【CSCO 2022 Prospect】Current status of diagnosis and treatment of betel nut-related oral cancer

Areca catechu L is a plant in the family Betel nut, widely distributed in Southeast Asia, tropical Asia, East Africa and parts of Europe, and the Pacific Islands, and its fruit can be eaten
fresh or processed.
About 600 million ~ 1.
2 billion people in the world chew betel nut, mainly in India, Pakistan and other Southeast Asian countries and regions, China is mainly found in Hunan, Hainan, Taiwan three provinces
.
With international economic and cultural exchanges, the habit of chewing betel nut has gradually become globalized
.
Existing studies have shown that long-term betel nut chewing can lead to oral mucosal diseases mainly including oral submucous fibrosis (OSF) and oral leukoplakia (OLK), which can be cancerous
in severe cases.

As early as 2003, the World Health Organization (WHO) recognized betel nut as a Class 1 carcinogen, that is, a substance
"determined to be carcinogenic to humans".
Also listed as first-class carcinogens are aflatoxin, aristolochic acid, asbestos and other substances
that seriously threaten human health.
Everyone is afraid of class 1 carcinogens such as aflatoxin and asbestos, but they do not pay enough attention to
betel nut, tobacco, and alcohol of the same grade.

As an addictive "soft drug", China's Hunan, Hainan, Guangdong, Guangxi, Taiwan and other provinces have suffered from it
.
About 60% of oral cancers are related
to eating betel nut.
Once oral cancer occurs, endless pain, surgery, and death
await the patient.
Professor Han Yaqian, director of the Second Department of Head and Neck Radiotherapy of Hunan Cancer Hospital, once analyzed that according to the current trend, by 2030, the number of oral cancer cases caused by betel nut may exceed 300,000
in Hunan.

Oral cancer is a general term for malignant tumors of multiple organs (parotid glands, submandibular glands and facial skin) in and outside the mouth, although the incidence is not high, but the 5-year survival rate is only about
50%.
The oral part of the organ is dense, and it is easy to invade important structures such as neighboring organs, which is important because the tongue lacks an anatomical structure barrier to prevent spread, the tongue has abundant lymphatic return, and the tongue is easy to spread to the opposite side
.

In addition to the biological behavior of tumors, treatment irregularities are also responsible for
affecting survival rates.
At present, the treatment of oral cancer is still a multidisciplinary comprehensive treatment based on surgery, including surgery, radiotherapy and drug treatment
.
Individualized treatment models
are formulated for patients according to different stages and biological behaviors of tumors.

In the past 20 years, due to the development and progress of surgery and comprehensive treatment, the local control rate and quality of life of oral cancer patients have been improved, so that patients with advanced stage can also obtain better survival and quality of life
through multidisciplinary comprehensive treatment.
At the same time, targeted therapy and immunotherapy also provide patients with new treatment models, improve the quality of life and prolong survival of
some patients.

On November 7, 2022, the 25th National Congress of Clinical Oncology and the 2022 CSCO Annual Conference invited Professor Han Yaqian to give a keynote speech to introduce the diagnosis
and treatment status of betel nut-related oral cancer.

Resources:

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weixin.
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https://mp.
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https://mp.
weixin.
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com/s/oigI-ZvNp25A8yCHjRYvKQ

https://mp.
weixin.
qq.
com/s/l7ki6OVePnKFPPoZMJNCrA