Mouth cancer on the rise due to use of betel nut

(4 Feb 2020) LEAD IN:
On World Cancer Day, medics in Pakistan are warning people to stop chewing betel nut, paan and gutka - a mixture of betel nuts, betel leaf, tobacco and lime.
Every year 200 thousand people are diagnosed with cancer in Pakistan, according to GLOBOCAN, the World Health Organisation's Global Cancer Observatory.
Cancers of the breast, head and neck are the most common forms, but oral cancer is also a big concern - largely due to the practice of chewing betel leaf and gutka.

STORY-LINE:
Forty year-old Irshad Ali has been suffering with mouth cancer, and for the past three months his wife Farzana has been caring for him in hospital.
Ali is from a part of Karachi called Jacob-line, a slum area where poor families are concentrated.
He is in severe pain and can't eat with his mouth. He takes liquid meals through a feeding tube in his neck.
Ali is in no doubt what has caused the cancer.
"I used to chew/eat betel leaf and gutka so I ended up here at hospital. I ask you all: please do not chew betel leaf and gutka," he says.
Ali has not seen his children since he was admitted to hospital. His wife doesn't want their children to see their father in such a poorly condition.
She says: "Irshad Ali got a cut in his mouth but we did not take it seriously, it became deep later. We visited doctors for two or three months.  We are from a poor family background. Later the doctors informed us that he has contracted cancer and it happened because of eating and chewing pan and gutka. (betel leaf and mixture of betel nuts and chemical). Our children suffered a lot and we have not been able to see our children for the last one and half months as we have to remain in hospital, we are so distressed."
Head and neck cancer is the second most common cancer in Pakistan after breast cancer according to the WHO's (World Health Organisation) most recent figures.
But cancer of the mouth is on the rise. In 2018, 18,881 patients were diagnosed with oral cancer.
According to doctors, that's largely due to the widespread habit of chewing paan, betel nuts and gutka which is a mixture of betel leaves, betel nuts, tobacco and lime mixed with sweet or savoury flavourings.
The burden falls most heavily on low income families. Treatment and medicines are expensive in Pakistan and poor families are helpless to deal with the situation. Patients often turn to spiritual healers in the hope of stopping the cancer spreading.
Dr. Adnan Abdul Jabbar works for the American board of Oncology at the Agha Khan Hospital in Karachi. He says there is no government-run central registry to keep accurate figures in Pakistan, so the real number of people with cancer can only be estimated:
"GLOBOCAN 2018  - there were almost two lakh (200,000) patients, new patients that were diagnosed in 2018 alone. At AKU (Agha Khan hospital) we see around five to six thousand new patients every year. Now one must realise that we cater for a very small portion of patients and the bulk of our patients go to our government sector and go to those hospitals where they cannot afford treatment, those who are financially challenged. So these numbers are an ambiguity, these numbers are just numbers that we throw according to estimates, so one of the biggest challenges is not knowing exactly what is the burden of cancer in Pakistan."
He adds: "Paan, gutka is another major reason and other thing that I always tell people is no preservatives, eat healthy stuff, we are now depending more and more on fast food which have more preservatives and hence we seeing more and more risk of cancer."

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  Mouth Cancer