Coordinated Oral Health Care in Patients With Cancer

Abstract Introduction Cancer therapy, either with ionizing radiation or chemotherapeutic agents, is based on the principle of destruction of rapidly replicating cancer cells. Although effective in holding back or eradicating cancer growth, it also causes unavoidable damage to normal cells. The short...

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Bibliographic Details
Main Authors: Rose Geist, James Geist
Format: Article
Language:English
Published: Association of American Medical Colleges 2013-04-01
Series:MedEdPORTAL
Subjects:
Online Access:http://www.mededportal.org/doi/10.15766/mep_2374-8265.9382
Description
Summary:Abstract Introduction Cancer therapy, either with ionizing radiation or chemotherapeutic agents, is based on the principle of destruction of rapidly replicating cancer cells. Although effective in holding back or eradicating cancer growth, it also causes unavoidable damage to normal cells. The short-term and long-term effects of cancer therapy on oral and adjacent tissues can be painful, life-threatening, and intolerable to the patient. These morbidities can contribute to the disruption or discontinuance of the cancer therapy and directly affect the success of treatment. For those who survive, these morbidities adversely affect the quality of life of the patient and family members and drive up the cost of health care. Many of these complications can be minimized by good oral health care before, during, and after the cancer therapy. Advances in cancer therapy can also limit the damage to normal tissues. The key to overcoming oral complications and their consequences is the coordination of care among oral health care providers, oncologists, and other supporting groups, especially before the initiation of cancer therapy. Eliminating dormant dental infections before head and neck radiation therapy and chemotherapy has had moderate success in curtailing oral complications. Methods This resource revisits the oral complications of conventional radiation therapy and chemotherapy. A PowerPoint presentation updates the new technology and pharmacological improvements in minimizing oral tissue damage that have arisen in recent years, as well as the interventions used to remedy such damage. The importance of the coordination of care is emphasized, and a mechanism for improving communication among the health care disciplines is provided. This resource also highlights IV bisphosphonate-associated and denosumab-associated osteonecrosis of the jaw (ONJ) in cancer patients to raise awareness of this new complication of cancer therapy. The resource provides strategies for minimizing the risk of ONJ and optimizing the outcome of cancer therapy through dental preparation before the initiation of these agents. Results This resource has been developed and used in dental education in the field of cancer patient care. We have published our results on the effectiveness of this material elsewhere. Discussion The resource was presented to the third and fourth dental student oral medicine courses and also converted to a section of the online clinical manual that students and faculty refer to when managing dental patients who have had cancer therapy, are undergoing it, or will undergo it in the near future. Communications with oncologists have been improved based on the instructional material in this section of the clinical manual.
ISSN:2374-8265