Doctors across India are raising alarm over the growing number of oral cancer cases linked to gutkha, khaini, paan with tobacco, and other smokeless tobacco products. What was once considered a disease seen mostly in older adults is now increasingly affecting younger people in their 30s and 40s.
According to Dr. Vijay Karan Reddy, HOD and Senior Consultant – Radiation Oncologist and Director of Oncology at Arete Hospitals, oral cancer has become one of the most common cancers seen in outpatient departments, especially among habitual chewing tobacco users. “One of the most difficult conversations in oncology is telling a relatively young patient that the non-healing ulcer inside the mouth is not a simple infection, but cancer,” he says.
Dr. Reddy also warns that the easy availability of flavoured tobacco sachets and growing consumption among young adults are contributing to the rise in oral cancer cases across India. “There is a widespread belief that smoking is harmful, but smokeless tobacco is somehow ‘less dangerous.” Medically, that is simply not true,” he adds.
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Why are gutkha and chewing tobacco dangerous?
Many people wrongly believe that smokeless tobacco products are safer than smoking. However, doctors say chewing tobacco exposes the inside of the mouth to cancer-causing chemicals repeatedly throughout the day.
The harmful chemicals remain in contact with the gums, tongue, cheeks, and inner mouth lining for prolonged periods, causing continuous damage over time. Experts say the danger often develops silently. Early symptoms may appear mild and are commonly ignored by users. “The inside of the mouth is repeatedly exposed to carcinogenic chemicals every time these products are placed between the gums and cheek. The damage is slow, but continuous. Initially, patients may notice only mild burning while eating spicy food or slight stiffness while opening the mouth. These symptoms are often ignored for months,” said Dr. Reddy.
Early oral cancer symptoms that people often ignore
Doctors say oral cancer usually begins with warning signs that may not cause severe pain initially. Common early symptoms include
- Non-healing mouth ulcers
- White or red patches inside the mouth
- Burning sensation while eating spicy food
- Difficulty opening the mouth
- Mild swelling inside the cheek
- Persistent mouth irritation
Many people self-medicate with mouth ulcer creams or gels instead of seeking proper medical evaluation, which delays diagnosis.
Younger patients are now diagnosed with advanced oral cancer
Oncologists say one worrying trend is the increasing number of younger patients being diagnosed with advanced oral cancer. Earlier, oral cancers were mostly seen in individuals with decades of tobacco exposure. Today, doctors are seeing severe cases in patients as young as their 30s and early 40s. “The easy availability of flavoured tobacco products and aggressive consumption habits are likely contributing factors,” said Dr. Reddy.
By the time many patients visit cancer specialists, they may already have:
- Difficulty swallowing
- Bleeding from the mouth
- Restricted mouth opening
- Large ulcers
- Visible growths inside the cheek or tongue
Why early detection can save lives?
Doctors stress that early diagnosis dramatically improves oral cancer treatment outcomes.
Small lesions detected early may be treated more effectively with less extensive surgery and fewer complications. However, advanced oral cancer may require major surgery, radiation therapy, chemotherapy, and reconstructive procedures that can permanently affect speech, swallowing, eating, and facial appearance.
Experts say families are often unprepared for the physical, emotional, and financial burden of oral cancer treatment.
Most oral cancer cases are preventable
Health experts say the tragedy is that a large percentage of oral cancer cases are preventable. Quitting tobacco in all forms remains the single most important step to reduce risk. Doctors say even long-term users benefit significantly from stopping tobacco use.
Regular dental check-ups and oral cavity screenings are also essential, especially for people who chew gutkha, khaini, paan, tobacco, or smokeless tobacco products regularly. Doctors warn that social acceptance of chewing tobacco continues to fuel India’s oral cancer crisis despite growing medical evidence about its dangers. Awareness, early diagnosis, and tobacco cessation could help save thousands of lives every year.