Oral complications in the treatment of cancer patients

Abstract

Oral Diseases (2011) 17, 550–559 While treatment for cancer in terms of chemotherapy and radiation therapy have evolved significantly since their inception, both of these cancer treatment modalities, especially if used in combination (e.g., as with head and neck cancers), have a very real potential to result in painful and debilitating adverse effects that clearly decrease quality of life and, potentially, increase mortality due to cancer. Herein, we discuss the prevalence and etiology of three broad categories of oral complications found during the treatment of cancer patients: mucositis, dysgeusia, and infectious disease. Lastly, we present therapeutic options that may be helpful in ameliorating these uncomfortable and, sometimes, life‐threatening oral complications.

Oral shedding of human herpesviruses in patients undergoing radiotherapy/chemotherapy for head and neck squamous cell carcinoma is not affected by xerostomia

“…In our study, we have observed the first reports of xerostomia in the first week of RT, with three patients (15%) presenting xerostomia grade 1. The authors also reported that xerostomia can be transient or permanent, depending on the irradiated field [12,24,25]. In our study, despite the short period of control after RT, 100% of the patients still had some degree of xerostomia in the follow-up visit, that is, one month after RT.…”

“…Patients undergoing RT may develop dysphagia, xerostomia, dysgeusia, mucositis and opportunistic infections (bacterial, fungal and viral) during treatment [12,21–23]. …”

“…In the study by Cardoso et al the authors observed that 100% of the patients irradiated with doses superior or equal to 60 Gy presented xerostomia [25], which was also observed in our study as all patients presented some degree of xerostomia. According to studies by Mosel et al and Trotti et al the sensation of dry mouth is usually observed in the third or fourth session of radiotherapy due to the lower secretion of saliva by the glands involved in the radiation field [12,24]. This dry mouth sensation impairs greatly the quality of life of the patients, interfering not only with chewing and swallowing, but also with speech, which limits their social life.…”

Appropriate and necessary oral care for people with cancer: guidance to obtain the right oral and dental care at the right time

“…Furthermore, speech, ability to maintain oral hygiene, wearing dental prostheses, and appearance may negatively influence oral health, social, and emotional wellness [2,[19][20][21][22]. These side effects may also affect the ability to deliver cancer therapy as planned and thus, systemic health, outcomes of cancer therapy, and the cost of care [2,5,9,20,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40].…”

Patient-reported outcomes for immediate identification of dental care needs

“…These may arise due to direct effects of treatment on the soft and hard oral tissues, or indirect damage through systemic toxicity (6). Oral complications diminish the quality of life (QOL) of oncology patient, impact the completion of planned treatment, and increase morbidity and possibly mortality (1,2,(6)(7)(8)(9). Additionally, preexisting dental and periodontal disease may exacerbate causing pain, local, regional and systemic infection in the setting of malignant disease, and these conditions may not be effectively managed when the patient is medically compromised.…”