The Family Man actor Sharib Hashmi opened up about his wife Nasreen Hashmi’s oral cancer relapse for the sixth time. “Nasreen’s cancer is aggressive,” said Sharib, while adding that “She has undergone the surgery 5 times now”. “She has relapsed 5 times. It has come back for the 6th time. This time it has spread everywhere. This shall pass too; the treatment is going on. Jis tareeke se ye deal kar rahi thi usse hum sab ko himmat fir milne lagi. Uska jo cancer hai, kaafi aggressive nature ka hai, isliye itni baar relapse hota hai lekin uske bawajoot bhi ye kaafi himmat ke saath ussey deal karti hain. Fight karti hain (The way she deals with it gives us the courage. This form of cancer is very aggressive, hence it has relapsed so much. But still she has been fighting it well),” Sharib said in a heart-wrenching conversation with Hauterrfly, where he can be seen almost breaking down.
Nasreen, who was first diagnosed in 2018, and married Sharib in 2003, said: “He didn’t leave my side. Even if there was a shoot and he was busy, he still managed to reach the hospital. From the time we are in the hospital till discharge, he would take his bag and sit there. He would not move. Constantly, his being there used to feel very good to me. That he is there for me. That was comforting. In many ways, he has been there.”
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
Taking a cue from Nasreen’s health struggles, we asked an expert all about ‘aggressive’ oral cancers and why they may relapse.
Dr Hitesh Singhavi, consultant, head and neck oncosurgery, KIMS Hospitals, Thane, said that when oral cancer comes back repeatedly, it means cancer cells have either survived treatment or developed again over time. “A sixth recurrence indicates that the disease has become more aggressive, resistant to treatment,” said Dr Singhavi.
Recurrence may occur at the original site, in nearby tissues, in lymph nodes, or in distant organs. “For head and neck cancers, doctors also watch for a second primary cancer, which is a completely new cancer appearing in the oral cavity or nearby areas due to long-term exposure to harmful substances. The rate of second primary cancers in head and neck cancer patients is about 7 to 10 per cent, making lifelong monitoring very important,” elucidated Dr Singhavi.
Each relapse requires a new evaluation because treatment options, outlook, and care goals may change with every recurrence.
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Why does oral cancer tend to come back in some patients?
Oral cancer has a high recurrence rate among head and neck cancers, especially in individuals who keep chewing tobacco, smoking, drinking alcohol, or have poor oral hygiene. Even after successful treatment, tiny cancer cells may remain hidden and later reactivate, said Dr Singhavi.
Another significant reason is something called field cancerisation. “Long-term exposure to harmful substances can damage the whole lining of the mouth and upper airway, making it susceptible to repeated cancerous changes and new tumors,” said Dr Singhavi.
The risk of recurrence also heavily depends on the stage at diagnosis. Over a five-year period:
* Stage 1: about 5 to 10% recurrence risk
* Stage 2: around 10 to 20% recurrence risk
* Stage 3: nearly 20 to 40% recurrence risk
* Stage 4: can exceed 40% recurrence risk
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Late diagnosis, aggressive tumor characteristics, lymph node involvement, and incomplete follow-up can further raise the chances of recurrence, he added.
Are some oral cancer patients more vulnerable to recurrence than others?
Yes, said Dr Singhavi, describing that patients diagnosed at an advanced stage, those with larger tumors, lymph node spread, close or positive surgical margins, or aggressive tumor behaviour generally have a higher risk of recurrence.
Poor nutrition, weak immune systems, uncontrolled health issues, and irregular follow-up visits can also harm long-term disease control, he added.
Some cancers are more likely to come back depending on how aggressive they are and their stage at diagnosis. “Oral cancer, ovarian cancer, glioblastoma, bladder cancer, certain breast cancers, and some blood cancers like leukemia can recur even after strong treatment,” he noted.
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Recurrent oral cancers can become progressively more difficult to manage because the disease may adapt over time. “Doctors usually reassess the stage, spread, and overall health condition before deciding the next line of treatment, which may include targeted therapy, immunotherapy, surgery, radiation, or supportive care approaches,” said Dr Mandeep Singh Malhotra, director, surgical oncology, CK Birla Hospital, Delhi.
Here’s what you should consider (Photo: Freepik)
However, recurrence does not always mean all treatment options are gone. “Many patients can still benefit from further surgery, radiation, chemotherapy, targeted therapy, or immunotherapy based on where and how far the disease has come back,” said Dr Singhavi.
Can recurrent oral cancer be prevented or detected early?
The key step is strict and lifelong follow-up after treatment. Patients should report warning signs right away, such as:
*Non-healing ulcers
*Persistent pain
*Difficulty swallowing
*Bleeding
*Neck swelling
*Changes in voice
*Loosening teeth
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Since patients with head and neck cancer have a lifelong risk of both recurrence and new tumors, regular monitoring with clinical exams and imaging when necessary is vital. Early detection allows for quicker treatment, which can greatly improve survival and quality of life.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.