Mouth cancers in PNG linked to lime and betel nut combination – expert

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The National, Wednesday November 6th, 2013

 A PAPUA New Guinea oncologist says funding is needed to inform the public about the risks of mouth cancer from chewing betel nut.

Betel nut chewing involves chewing the areca palm tree nut mixed with lime powder and mustard, before the red-tinged remains are spat out.

Dr John Niblett, director of the Angau Hospital in Lae, says the combination of lime and betel nut appears linked to the development of mouth cancers.

“It’s almost certainly due to the lime that’s being used, and there were experiments and research done here in the 70s which showed that mixtures of lime and betel nut juice on to rabbit’s ears caused cancers,” he said.

“Certainly the cancers occur in the part of the mouth where the betel nut is commonly chewed – so each individual chewer would have his favourite spot for his betel nut in the mouth, and that’s where generally we’ll see the cancer.”

Niblett says there are about 200-300 mouth cancers reported each year in PNG, and he believes that might be linked to the rise in betel nut chewing.

“It used to be common only in the coastal and islands areas of the country and not in the Highlands, but nowadays betel nut is available throughout the New Guinea Highlands, where there’s a large population,” he said.

“It’s chewed on a binge kind of basis, so when the truck goes up full of betel nut, everybody wants to have a big chew and have a smoke and also drink beer, so it becomes a big party issue.”

Niblett says early detection of mouth cancers can lead to effective treatment.

“If you get it at the very early stage one stage, where you’ve got a small malignancy perhaps less than a centimetre in size, that can be excised surgically,” he said.

“You would expect nearly 100 per cent cure rate, providing the patient does not carry on chewing betel nut after that.” 

Health Minister Michael Malabag said last week that men had the highest risk of developing mouth cancer. 

But women are quickly picking up on it because of the increase in the number of women chewing betel nuts and smoking.

He warned that the health system did not have enough cancer treatment specialists and equipment. 

And   practising   suicidal   habits such as betel nut chewing was avoidable. “More than 90% of mouth cancer patients seen at the Port Moresby General Hospital oral surgery clinic are associated with betel nut chewing,” he said.