<p>​It often begins with something that seems too minor to worry about, a small mouth ulcer, a patch inside the cheek, or a lump in the neck. Because it is often painless, many people ignore it or try home remedies. Others are reassured that it is &#39;just a sore&#39; or fear that a biopsy will make it spread. Months later, they arrive at the hospital with advanced cancer, requiring complex treatment that could have been avoided with earlier diagnosis.</p><p>As the world observes Head and Neck Cancer Awareness Month this July, led by the International Federation of Head and Neck Oncologic Societies (IFHNOS), it is an opportunity to remind ourselves that many head and neck cancers are preventable and, when detected early, highly curable.</p><p>Head and neck cancers include cancers of the mouth, tongue, throat, voice box and surrounding structures. Worldwide, they account for more than 900,000 new cases annually. Pakistan carries a particularly heavy burden because our risk factors differ from those seen in many Western countries. According to the first National Cancer Registry Comprehensive Report of Pakistan, published in 2023, cancers of the lip and oral cavity are among the most common cancers in the country and are the second most common cancer in men, highlighting a major public health challenge.</p><p>Unlike many high-income countries, where smoking and alcohol are the dominant causes, the vast majority of oral cancers in Pakistan are linked to smokeless tobacco and areca nut products, including gutka, paan, chalia, naswar and paan masala. These products are inexpensive, widely available, and commonly used by people of all ages, yet many remain unaware that they contain cancer-causing substances. Poor oral hygiene further increases the risk. The good news is that most of these risk factors are preventable.</p><p>Delayed diagnosis remains one of our greatest challenges. Many patients tolerate symptoms for months before seeking medical attention or first turn to alternative remedies. One of the greatest barriers to early diagnosis is the belief that a biopsy causes cancer to spread. Because of this misconception, many patients delay seeking medical attention and present when the disease is already at an advanced stage. Biopsy is a safe procedure. It is the only reliable way to confirm the diagnosis, and the first step towards appropriate treatment. As oncologists, one of the hardest conversations we have is telling a patient that a cancer which could have been cured just a few months earlier has become far more difficult to treat because medical help was sought too late.</p><p>The warning signs are often simple but should never be ignored: a mouth ulcer that does not heal, a persistent white or red patch inside the mouth, difficulty in swallowing, persistent or worsening hoarseness of voice, unexplained bleeding from the mouth, a lump in the neck or pain while chewing. When detected early, many of these cancers can be treated successfully with less extensive surgery or radiotherapy. Advanced disease, however, often requires a combination of surgery, radiation therapy and chemotherapy, with a much greater impact on speech, swallowing and quality of life.</p><p>Maintaining good oral health is another simple but powerful preventive measure. Regular dental check-ups help identify pre-cancerous changes before they become cancer. Dentists, family physicians and primary healthcare providers all play a key role in recognizing suspicious lesions and ensuring timely referral.</p><p>Modern treatment for head and neck cancer increasingly relies on multidisciplinary care, where surgeons, oncologists, radiologists, pathologists, dentists, specialist nurses, dietitians and rehabilitation experts work together to develop a single, coordinated treatment plan. Several tertiary care hospitals in Pakistan, including the Aga Khan University Hospital, have adopted this approach, helping improve treatment decisions while preserving patients&#39; speech, swallowing and overall quality of life.</p><p>Living with head and neck cancer can affect far more than physical health. Changes in speech, swallowing and appearance often take an emotional toll on patients and their families. Recognising this need, the Aga Khan University Hospital established a dedicated Support Group, <a href="https://www.facebook.com/hancsg">Head and Neck Cancer Support Group AKUH</a>, bringing together patients, survivors and healthcare professionals to provide encouragement, practical guidance and a sense of community throughout the cancer journey. </p><p>Reducing the burden of head and neck cancer will require a collective effort. Stronger regulation of smokeless tobacco products, greater public awareness, better oral hygiene, timely referrals by healthcare professionals and dispelling myths surrounding cancer are all essential. Every person can make a difference by avoiding any form of tobacco, encouraging family members to quit and seeking medical advice promptly for any persistent mouth lesion.</p><p>This Head and Neck Cancer Awareness Month, let us remember that the greatest advances in cancer care do not always come from new drugs or sophisticated technology. They begin with something much simpler: awareness, prevention and acting early. These small steps can save not only lives, but also voices, smiles, and families. No one should lose the chance of a cure because a preventable disease was ignored, or a harmful myth stood in the way of timely treatment.
</p><p><strong>About the Author:</strong><strong> </strong><a href="/pakistan/patientservices/pages/profiles.aspx?ProfileID=161&amp;Name=Yasmin%20Abdul%20Rashid&amp;page=findadoctor">Dr Yasmin Abdul Rashid​</a>,<strong> </strong>Consultant Medical Oncologist, The Aga Khan University Hospital.
</p><p>Note: This article was originally published in <a href="https://www.thenews.pk/print/1428478-prevention-and-awareness">TheNews</a>.
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