Homoeopathic management in oral and oropharyngeal cancer

Dr Ankita
Dr Poonam Verma

ABSTRACT
Oral & oropharyngeal cancers are among the most common malignancies worldwide, especially in populations with high tobacco and alcohol consumption. This article highlights their etiology ,pathophysiology ,clinical features ,diagnosis, prognosis, and homoeopathic therapeutic indications based on classical materia medica.

DEFINITION
Cancer occurring in the tissues of the oral cavity (begins at the lips and extends backwards to the front part of the tonsils) or oropharynx (part of the throat) is termed as oral cancer or oropharyngeal cancer .¹

ORAL CAVITY
The oral cavity includes the lips, gingiva, floor of the mouth, buccal mucosa, anterior two-thirds of tongue, hard palate, and retromolar trigone.

OROPHARYNX
The oropharynx includes soft palate, tonsils, walls of throat, and posterior one-third of tongue

ETIOLOGY

• Tobacco use
• Areca nut and betel nut chewing
• Alcohol consumption
• Viral infections (HPV)
• Nutritional deficiencies
• Chronic mechanical irritation
• Genetic and molecular factors
• Environmental and occupational exposure

PATHOPHYSIOLOGY
Oral cancers arise from stratified squamous epithelium progressing from dysplasia to carcinoma. Genetic mutations (TP53, EGFR, CDKN2A) and carcinogenic exposure play a major role. HPV-16 contributes via E6 and E7 oncoproteins. Chronic inflammation, oxidative stress, and immune evasion facilitate metastasis.

CONVENTIONAL TREATMENT

• Surgery
• Radiotherapy
• Dietary therapy
• Chemotherapy and targeted therapy

SIGN & SYMPTOMS OF ORAL CANCER

EARLY- Non-healing ulcer >2 weeks, Erythroplakia  / leukoplakia, Mild burning sensation,Minimal bleeding, Tooth mobility, Ill-fitting dentures

LATE- Deep pain radiating to ear, Trismus, Dysphagia, Fetid odor, Facial asymmetry, Lymphadenopathy, Weight loss

DIAGNOSIS
History and examination, Biopsy, HPV testing, CT/MRI, PET CT, Endoscopy, TNM staging

PROGNOSIS
Prognosis depends on stage, tumor site, histological grade, and treatment response.

HOMOEOPATHIC THERAPEUTICS

ARSENICUM ALBUM
Important remedy  indicated by its prostration, alternating or coexisting with a certain agitation, by its burning pains, ameliorated by heat ,ailments from alcoholism, chewing tobacco; odour of discharges is putrid. Ulceration of mouth with dryness & burning heat. Epithelioma of lips, tongue dry, clean & red ;stitching and burning pain in tongue ,ulcerated with blue colour. Bloody saliva .throat swollen , oedematous , constricted , burning , unable to swallow , looks dry and wrinkled .

AURUM MURIATICUM
Preferred remedy for cancerous ulcers in the inner aspect of the cheeks or on the tongue and palate. Ulcers have everted edges and indurated base with sub mandibular /cervical adenitis; there also may be excessive and a foul odour. Ulcers are deep, destructive with bone involvement.

CALCAREA CARBONICA
Persistent sour taste, dryness of tongue at night, bleeding of gums, offensive smell from mouth, burning pain at tip of tongue, vesicles in mouth and on the tongue. Stitches on swallowing , difficult swallowing . it can act selectively on the glandular hypertrophy. Glands are enlarged ,hard and painless initially and ulcers are slow healing.

CARCINOSINUM
Indicated for cancerous diathesis, where there is a history of malignancy , either personal or family .psychologically the subject may be fastidious ,is sensitive to music and has prolonged fear with worry and anticipation. Secretions in general may be acrid and thick.

HYDRASTIS CANADENSIS
Tongue swollen ,shows marks of teeth ,coated white ,excessive secretion of thick tenacious mucus, tongue as if burned or raw , with dark red appearance and raised papillae ; tumor in hard palate ,painful to touch hard somewhat elastic, disposed to bleed and discharge offensive matter, uvula sore and relaxed ,throat dry, raw, sore, cancerous ulcers on left side of throat

KALI CARBONICUM
Tongue white, much saliva constantly in mouth, bad slimy taste- dry, parched ,rough, sticking pain , as from a fish-bone. Swallowing difficult; food goes down oesophagus slowly. Mucous accumulation in the morning; ulcers are deep and punched out, and also with sharp stitching pain

LYCOPODIUM CLAVATUM
Bleeding ulcers on and under tongue (from tobacco) tongue is painful and swollen in different places, stiffness of the tongue, vesicles on tip of tongue; they feel scalded and raw, saliva becomes dry on the palate and lips ; and is converted into tough mucus, dry and bitter mouth.

LACHESIS MUTUS
Tearing pain in jaw bones, gums swollen, spongy ,bleed. Tongue swollen ,burns ,trembles, red, dry and cracked at tip, catches on teeth. Aphthous and denuded spots with burning and rawness. Nauseous taste. Teeth ache, pain extends to ears. Pain in facial bones, Sore Throat, worse left side, swallowing liquids. pain aggravated by hot drinks; chronic sore throat, Very painful; < slightest pressure, touch is even more annoying.; worse, swallowing saliva or liquids. Pain into ear. Collar and neck-band must be very loose, cannot tolerate pressure around neck

MERCURIUS SOLUBILIS
Salivary secretions greatly increased ; bloody and viscid ; saliva is fetid, coppery , speech difficult on account of trembling tongue. Gums spongy, recede, bleed easily . tongue heavy, thick with moist coating. yellow, flabby, teeth-intended, feels as if burnt, with ulcers, Fetid odour from mouth, can smell it all over room. Alveolar abscess, worse at night. Great thirst, with moist mouth, Bluish-red swelling. Constant desire to swallow. Putrid sore throat; worse right side Stitches into ear on swallowing; fluids return through nose. Sore, raw, smarting, burning throat. Complete loss of voice. Burning in throat, as from hot vapor ascending.

MURIATICUM ACIDUM
It is a very useful medicine for oral affections like stomatitis, cancer of tongue, etc. Gums and glands are swollen, bleeding and ulcerating. Foetid breath. Sores on teeth. Lips raw, dry, cracked, Tongue, pale, swollen, dry, leathery, paralyzed. Deep ulcers on tongue, hard lump on tongue. Cancer of tongue, epithelioma, edges bluish-red. Tongue is pale, swollen, dry, leathery and paralyzed. Ulcers and false membrane oedematous, dark, raw. Attempted swallowing produces spasm and choking

PHOSPHORUS
Over sensitive to external impressions, restless. Hypo-sensitive, indifferent . Mouth- swelled and easily bleeding gums , bleeding is bright red and profuse. Tongue dry, ulcerated , smooth, red or white, not thickly coated, dryness in pharynx and fauces, sour taste and sour eructations after every meal, post-operative vomiting

RADIUM BROMATUM
Radium bromatum is best used in post radiation effects. Aching pain in the angle of right lower jaw, dryness of mouth along with metallic taste, pricking sensation on end of tongue. Severe aching pains all over with restlessness, better moving about. Ulcers due to radium burns, take a long time to heal, great weakness

THUJA OCCIDENTALIS
Flat white ulcers on the inside of the lips and on the corners of the mouth, aphthae in mouth ( ulcers, mouth feels as if burnt) bitter saliva, swelling of tongue specially on right side. Tip of tongue very painful. Teeth decay next to the gums, very sensitive ; gums retract, pressure and pain as from excoriation, in throat and mouth, like chancres, painful swallowing especially empty swallowing

A history of tobacco, HPV and suppression is also found

ZINCUM METALLICUM
Teeth loose, gums bleed, blisters on tongue ,Tingling of internal surface of cheeks, and copious secretion of saliva, having a metallic taste, tongue swollen left side. Throat dry, constant inclination to hawk up tenacious mucus, rawness and dryness in throat, pain in muscles of throat when swallowing, tearing more frequently when not swallowing .Trembling, restlessness, Mental fatigue

CONCLUSION
Homoeopathy emphasizes a holistic approach in the management of oral and oropharyngeal cancers by addressing the individual constitution and symptomatology. Homoeopathy addresses the dynamic disturbance of vital force , as expressed through the totality of characteristic symptoms- mental, general and particular. Remedies should be selected on the basis of totality of symptoms. However , homoeopathic intervention should be employed as an adjuvant with standard care , it will help in improving the well being as well as quality of life of the patient.

REFERENCES

1. DeVita VT Jr, Hellman S, Rosenberg SA. Cancer: principles and practice of oncology. 10th ed. Philadelphia: Wolters Kluwer; 2015
2. Master FJ. Healing cancer: complementary cancer care. New Delhi: B. Jain Publishers; 2006
3. Clarke JH. A dictionary of practical materia medica. New Delhi: B. Jain Publishers; 1999.
4. Boericke W. Pocket manual of homoeopathic materia medica with repertory. 9th ed. New Delhi: B. Jain Publishers; 2002

Dr. Ankita (PG Scholar) Bakson Homoeopathic Medical College , Greater Noida
Dr. Poonam Verma (PG Scholar ) Bakson Homoeopathic Medical College, Greater Noida
Email : kushwahaankitaa96@gmail.com