Mouth Cancer Concepts for Patient
Cancer is a terrible disease to have. Everyone tells us that it is curable in early stages. That is undoubtedly true. With laser now it may be possible to cure even small advanced cancers in stage 4. The curability factor gets multiplied many times after laser with practically no side effects.
Many tumours for which there was no hope have now been shown to be manageable with Laser.
There are 3 main pillars of oncology -Surgery,Chemotherapy,Radiotherapy.Now a 4th Pillar has been added and that is Laser.
Laser can burn out the tumour from within with no need for cutting with a knife.Allthoughuntrained surgeons still use laser as a knife.
But that is more from a force of habit anda comfort factor than any real scientific reason.
Why is mouth cancer different?
Yes it is different from other cancers since it causes death by an uncontrolled increase in the mouth leading to mouth closure, nutritional disturbances and bleeding.
There are hardly any patients that die from distant spread of cancer. Therefore if we can control the number of cells in the oral cavity the patients life can be extended.
Also it needs to be noted that the last cancer cell can be taken out by only the immune system of the body .
After surgery, chemotherapy and radiotherapy the mouth is so badly disturbed that normal eating is not possible. This leads to a decrease of immunity which leads to an increase of cancer.
I want a cure
Cure of cancer would mean a halt to the spread of cancer or reversal of disease. Unfortunately this is not possible in the current level of knowledge. Most often than not what is available to the patient is remission rather than a cure .Remission is a temporary slowdown of the disease process.
This is different from Palliation in which the disease progress is not slowed down and only pain control or essential functions like nutrition and breathing are maintained.
In advanced cancer of mouth the choice is really between a good quality of remaining life with laser or a bad quality of remaining life with surgery.
Boon for patients.
There are many patients who are adamant on not wanting surgery at any cost. These patients were scorned and ridiculed by their relatives and friends when things went bad. If the patient underwent surgery these relatives would a turn a blind eye and blame Providence and God when even in spite of the best efforts the patient did not recover. This is the scenario in nearly all cases of advanced Oral cancer.
Now these patients can have the same benefits of tumour control, may be even better without having to undergo the knife for a very mutilating surgery.
In addition patients of early carcinoma can adopt a wait and watch policy after laserisation of their tumour before opting for a damaging surgery.
Remember even in early cases there is no guarantee of a cure after the most mutilating surgery.
We see alot of patients being forced to get a surgery done under pressure from their relatives and friends. This is obviously done in good faith. Also in when multiple second opinions are taken, theoptions always veer towards radical surgery.This is because all parties involved in the decision process have a nihilistic or fatalisticattitude towards oral cancer.No one wants to bell the cat by saying that there is no hope with the current knowledge of cancer to cure the patient with any amount of guarantee.
The reality is that no one wants to be caught on the wrong foot in the event of the patient�s demise.
The suffering patient will have to undergo is written off to his fate. The remaining days of the patients life are spent in absolute misery.
We firmly believe if the doctor cannot make the patient�s life better he has no right to make it worse.
Case against Surgery
Surgery is blunt solution to oral cancers which is a throwback to 1940�s when the surgeons reigned supreme and there was no advancement in chemotherapy and radiotherapy. So extensive cutting was the only answer. Over the years �the surgical field has has become so powerful that nobody dares question the logic of taking a patients remaining life without� any hope for a cure. Remember there is no guarantee of cure even in early stages of oral cancer.
Hospital take on Cancer
Laser treatment for oral cancer is the direct opposite of surgery since no cutting is involved.
Oncosurgery is the most revenue generating of all departments in any major hospital. Consequently the oncosurgeons are therefore a very powerful decision making body in the hospital .To expect them to change their way of working is asking too much from any human being.
Remember� a surgeon is trained and lives to operate .He is not going to sign his own demise just because you expect him to work in the best interest of the patient.
If you think that is an overstatement please check the OPD of any oral cancer surgeon ask him about the consequences of the operation he has performed on patients. Ask the patients if they were aware of the consequences and whether the patient was sincerely advised of the side effects of the surgeries.
Patients need to come to terms that oral cancer surgery is an extremely demanding field� requiring years of observation and training.No surgeon in his right mind will be willing to give away those years of hard work for a technology which is directly opposite to his training.
That is precisely the reason why Cardiovascular Surgeons did not take up Angioplasty in the infancy.
It was too simple and hence below them.
Why surgery cannot defeat cancer
Surgery is a very blunt way of treating a disease which is widespread and at a microscopic level. Even if 1 single cell is left behind , it will behave in an autonomous way and will result in a new tumour.This is called recurrence which is what all patients and doctors are afraid of.
In layman�s terms it is like a termite infestation. One cannot take out a single part of the wall and hope for a permanent cure of termite problem.
This is precisely the reason why most of all surgeries fail to cure a patient.
It is also the reason why surgery should not be done in Oral cancer.
How can laser help?
Laser is a perfect way to decrease or debulk the cancer.In effect it is same as surgery which also only decreases the no of cancer cells.
If surgery could take care of 100% cancer why would there be a need for chemotherapy and radiotherapy.
A fact known but never emphasized.
Laser does the same debulking without surgery and no blood loss.
Quite frankly if laser was present before surgery .Most of surgeries today would not have been invented at all.