LAHORE: Offering services that are rarely available in the public sector health facilities, the department of Oral and Maxillofacial Surgery (OMFS) of the Jinnah Hospital Lahore/Allama Iqbal Medical College (AIMC) has started treatment of patients suffering from stage-IV oral cancer.

The largest teaching hospital of the city started offering the services following studies showing an alarming surge in the death rate among oral cancer patients as compare to those suffering from other cancers, including the cervical.

The hospital’s OMFS department also offers management of patients with stage-IV oral cancer, needing extensive treatment, including reconstruction of the affected body parts after removal of diseased tissues, in collaboration with the Plastic and Reconstructive Surgery Department of the facility.

OMFS dept offers free of cost services

Though five other government hospitals in the province have units to treat cancer patients, those suffering from stage-IV oral cancers are being provide maxillofacial surgery services at only two other public sector facilities in Punjab -- Mayo Hospital and Inmol. Because of lack of such facilities in the public sector hospitals, the poor patients suffering from the disease have to opt for costly private treatment.

Dr Gulraiz Zulfiqar who was among the founding practitioners of the Jinnah Hospital’s OMFS department established back in April 2013, is currently heading it as an assistant professor.

Talking to Dawn, he said though his unit had been providing full-scope care to those in need of OMFS and the disease trauma since its establishment, it decided to also take in stage-IV patients after an alarming surge was witnessed in such cases.

He said the poor patients with the fatal disease were being managed absolutely free of cost.

In private sector, he said, this type of surgery costs from Rs600,000 to Rs1000,000 depending on the stage of the disease and general condition of the patient.

“This service is offered by only two (Punjab) government hospitals in the provincial capital -- Jinnah and the Mayo,” says Dr Gulraiz.

He added the treatment of OMF fractures cost approximately Rs200,000 to Rs400,000 in private sector, but it was being provided free of cost at his unit.

He added that the type of disease mostly affected the poor and middle-class patients like labourers, motorcycle and rickshaw drivers, besides those addicted to naswaar (chewing tobacco) chhalia and paan.

Explaining the reason, he said: “The oral and maxillofacial area of body mostly remains exposed.” He said the disease affected not only the important functions of speech and swallowing but also had psychosocial effects on the patient and his or her family”, Dr Gulraiz said.

OMFS specializes in treating many diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral (mouth) and maxillofacial (jaws and face) region.

The first OMFS specialty in Pakistan was set up at de’Montmorency College of Dentistry in 1981 which was later expanded by establishment of OMFS departments at the Mayo Hospital, Jinnah hospitals in Lahore, Nishtar Hospital, Multan and Allied Hospital, Faislabad.

“Our department was initially started with an OPD room and Day Care Centre (DCC) to manage patients seeking minor oral and maxillofacial surgical care”, he said, adding the DCC worked six days a week and the patients got admitted in the morning, treated surgically and discharged the same day with medication.

“We later expanded the department in 2016 by establishing an independent 10-bed ward with two operation lists per week,” he said.

He said it was a College of Physicians and Surgeons accredited centre for FCPS training unit since July, 2017 under his supervision and at present five doctors were training there.

The department of OMFS department at AIMC caters a considerable number of patients with oral and maxillofacial trauma and pathology because of its proximity to Motorways, Multan Road and Canal Road.

At least 20-25 patients visit the facility’s emergency every week with oral and maxillofacial fractures, 15-20 patients of oral cancer, predominantly with stage-III and IV cancer, 10-15 of jaw joint disorders, 25-30 with wisdom tooth infection and 20-25 patients with general oral and maxillofacial issues are brought in the OPD.

Dr Gulraiz suggested the government to establish such departments in all teaching hospitals of the province as oral cancer patients were increasing at an alarming rate.

He said the World Health Organization has already placed Pakistan on red list for oral cancer. Neighboring India has recently established three world-class tertiary care oral cancer centers in Kerala, Mumbai and Delhi to fight the disease.

Published in Dawn, October 19th, 2018