Cancer sometimes does not wait until it gets to the liver, or absorbed by the lungs.
It can start right at the mouth, and doctors say people can protect themselves by watching what they take in.
Oral cavity cancer has risen to the list of ten most common cancers in the country, but patients usually mistake it for normal ulcers and only seek for treatment when it's too late, the Nguoi Lao Dong reports.
The K Hospital, a leading cancer hospital in Hanoi, recently received a 42-year-old patient who had to have his tongue removed as it had ulcerated all over and gone numb, making him unable to speak.
His family said the cancer started with some lesion and he thought it was due to the body heat, so he kept taking in juices and herbal medicine.
But it only became worse and he went to a provincial hospital, where doctors suspected cancer and forwarded him to Hanoi.
Dr. Nguyen Quoc Bao of the hospital said the patient, Trinh Van Ngoc from the nearby Ninh Binh Province, had tongue cancer, a more common kind of oral cavity cancer.
Bao said oral cancer is easily diagnosed, but many patients only come to the hospital when it is in its later stages with the malignant ulcers have grown and damaged nearby organs.
The doctor said the cancer starts with an ulcer inside the oral cavity area, which includes lips, the front part of the tongue, the inner part of cheeks, the palate, the mouth floor, and gum.
It starts with little pain and the patients, mistaking it for normal ulcers, wait for it to go. But it only spreads further.
When the patient has difficulty swallowing, bleeding, pain in the ears and tumors in neck, it is already late, Bao said.
"In most hospitalizations, the ulcers have grown beyond four centimeters in diameter, invading the mouth floor and the tongue," he said.
Statistics released in late 2010 said mouth cancer accounted for between 5 and 10 percent of all cancer cases, and 2 to 3 percent of cancer deaths.
Bao said the disease has not only become more frequent of late, but like other forms of cancer, it was also getting to younger people. Typically, patients are between 40 and 60 when they are diagnosed with oral cavity cancer.
"A couple weeks ago, we received a boy 17 years old and a woman 23 years old, ages rarely seen with this cancer before," he said.
Doctors say the disease can be easily treated when the patients are cautious with mouth ulcers and go to the hospital early.
It is also easily prevented with a healthy lifestyle.
Doctor Tran Xuan Bach of the National ENT Hospital in Hanoi said most patients are addicted to tobacco and alcohol.
"Having a cigarette once in a while is as risky as regular smoking.
The risk is multiplies for people who smoke and also drink," he said, noting that passive smokers are also under threat.
Chewing areca nuts and betel, a traditional pastime for old women, a habit still popular in rural areas, is also related to the condition as arecoline, an alkaloid found in the areca nut, and anilin from the lime used to line the leaf are cancer-causing substances, he said.
Other risky habits are too much exposure to sunshine that can harm the lips, eating pickles and fermented seafood, or oral sex, the doctor said.
Bach said tests have found that dental inflammation, caused by bad hygiene of teeth and mouth or improper installation of dentures, can also produce cancer cells.
He said people should seek medical examination if they have a tumor in the oral cavity that does not heal in two weeks and seems to spread. They should also seek urgent treatment when an ulcer causes them to choke when swallowing, or when their voice becomes hoarse, parts of the mouth go numb, or they suddenly lose weight and feel fatigue, he said.
Oral cancer used to be treated with chemotherapy, but doctors have found that the kind of tumors is rather resistant to the treatment, and the condition can return after sometime.
Recent treatment combines chemotherapy with surgery to remove the infected organs, which have to be followed with some plastic surgeries for cosmetic or functional purposes.
Thus the earlier people come to hospital, the better, doctors say.
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