Managing the Oral Effects of Cancer Treatment. Diagnosis to Survivorship

Description

Oral cancers can be devastating, and toxicities from oncology treatments can compound existing conditions and lead to poor oral health.

The first oncology textbook to guide clinicians through the management of oral health problems, Managing the Oral Effects of Cancer Treatment edited by Marilyn L. Haas and Deborah L. McBride, provides an overview of the fundamental skills of oral assessment and dental hygiene, treatment side effects related to the oral cavity, management strategies, and insight into survivorship issues.

Chapters cover the basics of oral health including common oral conditions and manifestations; fundamentals of dental hygiene and conducting oral assessments; treatment of side effects such as oral mucositis, among others; evidence-based practice and measuring tools; nutrition management; xerostomia and cytoprotection; pain management; issues involving speech, voice, and swallowing; and much more.

The book also details how to develop an innovative mini-oral clinic in your practice, how to treat special patient populations, and defines a 'symptom cluster' model for oral health across the continuum of care.

CONTENTS

• Preface

• Chapter 1. Oral Health: The Basics
• Introduction
• History of Oral Care
• Epidemiology of Oral Diseases
• Anatomy of the Oral Cavity
• Common Oral Conditions
• Oral Health and Overall General Health
• Common Oral Manifestations of Systemic Medical Diseases
• Oral Manifestations During Women’s Reproductive Years
• Maintenance of Oral Hygiene and Health
• Conclusion
• References

• Chapter 2. Fundamental Skills: Oral Assessment and Dental Hygiene
• Introduction
• History Taking
• Diagnostic and Assessment Tools
• Dental Care in Patients With Cancer
• Barriers to Dental Care
• Conclusion
• References

• Chapter 3. Treatment of Side Effects
• Introduction
• Oral Mucositis
• Xerostomia and Hyposalivation
• Chronic Graft-Versus-Host Disease
• Dental Caries and Periodontal Disease
• Taste Changes
• Persistent Dysphagia
• Trismus
• Fungal Infections
• Osteoradionecrosis
• Osteonecrosis
• Conclusion
• References

• Chapter 4. Evidence-Based Practice: Tools to Measure Progress
• Introduction
• Evidence-Based Practice
• Types of Tools
• Description and Critique of Specific Tools
• Special Populations and Considerations
• Naturopathic, Complementary, and Alternative Medicine
• Conclusion
• References

• Chapter 5. Nutrition Management Strategies for Oral Effects of Cancer Treatment
• Introduction
• Mucositis
• Xerostomia
• Dysgeusia and Hypogeusia
• Dysphagia
• Other Oral Effects of Treatment
• Nutrition Support
• Conclusion
• References

• Chapter 6. Xerostomia and Cytoprotection
• Introduction
• Sjögren Syndrome of the Oral Cavity
• Review of Oral Cancers
• Treatment for Oral Cancers
• Advances in Radiation Therapy
• Cytoprotection
• Quality of Life
• Conclusion
• References

• Chapter 7. Pain Management
• Introduction
• Causes of Oral Pain
• Assessment
• Interventions for Oral Pain
• Other Treatments
• Barriers to Pain Management
• Conclusion
• References

• Chapter 8. Speech, Voice, and Swallowing Problems: The Speech Pathologist’s Role
• Introduction
• Common Speech, Voice, and Swallowing Problems Related to Radiation Therapy and Chemotherapy for Oral and Oropharyngeal Cancers
• Pretreatment Involvement of Speech Pathology
• Speech Pathology Evaluations
• Speech Pathology Treatment
• Conclusion
• References

• Chapter 9. Complementary and Alternative Medicine and the Mouth
• Introduction
• Definitions
• Evidence for Use
• Interventions for Dysgeusia
• Interventions for Oral Mucositis
• Interventions for Orofacial Pain (Excluding Oral Mucositis)
• Interventions for Xerostomia
• Conclusion and Nursing Implications
• References

• Chapter 10. Developing a Nursing-Centered “Spray and Weigh” Program
• Introduction
• Oral Cavity Assessment
• Symptom Assessment
• Dental Health
• Oral Hygiene at Home
• Conclusion
• References

• Chapter 11. Sexuality and Quality of Life
• Introduction
• Factors in Sexuality
• Patient Oral Symptoms and Their Effects on Sexuality and Intimacy
• Assessing Sexual Health
• Assessments and Interventions
• Conclusion
• References

• Chapter 12. Paradigms of Eating
• Introduction
• Diet Following Chemotherapy
• Bisphosphonate-Associated Osteonecrosis
• Stem Cell Transplantation and Oral Development
• Diet Following Radiation Therapy
• Diet Following Surgery: Dysphagia
• Conclusion
• References

• Chapter 13. Psychosocial Challenges
• Introduction
• Oral Complications of Survivorship
• Financial Challenges
• Assessment Tools
• Screening Tools for Patients With Oral Complications
• Additional Resources
• Conclusion
• References

• Chapter 14. Considerations for Older Cancer Survivors—Aging, Comorbidity, and Cancer Treatment
• Introduction
• Oral Health and the Aging Population
• Oral Health Problems Among Older Adults
• Considerations in Assessment and Intervention for Oral Effects in Older Survivors
• Conclusion
• References

• Chapter 15. Special Considerations in Pediatric Populations
• Introduction
• Oral Complications Associated With Cancer Treatment in Children
• Pediatric Oral Assessment Tools
• Infections Associated With Cancer Treatment
• Salivary Gland Dysfunction
• Oral and Dental Management
• Oral Care After Cancer Treatment
• Conclusion
• References

• Chapter 16. Second Primary Cancers and Recurrence
• Introduction
• Scope of the Problem
• Chemoprevention
• Fear of Recurrence and Psychosocial Effect on Patients With Oral Cancer
• Nursing Implications
• Conclusion
• References

• Chapter 17. Oral Health Across the Continuum of Care: A Symptom Cluster Model
• Introduction
• Major Advances in Treatment of Oral Problems in Cancer Treatments
• Clinical and Functional Impairments
• Prevention and Early Detection of Oral Complications
• Oral Care Protocols
• Symptom Clusters
• Case Study in an Allogeneic Hematologic Stem Cell Transplant Recipient
• Conclusion
• References

• Index

Preface

The mouth is a “mirror”: the oral cavity can reflect the general health of a patient and reveal toxicities from oncology treatments.

Oral diseases may not be life threatening, but they can have systemic effects and greatly affect a person’s quality of life. Oral cancers can be devastating, and the toxicities from oncology treatments can compound problems already experienced by patients who suffer from poor oral health and periodontal diseases. Concomitant high-dose radiation therapy and chemotherapy (targeted therapies) improves locoregional control of cancers but increases toxicities. Oral health becomes one of the primary responsibilities of the entire multidisciplinary team. Healthcare providers should employ interventions that prevent oral problems or anticipate oral side effects and be aggressive in treating the problems so as to not delay or interrupt therapy. Once the patient has completed therapy, follow-up over time is extremely important to maintain oral health.

This is the first oncology textbook available to guide physicians, nurse practitioners/physician assistants, and nurses who care for patients with cancer through the management of oral health problems. Comprehensive information about evidence-based principles and practice guidelines in caring for the oncology patient who has developed oral problems is presented. Managing the Oral Effects of Cancer Treatment: Diagnosis to Survivorship begins with an in-depth discussion about the fundamental skills of oral assessment and dental hygiene, treatment side effects as they relate to the oral cavity, management strategies, and insight into survivorship issues.

Initial chapters will discuss general overall oral health care, explain the necessary fundamental skills to perform a comprehensive oral assessment, and explain oral side effects from oncology treatments. Evidence-based tools to describe the progress back toward oral health will be shared. The second section will discuss management strategies to improve nutrition status, identify advantages of cytoprotection interventions, and gain control over pain issues. Speech therapy resources, complementary therapies, and an innovative mini-oral clinic will be discussed to improve the patient’s tolerance with oncology treatments. Finally, the third section will provide in-depth insight into survivorship issues, sexuality, changing eating habits, psychosocial issues, older adult and pediatric challenges, recurrent cancers, and a symptom cluster model of care.

This textbook shares the efforts of many authors to synthesize scientific information to support patients toward better oral health care. Applying oral healthcare principles will improve the quality of care for patients with cancer.