Increased Cancer Risk with Betel Nut Chewing
Oral cancer is not often mentioned in the media, which is why public awareness is practically nonexistent, even though it is among the ten most common cancers in the world. The results of many studies on oral cancer have been summarized by the International Agency for Research on Cancer (IARC), which shows the importance of specific risk factors such as chewing tobacco and betel nuts (also known as areca nuts or *chaliyah *in Urdu), which contain several known carcinogens that are toxic to the body. Chewing the mixture of betel nut and betel leaf in a quid (known as *paan *in some countries) is a tradition and popular cultural activity in many Asian countries, including India, Pakistan, Sri Lanka, and Bangladesh. In the quid, a few slices of the nut are wrapped in a betel leaf along with lime and may include clove, cardamom, and coconut for extra flavoring.
Chewing the betel leaf and seeds can have hypertensive effects, because they contain chemicals which cause the arteries to constrict. They may also contain tobacco, which adds to the effects of nicotine damage and greater addiction. More dire consequences are due to the carcinogens found in these nuts. Regular chewers of betel leaf and nut have a greater risk of cancer of the mouth, pharynx, esophagus, and stomach. It is important to note that support is provided by a recent study which found that paan with and without tobacco increased oral cancer risk by 9.9 and 8.4 times respectively. According to MedlinePlus, “Long-term use has been associated with submucous fibrosis (SMF), pre-cancerous oral lesions, and squamous cell carcinoma.” SMF produces a hardening of the mouth lining, which can develop into oral cancer. People suffering from this disease find it increasingly more difficult to open their mouths. In some of the worst cases, patients are forced eat and drink liquidized food through a small opening in their mouths.
Immediate effects of betel chewing also include worsening of asthma, increased blood pressure, and increased heart rate. All of these symptoms put greater strain on the heart and can further lead to heart disease. The International Journal of Cancer found that there may be a higher risk of cancers of the liver, prostate, cervix, and lung with regular betel use. Other consequences can include adverse effects on blood sugar levels and possibly increasing the risk of type 2 diabetes. It is clearly seen that the positive reasons some appreciate betel seeds, such as breath freshening and pleasant taste, are tremendously outweighed by their harmful consequences.
Compounding this severely under-recognized problem is that betel chewing is addictive, and it is very difficult to coax a life-long chewer to quit. A recent study of Gujarati betel users in London demonstrated their dependency as similar to that of cocaine users, especially if there is tobacco in the paan. Patients describe dependency symptoms as difficulty in abstaining, and withdrawal symptoms including headache and sweating.
Betel quid mixtures (paan masala) are also widely available to all ages very inexpensively. Some are now chocolate-flavored and are sold in brightly-colored packages with children’s faces on them. This is why many children are also exposed to betel chewing along with adults. Experts say that 11 and 12-year-old children are getting pre-cancerous growths after just two years of chewing. It is crucial to understand that oral cancer is a disease which progresses over time, so if the chewer has not experienced symptoms over many years, it does not mean they will never have to deal with irreversible and possibly fatal consequences. This is because oral cancer has an approximately 10-year incubation period. It is very hard to treat and spreads very quickly. Therefore, awareness and prevention are necessary to maintaining wellness. Please consult your physician for more information.