Oral Effects of Cancer Treatment

Summary of the article

Kawashita et al. (2020) conducted a review article titled “Oral management strategies in radiotherapy of head and neck tumors, “published in the Japanese Dental Science Review. The review aims to present a comprehensive overview of oral side effects secondary to radiotherapy for head and neck cancer and the coping strategies for the management of this condition. Extending attention to supportive measures and preventability draws our attention to the fact that they are the corner tapos of good cancer outcomes. This is by enhancing people’s quality of life and mitigating harsh oral effects. Preventive initiatives involve regular oral hygiene and fluoride treatment regimens to reduce oral complications, including radiation-induced mucositis, xerostomia, and dental caries. One of the ways through which dentists can be of assistance to their patients is to circumvent the discomfort of the patient and to prevent invasive intervention by being proactive. As a result, not only is their treatment experience improved, but they are also more likely to prefer an overall adherence to therapy. Supportive care comprises the liquefying substances and saliva replacements designed to make the xerostomia experience more bearable and confer comfort to the patient from an oral perspective, resulting in better wellbeing and life quality. The role of dental professionals in healthcare cannot be underestimated, as they are an integral part of the supportive and preventive care strategies introduced in the treatment of HNC patients. This is because this approach provides optimized dental health outcomes and an improved overall patient treatment experience.

The authors outline general oral complications like mucositis, xerostomia, and dentures that result from radiation. They show the importance of dietetic management, choosing healthy foods, reducing sugar and fruit snack consumption, brushing twice daily with fluoride toothpaste, regular dental check-ups, and other supportive interventions in managing these complications. The review is an important tool for dental specialists, giving them a practical skills course that is burdened by patients` care issues and avoiding oral complications during patients` treatment with radiation therapy. Coming up with recommendations by consolidating the available knowledge and the experts’ opinions enables us to contribute practical advice on the oral management of geriatric patients while taking issues into account. Dentists will obtain the recommendations in the discussion article to develop an integrated care strategy that treats the immediate dental complications from radiotherapy, such as mucositis, xerostomia, and dental caries, and the long-term health effects on oral health and quality of life. The alternative suggestions, which cover fluoride application, oral hygiene regimen, and supportive care procedures, will make this a team effort to beat oral difficulties and make patients comfortable, improving treatment results and their general health during the cancer treatment journey.

Study analysis

1. Type of study: This paper reviews pertinent literature in the existing literature. A proposal of recommendations for management in head and neck cancer patients undergoing radiation therapy is also provided. The present study stage has its roots in Japan and was published in January 2020 in the Japanese Dental Science Review. Therefore, it will be placed within the range of the literature review. Ensuring consideration of the local specificities that influence healthcare and research, the investigation will likely use applicable scientific approaches and practices widely used in the Japanese healthcare system, which may help dentists in Japan and their patients. When the study is published, its time is sequenced to ensure that it has the demand reflecting the most recent awareness and guidance on oral management techniques for radiation patients suffering from head and neck cancer. As a literature review, there is a coalescence of knowledge and a reassortment of information from various sources, such as research papers, clinical guidelines, and opinion leaders, which is instrumental in giving a descriptive epitome of the subject focus. The whole-book-writing strategy supports the authors in including the latest observations and evidence-based recommendations in the Japanese health care system to guide dental professionals towards the maximum wellbeing of patients undergoing cancer treatment.

1.  Study purpose: No other studies on oral management strategies for head and neck cancer patients undergoing radiotherapy or chemotherapy were obtained, so the authors intended to consolidate current knowledge. By critically examining existing literature, authors have aimed to create a novel scientific contribution towards developing the theory of oral oncology and bringing the research discoveries to application in clinical practice. The review is like a synthesis of the available evidence coupled with a critical appraisal of the evidence sources, which is useful to dental professionals who aim to enhance the quality of treatment for cancer patients. These hours can outline pathways and suggestions that will assist the most educated decision-makers in clinical scenarios by pinpointing tendencies, emptiness and points of agreement within the literature. Such a process is aimed at making users aware of oral problems caused by cancer treatment and offers evidence-based methods of cancer care, prevention, and supportive care. The review enables dental practice professionals to adapt their techniques depending on the specific needs of head and neck cancer patients undergoing radiotherapy, improving the general level of care and effects for these vulnerable population groups.

3. Experimental design: This research involved a thorough literature review through a literature search instead of performing experiments. The absence of a specific sample and control size or group in this article shows that this article belongs to the review type, not experimental studies. In doing so, the review summarised the already available literature and the expert opinion to supply overall and comprehensive guidance on proper oral care for individuals undergoing radiotherapy for head and neck cancer. The author tried to provide a full picture of the topic being discussed by integrating data from different sources, such as research study findings, clinical practice guidelines, and the work of experts. Such as a method expanding the territory of oral hygiene strategy, ranging from multiple care philosophies to the efficacy of different approaches. While no experiment design restrictions are in place to establish a direct causal relationship or the efficiency of specific interventions, examinations’ impact strength is that they can integrate, analyze and amalgamate several information to guide clinical approach as well as direct research in oral oncology.
4. Results: The review brings to the fore the different oral side management strategies and demonstrates multiple methods to mitigate the deformity of radiotherapy in head and neck cancer patients. Oral health maintenance entails properly executed care with strict attention not to develop bacteria buildup and for the better health of our mouth area, which is the same as preventing dental infections. Fluoride application strengthens enamel, thus making it more resistant to acid attacks and decay. This factor is special since cavities are often encountered in patients with decreased salivary flow and weakened oral tissues. Along with these, supportive care practices like moisturizing agents and saliva replacements try to relieve xerostomia (dry-mouth) symptoms, enabling patients’ guaranteed good health and life during the treatment period. Through the process of treatment, which is centred on the main aspects of oral care, doctors can enable patients to contain or reduce the risk of complications related to head and neck cancer that are associated with radiotherapy treatment.
5. Conclusions: It has been decided by the authors that complete oral care is necessary for head and neck cancer patients undergoing radiotherapy so that complications during the treatment procedure could be minimized with a better quality of life would be durable for them. They said that preventive measures and supportive interventions like counselling and monitoring oral health during treatments had shown a favourable effect in managing oral side effects. These deficiencies were further highlighted during the identification of existing research gaps, demonstrating the corps’ awareness that there is still much to be understood and resolved when handling oral complications in cancer patients with radiation treatment. The research needs may include developing new preventive and therapeutic approaches, the mechanisms behind the oral side effects, and the reactions caused by patients’ “individualities.” Furthermore, research should be dedicated to developing predictive systems to recognize patients with a high risk of developing severe oral complications so that early interventions such as individualized care plans and prevention strategies can be implemented. Besides, such studies need to be undertaken to assess issues such as the long-term effect of radiotherapy on oral health, the general wellbeing of individuals, and the influence of longevity of this intervention over time. Through undertaking these research priorities, dentists will be the key implementers of evidence-based practices alongside the general guidelines aiming at the optimization of dental care and better health outcomes for cancer patients during radiation therapy.

Your impression: Such a survey contributes to an enormous understanding of managing or administering oral treatment in radiotherapy among head and neck cancer patients. Dental Hygiene student, I see the importance of preventive care and education as a patient assistant to strengthen oral health during cancer treatments. I also recommend the review provide the principal role of dentists in ensuring holistic care, which may reduce treatment-related complications and, in turn, improve the favourable result. Furthermore, the part played by dental practitioners in treating head and neck cancer patients with assistance from oncologists, radiation oncologists, and other healthcare providers is investigated more deeply. Such integrated practices encourage collaborative efforts among diverse disciplinary teams to formulate holistic plans targeting oncological and dental health issues. Through this partnership, adaptive measures could be implemented to account for the patient-specific treatment, oral hygiene conditions, antibiotics, and other factors predisposing to complications. Interdisciplinary cooperation entails the transference of knowledge and skills, which are critical in developing varied, as well as more effective, strategies for delivering oral care that enhances patient outcomes. Through ongoing research and collaborative efforts, the dental team can, therefore, tune in to achieve the best outcomes while striving to provide optimum oral care and improve the quality of life of individuals suffering from head and neck cancer who are undergoing radiotherapy.

References

Kawashita, Y., Soutome, S., Umeda, M., & Saito, T. (2020). Oral management strategies for radiotherapy of head and neck cancer. Japanese Dental Science Review, 56(1), 62-67. https://www.sciencedirect.com/science/article/pii/S1882761620300028