Mumbai Experts Shift Oral Cancer Care to Organ Preservation

Oral cancer treatment in India is undergoing a significant transformation, with doctors in Mumbai focusing on preserving organs and improving quality of life rather than relying solely on extensive surgeries.

This shift was discussed by experts at the third Foundation Day of the Punyashlok Ahilyadevi Holkar Head & Neck Cancer Institute of India (HNCII) in Mumbai. According to Dr. Sultan A. Pradhan, Chairman of HNCII and Senior Oncologist, advances in immunotherapy, precision diagnostics, and reconstructive surgery are enabling doctors to offer more personalised treatment.

Dr. Pradhan explained that earlier, surgery was considered the only option for many oral cancers. However, today, combinations of immunotherapy, chemotherapy, and radiation can shrink tumours and help preserve organs such as the cheek, lip, or larynx, reducing the need for disfiguring operations.

Programmed Death-Ligand 1 (PD-L1) testing is becoming an important tool in deciding treatment, as it helps identify patients likely to respond to immunotherapy. This personalised approach can also reduce unnecessary procedures in carefully selected patients.

The submental flap, a reconstructive technique that uses tissue from beneath the chin to rebuild areas removed during oral cancer surgery, has been successfully used in more than 3,000 patients. This procedure takes nearly 50% less operating time compared to complex microvascular free flaps, making it particularly suitable for India's high patient load.

Despite these advances, doctors cautioned that treatment outcomes continue to be affected by delayed diagnosis. Patients often reach hospitals 7-8 months after symptoms first appear due to fear, denial, financial constraints, or reliance on unproven alternative therapies.

India's head and neck cancer burden is expected to rise sharply in the coming decades, with annual cases projected to reach 5.57 lakh and an estimated 2.63 lakh deaths by 2050. Early diagnosis, timely treatment, and wider access to advanced therapies are critical to improving survival and reducing disability among patients.

Oral cancers detected at an early stage have a cure rate of over 80%, while advanced cancers usually require a combination of surgery, radiotherapy, and chemotherapy, increasing both treatment costs and the risk of permanent functional loss.

The conference, themed 'Controversies Shaping Modern Oral Cancer Care,' brought together oncologists, surgeons, and researchers from across the country to discuss emerging treatment strategies and the need to combine technological advances with stronger public awareness for earlier diagnosis.

In conclusion, the shift towards organ preservation and personalised treatment in oral cancer care is a significant step forward in improving patient outcomes. However, addressing the challenge of delayed diagnosis and increasing access to advanced therapies will be crucial in reducing the burden of oral cancer in India.