Oncology Flashcards
when would a chemotherapy patient experience dry mouth
during treatment but then returns to normal after treatment
what is mucositis
inflammation of the oral mucosa
when would mucositis appear
from 7-14 days after initiation of chemotherapy
how would mucositis present to the patient
mucosal irritation accompanied by ulcer development
what treatment would be given for mucositis
opioid analgesics
oral care
avoid spice/hard/hot food and drinks
oral cryotherapy
laser therapy
recombinant keratinocyte factor 1
topical anaesthetics
caphosol and chlorhexidine
soluble aspirin
difflam spray
what is used to monitor oral mucositis progression
WHO oral mucositis grading scale
what should be done to a cancer patient prior to chemotherapy
remove any current source or potential source of infection
institute prevention
what is the total dose that is given during radiotherapy
64-70Gy
what do patients with advanced cancer present with in regards with oral complications
dry mouth, sore mouth, taste disturbance, difficulty wearing dentures
oral fungal infections
how does trismus result in cancer patients
due to replacement fibrosis of muscles of mastication
tumour growth/infection/surgery
when would trismus due to radiotherapy become apparent
3-6 months after radiotherapy
what oral complications occur from radiotherapy
dry mouth
trismus
loss of taste
radiation caries
ORN
how does radiotherapy lead to ORN
it induces endarteritis obliterans which leads to progressive fibrosis and capillary loss leaving bone susceptible to avascular necrosis
when is ORN risk greater
at radiotherapy doses over 60Gy
local trauma (extraction)
uncontrolled periodontal disease
ill fitting prosthesis
immunodeficiency
malnourished person
how can ORN be prevented
avoid extractions after jaw irradiation
remove unsalvageable teeth at least 2 weeks prior to start of radiotherapy
what try of prevention is good for radiotherapy patients
fluoride toothpastes, fluoride trays, CPP-ACP
what is the role of the GDP in head and neck cancer
detect through soft tissue exam
photograph
referral
pre-treatment assessment
when do we refer for possible head and neck cancer
stridor
persistent unexplained head and neck lumps
ulceration or unexplained swelling of oral mucosa
red or white and red patches of oral mucosa
persistent hoarseness
dysphagia or odynophagia
persistent pain in throat
how long should symptoms last for before sending a patient for referral
> 3 weeks
what do we provide at the pre-assessment
detailed oral hygiene
topical fluoride
tooth mousse
dietary advice - oral comfort
PMPR
chlorhexidine mouthwash and gel
restore caries
remove trauma
impressions for fluoride trays/soft splints
denture hygiene and instructions
remove ortho
extractions
what should we provide during cancer treatment
oral and denture hygiene
chlorhexidine
diet advice
fluoride
exam for fungal and viral infections
treatment of mucositis and xerostomia
how long does mucositis last
6 weeks after treatment complete
what antifungals are used for candida infections
chlorhexidine
miconazole
fluconazole
nystatin
what is traumatic ulceration caused by
teeth rubbing against delicate intraoral tissues
