Areca Nut 51scientists are uncertain that the substance causes cancer in humans unless used
in combination with tobacco.
In a mice experiment a small percentage of animals receiving pan masala
developed assorted cancers, but animals receiving no pan masala developed
no cancers. Humans who habitually chew the nut can get noncancerous and
precancerous abnormalities in the mouth. Fatal oral tumors may develop, but
reports are not always clear about persons’ use of other substances that may
promote cancer. Oral submucous fibrosis (OSF) is a serious mouth disease
directly attributed to chewing plain areca nut or pan masala. Some victims
also chew or smoke tobacco. In evaluating precancerous and cancerous
growths in the mouth, however, some researchers analyzing medical cases
have found areca nut to be a far more likely cause of such afflictions than
tobacco. (That type of research examines outcomes of drug usage, not mech-
anisms by which usage promotes cancer.) Animal experiments suggest that
consuming alcohol may heighten the risk of mouth cancer from pan masala,
a suggestion supported by clinical experience. Tests on pan masala users find
them to suffer from increased DNA damage in tissues exposed to pan masala,
a tendency duplicated in laboratory tests of pan masala and areca nut. Such
chromosome damage is suspected of causing mouth, throat, and esophageal
cancers ascribed to areca nut. A study examining the combined effects of pan
masala, tobacco smoking, and alcohol drinking found that persons who do all
three are 123 times more likely to get mouth cancer than persons who do
none. Experiments suggest that vitamins A and E might help reduce the health
risks of pan masala.
Pregnancy.In male mice pan masala damages chromosomes and sperm,
and ingestion of pan masala by male rats has caused their gonads to shrink
in weight. Examination of human uterine cells indicates mutation from chew-
ing areca nut preparations. Examination of human white blood cells shows
increased chromosome damage in pregnant women who chew areca nut prep-
arations and still more damage if nonpregnant chewers use birth control pills.
Chicken experiments produce birth defects when an alcohol extract of areca
nut is injected into embryos, but results from chicken embryo testing are not
accepted as evidence of human risk. One human study found that pregnant
chewers were almost three times more likely to have adverse pregnancy out-
comes than nonchewers. Another study found that infants of pregnant chew-
ers had lower birth weight but were also less likely to have jaundice.
Additional information.Betel pepper leaves are chewed, but this plant
(Piper betle, also calledPiper betel)isnotAreca catechu. Betel pepper leaves,
areca nut, and mineral lime (not the fruit) are combined into a product called
betel. Studies indicate that leaves of betel pepper reduce areca nut’s ability to
cause chromosome damage. Chewing betel is thought to convert arecoline into
arecaidine, which some researchers consider more benign in its effects than
arecoline.
Additional scientific information may be found in:
Burton-Bradley, B.G. “Arecaidinism: Betel Chewing in Transcultural Perspective.”Ca-
nadian Journal of Psychiatry24 (1979): 481–88.