According to a cancer registration report published by the Department of Health in 2020, oral cancer is one of the top 10 cancers among males in Taiwan, with the fastest increase in the number of cancer cases and deaths. Every year, there are about 8000 cases of oral cancer and more than 3300 deaths from the disease and is the most common cancer among young and middle-aged men (25 to 44 years old).

According to medical research, betel nut chewing causes leukoplakia and oral submucous fibrosis and other symptoms, which are likely to lead to oral cancer. More than 80% of Taiwan's oral cancer patients have the habit of chewing betel nut, and the most common sites are the buccal mucosa and tongue. In addition to betel nut, tobacco and alcohol are also closely related to oral cancer. Those who chew betel nut, smoke and drink alcohol at the same time have a 123 times higher risk of developing oral cancer than those who do not.

What harmful substances are contained in betel quid prepared by betel nut stalls? The betel quid on the market is composed of areca nut and additives slaked lime and unriped fruit of piper linn, as folows:

• Areca nut: contains arecoline and arecaidine, which are carcinogenic.
• Slaked lime: makes oral environment alkaline, and betel nut will release free radicals in alkaline state, which is prone to cellular degeneration.
• Unriped fruit of piper linn: containing safrole and recognized as a carcinogen.

Possible Health Hazards of Chewing Betel Nut

• Betel nut-induced oral cancer.
• Oral premalignant lesions: leukoplakia, erythema, verrucous hyperplasia, oral submucous fibrosis (referred to as oral sclerosis).
• Other oral diseases: periodontal disease, tooth discoloration and severe attrition.
• Reproductive disorders (preterm birth, miscarriage, deformed child).
• Hypercalcemia (swallowing betel juice).
• Glucose tolerance disorder (animal experiments by British researchers).

Ways to Stay Away from Betel Nut

• Know the harm of chewing betel nut without being tempted and learn to refuse.
• Choose alternatives, such as gum or throat lozenges.
• Pay attention to a normal, balanced diet; eat more vegetables and fruits.
• Brush your teeth regularly and keep your mouth clean.
• Say no to betel nut on festive occasions or gatherings.
• Exercise regularly.
• Drink plenty of water.

Notes for Oral Self-examination for head and neck cancer

• Check Your Face in the Mirror
• Check if the face is asymmetrical, or whether there is a prominent mass.
• Check if it's difficult to open your mouth.
• Touch both sides of the neck with your hand and note any lumps.
• If there is any foreign body sensation or pain in swallowing for more than 2 weeks without improvement.
• Check the Oral Cavity in the Mirror
• Open upper and lower lips: Examine the oral mucosa and gums for lumps, discoloration (white or red), roughening or ulcers that have not healed for more than two weeks.
• Put out the tongue and swing around to see if the sensation is normal; roll up the tongue to see if there are protrusions, painful lumps, ulcers and other symptoms at the tongue abdomen, edge and bottom of the mouth.
• Open your mouth and make a "ah" sound. Check whether there are any abnormal phenomena such as protrusions, lumps and ulcers in the soft jaw, hard jaw and uvula.

If you have any of the above symptoms, please go to otolaryngology or oral and maxillofacial surgery as soon as possible! An appetite for a moment will only lead to irreparable regret!