. IT IS POSSIBLE TO QUIT.
  2. Medical treatment is available to help quit tobacco.
  3. STANDARD PROTOCOL for intervention is available on ICanCaRe app (http://app.icancare.in)
  4. SPECIALISED TOBACCO CESSATION SPECIALIST are now available
  5. SPECIALISED centres – Physical and Virtual are available.
  6. ICanCaRe trains doctors and social workers to be Specialist and TOBACCO MARSHALS in the society.(www.icancare.in/academy)
  7. Oral cancers are a chronic disease and it has a long incubation period. When changes occurs initially it is possible to reverse by quitting tobacco however, if it has progressed it is possible to treat with cure.

ICanCaRe runs a physical centre at MAX hospital and it also runs virtual tobacco cessation program, to enroll – contact 011-43077695. In addition ICanCaRe ensures that medications reach the client wishing to quit tobacco through its unique online pharmacy www.icancare.org

18 patients were seen of which

  1. 3 had cancers – guidance was given to them as per requirement. All three were tobacco users.
  2. 8 had oral lesions and required treatment for the same
  3. All had dental problem related to tobacco
  4. 7 started medical treatment to quit
  5. 4 planned to quit tobacco by self and were advised in case they fail they can reach Mr Saket who would facilitate to register for virtual program to quit.
  6. 2 had quit earlier of which one was normal and other had lesions, but very much reluctant to except.
  7. 4 disagreed that they need to stop tobacco, although they had lesions. They were advised to comeback for review after a month, hope by then they would have change in mind.
  8. One participant immediately threw away tobacco from his pocket as start of his tobacco free journey.
  9. 2 patients were non tobacco user and just came for check-up. They were found to be normal.

Arrangement for medications were made at the camp and willing people immediately purchased medicines for their use.

This was a unique camp and of real benefit to the participants, unlike other pseudo camps which is mostly for advertisement. All credits to Mr. Saket Varshney and his team.

Mr. Vinay Sharma coordinated on behalf of MAX Patparganj for smooth conduct of the camp.

#icancare #icancareacademy #pawangupta #ctcs #rotary #rotaryclubofaligarhrudra #saketvarshney #MAX #aligarh

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 Specialty Hospital, Vaishali. Patparganj and Noida. He is founder of ICanCaRe. 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)