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Oral Complications of Chemotherapy and Head/Neck Radiation (PDQ®)

Health Professional Version
Last Modified: 04/23/2014

Psychosocial Issues

Oral complications of cancer, including oral mucositis [1] and salivary gland hypofunction/xerostomia,[2] are among the most devastating of both short- and long-term problems encountered by people with cancer because they affect eating and communication, the most basic of human activities. Patients with these problems can become withdrawn, socially avoidant, and even clinically depressed as a result of the difficulties and frustrations they encounter living with oral complications.

When psychotropic drug interventions are employed in the treatment of such patients, it is important that the drugs chosen will improve, or at least not worsen, their oral complications. For example, in the treatment of depression, highly anticholinergic drugs should be avoided in patients with xerostomia and salivary problems. (Refer to the PDQ summaries on Adjustment to Cancer: Anxiety and Distress and Depression for more information.)

Supportive care, including education and symptom management, are important for patients experiencing oral complications related to cancer therapy. It is important to closely monitor each patient’s level of distress, ability to cope, and response to treatment. This approach provides a setting for the health professional to demonstrate concern for the patient’s complications and to educate the patient and family caregivers. Comprehensive supportive care from staff and family can enhance the patient’s ability to cope with cancer and its complications.

References
  1. Dodd MJ, Dibble S, Miaskowski C, et al.: A comparison of the affective state and quality of life of chemotherapy patients who do and do not develop chemotherapy-induced oral mucositis. J Pain Symptom Manage 21 (6): 498-505, 2001.  [PUBMED Abstract]

  2. Langendijk JA, Doornaert P, Verdonck-de Leeuw IM, et al.: Impact of late treatment-related toxicity on quality of life among patients with head and neck cancer treated with radiotherapy. J Clin Oncol 26 (22): 3770-6, 2008.  [PUBMED Abstract]