Oral Cancer (cont.)
Side effects of treatment for oral
cancer
Because treatment often damages healthy cells and tissues, unwanted side
effects are common. These side effects depend mainly on the location of the
tumor and the type and extent of the treatment. Side effects may not be the same
for each person, and they may even change from one treatment session to the
next. Before treatment starts, your health care team will explain possible side
effects and suggest ways to help you manage them.
The NCI provides helpful booklets about cancer treatments and coping with
side effects. Booklets such as Radiation Therapy and You, Chemotherapy and You,
and Eating Hints for Cancer Patients may be viewed, downloaded, and ordered from http://cancer.gov/publications. These materials also may be ordered by calling
the Cancer Information Service at 1-800-4-CANCER.
The National Institute of Dental and Craniofacial
Research (NIDCR) also
provides helpful materials. Head and Neck Radiation Treatment and Your Mouth,
Chemotherapy and Your Mouth, and other booklets are available from NIDCR. See
"National Institute of Dental and Craniofacial Research Information Resources"
for a list of publications.
Surgery
It takes time to heal after
surgery, and the time needed to recover is different for each person. You may be
uncomfortable for the first few days after surgery. However, medicine can
usually control the pain. Before surgery, you should discuss the plan for pain
relief with your doctor or nurse. After
surgery, your doctor can adjust the plan if you need more pain relief.
It is common to feel tired or weak for a while. Also, surgery may cause
tissues in your face to swell. This swelling usually goes away within a few
weeks. However, removing lymph nodes can result in swelling that lasts a long
time.
Surgery to remove a small tumor in the mouth may not
cause any lasting problems. For a larger tumor, however, the surgeon may remove
part of the palate, tongue, or jaw. This surgery may change your ability to
chew, swallow, or talk. Also, your face may look different after surgery.
Reconstructive or plastic surgery may be done to rebuild the bones or tissues of the mouth. (See
"Reconstruction.")
Radiation therapy
Almost all patients who have
radiation therapy to the head and neck area develop oral side effects. That is
why it is important to get the mouth in good condition before cancer treatment begins. Seeing a dentist two weeks before
cancer treatment begins gives the mouth time to heal after dental work.
The side effects of radiation therapy depend mainly on
the amount of radiation given. Some side effects in the mouth go away after
radiation treatment ends, while others last a long time. A few side effects
(such as dry mouth) may never go away.
Radiation therapy may cause some or all of these side effects:
- Dry mouth: Dry mouth can
make it hard for you to eat, talk, and swallow. It can also lead to tooth
decay. You may find it helpful to drink lots of water, suck ice chips or
sugar-free hard candy, and use a saliva substitute to moisten your mouth.
- Tooth decay: Radiation
can cause major tooth decay problems. Good mouth care can help you keep your
teeth and gums healthy and can help you feel better.
- Doctors usually
suggest that people gently brush their teeth, gums, and tongue with an
extra-soft toothbrush and fluoride
toothpaste after every meal and before bed. If brushing hurts, you can
soften the bristles in warm water.
- Your dentist may suggest that you use fluoride gel
before, during, and after radiation treatment.
- It also helps to rinse your mouth several times a
day with a solution made from 1/4 teaspoon baking soda and 1/8 teaspoon salt
in one cup of warm water. After you rinse with
this solution, follow with a plain water rinse.
- Sore throat or mouth:
Radiation therapy can cause painful ulcers and inflammation. Your doctor can
suggest medicines to help control the pain. Your doctor also may suggest
special rinses to numb the throat and mouth to help relieve the soreness. If
your pain continues, you can ask your doctor about stronger medicines.
- Sore or bleeding gums: It
is important to brush and floss teeth gently. You may want to avoid areas that
are sore or bleeding. To protect your gums from damage, it is a good idea to
avoid the use of toothpicks.
- Infection: Dry mouth and
damage to the lining of the mouth from radiation therapy can cause infection
to develop. It helps to check your mouth every day for sores or other changes
and to tell your doctor or nurse about any mouth problems.
- Delayed healing after dental care: Radiation treatment may make it hard for tissues in the mouth to
heal. It helps to have a thorough dental exam and complete all needed dental
treatment well before radiation therapy begins.
- Jaw stiffness: Radiation
can affect the chewing muscles and make it difficult for you to open your
mouth. You can prevent or reduce jaw stiffness by exercising your jaw muscles.
Health care providers often suggest opening and closing the mouth as far as
possible (without causing pain) 20 times in a row, 3 times a day.
- Denture problems:
Radiation therapy can change the tissues in your mouth so that dentures do not
fit anymore. Because of soreness and dry mouth, some people may not be able to
wear dentures for as long as one year after radiation therapy. After the
tissues heal completely and your mouth is no longer sore, your dentist may
need to refit or replace your dentures.
- Changes in the sense of taste
and smell: During radiation therapy, food may taste or smell different.
- Changes in voice
quality:
Your voice may be weak at the end of the day. It may also be affected by
changes in the weather. Radiation directed at the neck may cause your larynx
to swell, causing voice changes and the feeling of a lump in your throat. Your
doctor may suggest medicine to reduce this swelling.
- Changes in the thyroid:
Radiation treatment can affect your thyroid (an organ in your neck beneath the
voice box). If your thyroid does not make enough thyroid hormone, you may feel
tired, gain weight, feel cold, and have dry skin and hair. Your doctor can
check the level of thyroid hormone with a blood test. If the level is low, you
may need to take thyroid hormone pills.
- Skin changes in the treated area: The skin in the treated area may become red or dry. Good skin care
is important at this time. It is helpful to expose this area to the air while
protecting it from the sun. Also, avoid wearing clothes that rub the treated
area, and do not shave the treated area. You should not use lotions or creams
in the treated area without your doctor's advice.
- Fatigue: You may become very tired, especially in the later weeks of
radiation therapy. Resting is important, but doctors usually advise
their patients to stay as active as they can.
Although the side effects of radiation therapy can be distressing,
your doctor can usually treat or control them. It helps to report any
problems that you are having so that your doctor can work with you to
relieve them.
Chemotherapy
Chemotherapy and radiation therapy can cause some of the
same side effects, including painful mouth and gums, dry mouth, infection, and
changes in taste. Some anticancer drugs can also cause bleeding in the mouth and
a deep pain that feels like a toothache. The problems you have depend on the type and amount of
anticancer drugs you receive, and how your body reacts to them. You may have
these problems only during treatment or for a short time after treatment ends.
Generally, anticancer drugs affect cells that divide rapidly. In
addition to cancer cells, these rapidly dividing cells include the
following:
- Blood cells: These cells
fight infection, help your blood to clot, and carry oxygen to all parts of the
body. When drugs affect your blood cells, you are more likely to get
infections, bruise or bleed easily, and feel very weak and tired.
- Cells in hair roots:
Chemotherapy can lead to hair loss. The hair grows back, but sometimes the new
hair is somewhat different in color and texture.
- Cells that line the digestive
tract: Chemotherapy can cause poor appetite, nausea and vomiting,
diarrhea, or mouth and lip sores. Many of these side effects can be
controlled with drugs.
Next: What is rehabilitation for oral cancer? »
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