Doctors in UAE sound oral cancer alarm over use of qat, betel leaves

Release of book of the WHO FCTC Global Knowledge Hub on “Global Smokeless Tobacco Control Policies and their Implementation”
May 3, 2018
Press release
May 7, 2018

By Jasmine Al Kuttab /Abu Dhabi/Khaleej Times

The trafficking, possession or consumption of the substance is a criminal offence.
Doctors in the UAE are warning against the illegal use of betel leaves (paan) and qat leaves, which they said are among the top causes of oral cancer.

“We have noticed people consuming these dangerous carcinogenic substances, mainly coming from South Asia and Yemen,” Dr Norbert W. Dreier, consultant – oncology at Burjeel Hospital, told Khaleej Times.

According to the UAE law, qat leaves are banned. The trafficking, possession or consumption of the substance is a criminal offence.

Betel leaves, which are widely chewed in Asia as a stimulant substance, are also banned in the UAE and those caught trafficking or consuming the product will face penalties.

Dr Dreier pointed out although oral cancer is not the leading cancer in the UAE, expats from South Asia, who have been using these substances are mostly at risk. “What we have noticed is patients from these areas who have a habit of chewing the betel and qat leaves are more prone to the disease.

“In Western countries, we see more people with oral cancer, which has been caused mainly by tobacco and alcohol consumption. However, here we see more cases among people chewing betel and qat leaves.”

Dr Anoop Azad, specialist in prosthodontics at Universal Hospital, said betel nut (paan) chewing is popular among Asian people, and is a top risk factor for oral cancer.

However, oral cancer causes are not only related to the prohibited substances, but also to tobacco chewing or ‘reverse smoking,’ he warned.

“In India, many people smoke without filters,” he said, adding that he had noticed that oral cancer cases are more common among Indian expats in the UAE, particularly the workers in camp sites.

“The expats are the major part of the volume, and when we ask about their history, they refer to such substance use.”

He said the disease can be deadly because it can quickly spread to the neck and chest.

“The chances of oral cancer spreading to other areas is much faster, because of the extensive blood supply.”

He stressed that early intervention is crucial, and urged the public to undergo regular screenings, warning that the disease is difficult to detect and can thus turn fatal.

“If people ignore the signs, it will not only get worse, but it can turn fatal very quickly.”

“People tend to take this issue very light. They don’t understand how important it is to have their screening done.”

He said in the last two years, he has seen around 15 cases related to oral cancer, and the youngest patient was just 22 years old. He said he attends at least six cases of patients who have developed lesions and ulcers a month, which can develop into cancer.

Dr Per Rehnberg, CEO of Snö Dental, said the potential for death can significantly be reduced if the cancer is detected early, making treatment easier, less invasive and more than 90 per cent curable.

“The best way to manage and treat an oral cancer diagnosis is by combining early detection of the disease with timely treatment.”

He urged people to regularly examine their mouth, to look for non-healing ulcers, areas of bleeding, abnormal patches and swellings.

Dr Rehnberg added that professional screening should be conducted every six months.

He also advised people to protect themselves from sun exposure, as lip cancer is directly related to ultraviolet radiation from sunlight.

“People who work outdoors and have prolonged exposure to the sun are more likely to develop lip cancer.”

Top causes of oral cancer
>Chewing betel or qat leaves

>Around 50 per cent of the oral cancer cases are related to tobacco use

>Reverse smoking

>Human papilloma virus is another risk factor

>Those with a family history of cancer, and/or a weak immune system are at a greater risk