* Genetic changes inflicted through tobacco, betel quid/nuts, gutka, naswar or mainpuri cause oral cancer, study suggests
By Ahtesham Azhar
KARACHI: Oral Cancer, also known as Oral Squamous Cell Carcinoma (OSCC), a major medical complication that persists in underdeveloped countries, including Pakistan occurs due to the genetic changes inflicted through tobacco, betel quid (paan), betel nut (chhalia), gutka, niswar and mainpuri chewing.
This was established by Dr Saima Saleem, a doctorate research student of Prof Dr – Abid Azhar, Director General of Khan Institute of Biotechnology and Genetic Engineering at Karachi University.
Dr Saleem further discovered that these days gutka was considered the most hazardous and carcinogenic chewing agent in Pakistan. Different types of unhygienic, unpacked and homemade gutkas are also available in market like geela gutka (wet gutka) and sukha gutka (dry gutka).
For her study, Dr Saleem collected a total of 260 OSCC patients’ tissue and blood specimens with informed consent from local hospitals of Karachi. The samples were later compared with blood samples of 260 age and sex matched controls. The histopathology of tissues of such patients helped in identifying the oral cancer.
Patients’ blood and tissue samples extracted from the DNA aided in studying the genetic alteration as well. It has been informed in the study that the early signs of oral cancer include appearance of white and red patches inside the mouth; this is considered as the early stage or primalignant stage of oral cancer. Along with this, a bruise, guilty, ulcer or discolorations inside or around lips, tongue or mouth are the most definite indications.
At this stage cancer is usually curable through surgery. However, since initially these symptoms are absolutely painless as a result of which patient keeps ignoring them but the burning sensation and pain later on is unbearable. This is called the advanced stage of oral cancer and the only possible treatment at this stage is chemotherapy and radiation therapy.
The research study states that chewing habits of paan, chhalia, tobacco, gutka, niswar and mainpuri containing carcinogens (agents that causes cancer) causes mutation of tumor suppressor genes. Tumor suppressor gene is a gene that suppresses tumor. The germ line mutation/polymorphism of this gene has been reported to be involved in multiple steps of carcinogenesis. It has been reported in the research that they are hot spots of the mutation in the tumour suppressor gene. Mutagens can damage DNA and generate promutagenic lesions. This study found out the loss of functions due to mutation/polymorphism caused by genomic alteration and interaction with tobacco and its related ingredients in Pakistan.