Recent results of oral cancer research in Kerala, India.

Findings from a research program in oral cancer at Regional Cancer Centre, Trivandrum, Kerala, India are reviewed. There is evidence of immune impairment in oral cancer patients. Plant lectins are being investigated for specific binding characteristics in various oral precancers and different histological subtypes of oral cancer. Tobacco and alcohol have been identified as the major risk factors for oral cancer. The chemopreventive potential of carotenoids and retinoids have been evaluated in oral leucoplakias. Beta-carotene and vitamin A in heavier doses induced remission of oral leukoplakias in 25%-50% of trial participants who continued with their tobacco and alcohol habits during the trial. The remission could be maintained with lower doses. Less than 20% of our patients with oral cancer were initially seen in localized stages. Various community-oriented programs for prevention of primary and secondary oral cancers are being evaluated. These include antitobacco health education, oral self-examination, and oral examination by trained volunteers. The results of radical radiotherapy and surgical salvage of radiation failure are also discussed. The 5-year disease-free survival rate of 34% is a reflection of the advanced stages of the disease when initially seen. Salvage rates with surgery for radiation failures were encouraging.