Tobacco Kills

As one more World No-Tobacco Day passes by, TNIE looks at its ill-effects and uses in any form—smoking or chewing—that can lead to a range of illnesses including cancer & heart disease

- HEMANT KUMAR ROUT @Bhubaneswar

ANAB, from Kalahandi district in Odisha, had a habit of chewing tobacco that he had picked up when he was young and was addicted to it. Its effects caught up to him when he was 38 years old, when a seemingly minor mouth ulcer turned into a daunting health ordeal. Little did he imagine that the burning sensation and persistent sore in the left buccal mucosa (inside lining of the cheek) would escalate into a serious, life-threatening disease that would require a complex surgery.

The ulcer refused to heal despite medications for three months, gradually spreading to the jawbone. Manab began experiencing trismus (lockjaw), a condition where he could no longer open his mouth properly. Alarmed by the condition, he approached Manipal Hospitals in Bhubaneswar, where a detailed clinical examination, including CT scan and biopsy, revealed an advanced case of oral cavity cancer with significant jawbone involvement.

Given the severity and spread of the cancer, doctors recommended a composite surgical intervention that would both remove the tumor and reconstruct the damaged jaw. A multidisciplinary team led by surgical oncologist Dr Nitish Ranjan Acharya and plastic surgeon Dr Biswajit Mishra performed a composite resection of the cancerous lesion and followed it up with a microvascular reconstruction using a free fibula bone graft harvested from the patient's leg, along with a large skin paddle for facial contour and mucosal lining.