Oral and Throat Cancer Symptoms: What a Head and Neck Surgeon Wants You to Know
Watch: Cancer Surgeon – symptoms, causes, diagnosis and treatments| Dr. Ravi Shankar | Sarvesh Mishra · ~70 min
A mouth ulcer that will not go away. A lump you keep putting cream on. A “doctor” who was never a doctor. In this episode of The Sarvesh Mishra Show, Sarvesh Mishra sits with Dr. Ravi Shankar — a head and neck oncology surgeon trained and worked at Tata Memorial Hospital, formerly head of department at Mahavir Cancer Sansthan in Patna, now practising at Asian Hospital, Faridabad — on what those signs actually mean.
This conversation is distinct from the Show episode with Dr. Sumedh Sandanshiv on when knee surgery is really necessary. For the series itself, start at What Is The Sarvesh Mishra Show?
Figures are as stated by the guest in the episode. Individual medical decisions require a qualified clinician.
What this conversation covers
- Why India carries the world’s highest oral cancer burden
- The mouth ulcer or lump you should never wait out
- Why late detection kills more often than the disease itself
- Whether cancer treatment really has to be expensive
- The biopsy and surgery myths worth putting to rest
- Why not every thyroid lump — or lump anywhere — needs surgery
- How surgery affects appearance, and how patients are supported through it
- How to actually pick the right kind of cancer surgeon
Why India is called the oral cancer capital
Dr. Ravi Shankar does not hedge on this one. Tobacco, in every form — chewed or smoked — plus gutkha, is by far the leading cause behind India’s disproportionate oral cancer burden. The same belt — India, Pakistan, Sri Lanka, Bangladesh — carries most of the world’s cases for exactly that reason.
He is careful about the “but my uncle chewed for thirty years and never got it” argument people bring him. Tobacco is a risk factor, he says, not a guarantee — the same way riding a motorcycle carelessly does not guarantee an accident. It just makes one several times more likely.
Tobacco is a risk factor, not a guarantee — the same way riding a motorcycle carelessly doesn’t guarantee an accident. It just makes one several times more likely.
— Dr. Ravi Shankar, The Sarvesh Mishra Show Episode 27
The ulcer or lump you are ignoring right now
This is probably the single most useful thing in the whole conversation. A mouth ulcer or a lump that has not healed in ten to fourteen days needs a proper doctor, not another round of the pharmacy cream you have already tried twice.
He is blunt about why late detection kills more people than the disease itself is often treatable: patients do not neglect symptoms out of carelessness. They genuinely do not know an ulcer that will not heal is a warning sign. Months pass while they self-medicate.
A mouth ulcer or lump that has not healed in 10–14 days — or persistent hoarseness — needs a qualified doctor. Pharmacy cream is not a diagnosis.
The bigger problem: “He wasn’t even a real doctor”
One line from the episode is hard to shake. Patients tell him they had been “seeing a doctor” for two or three months before diagnosis — except that person was not actually a qualified doctor.
In rural areas especially, treatment often targets the symptom: pain medicine for pain, fever medicine for fever, rather than asking why the pain or fever exists in the first place. His advice is plain: if a basic ultrasound has not been suggested after weeks of unexplained pain, that is worth pushing back on.
Does cancer treatment have to bankrupt you?
Not the disease itself, he argues — the setup around it does. A hospital built on prime real estate in a big city carries that cost into every bill. According to him, 70 to 80 percent of cancer cases can be treated well in a decent district-level facility, and he has seen it firsthand rebuilding a head and neck surgery program in Patna that now routinely performs complex reconstructive surgery.
The real question, he says, is not why treatment is expensive in one city. It is why every medical college in the country does not already offer proper cancer care.
Expense is largely tied to hospital location and infrastructure, not to the treatment itself. He says most cases can be treated well at a decent local facility — if that facility exists.
Two myths worth killing
- A biopsy makes cancer spread faster
- Surgery causes cancer to spread through the body
- A tumour has a fixed doubling rate whether you biopsy it or not. You are noticing growth that was already happening.
- Removing a tumour removes the tissue that could otherwise shed cells into the bloodstream — cutting that risk, not raising it.
Not every lump is cancer. Not every cancer needs surgery.
He makes a point of saying thyroid nodules, for instance, are not automatically cancer. Even when a thyroid cancer is confirmed, current guidelines sometimes favour watching it every six months over immediate surgery, because papillary thyroid cancer has an unusually strong long-term survival rate.
This is a reminder that “cancer” is not one disease with one playbook. It depends entirely on which tissue it started in and how it behaves.
When the face changes, the fear changes too
Head and neck cancer carries something other cancers do not: surgery can visibly change how someone looks or sounds, and that fear alone stops people from getting treated.
Dr. Shankar’s counter to patients weighing this is direct: choosing not to treat guarantees the disease never goes away. Choosing surgery, even with reconstruction involved, gives a real shot at being cancer-free. He also talks about “prehabilitation” — counselling and preparing patients emotionally before surgery, not just physically — because recovery is as much psychological as clinical.
Choosing not to treat guarantees the disease never goes away. Choosing surgery, even with reconstruction, gives a real shot at being cancer-free.
— Dr. Ravi Shankar, on the fear of how surgery will look
How to pick the right kind of cancer surgeon
Look for someone who specialises specifically in that cancer type — a gynae oncologist for gynaecological cancers, a head and neck oncologist for oral and throat cancers — rather than a general surgeon who sees such cases occasionally.
| If the cancer is… | Look for… |
|---|---|
| Oral or throat | A head and neck oncologist |
| Gynaecological | A gynae oncologist |
| Anything else | A specialist in that cancer type — not a general surgeon who sees such cases only occasionally |
Frequently asked questions
What are early symptoms of oral cancer?
Does a biopsy make cancer spread?
Does surgery cause cancer to spread in the body?
Is every thyroid lump cancerous?
Why is cancer treatment considered expensive in India?
How do I choose the right cancer surgeon?
The practical thread is early, qualified attention: an ulcer that will not heal is not a cream problem, a biopsy is not what spreads the disease, and the right specialist matters more than the nearest general surgeon. Related health conversations on the Show: Dr. Sumedh Sandanshiv on knee replacement and Dr. Sunetri Singh on Ayurveda and wellness.
Sarvesh Mishra is an Indian entrepreneur, journalist, interviewer and the host of The Sarvesh Mishra Show. He is the Founder of Red Hot Media House Pvt. Ltd. and CureSoulLife Pvt. Ltd., and the author of Love With Benifit.