ON GOING & AFTER CARE FOR THE MOUTH CANCER PATIENT IN GENERAL PRACTICE

Treatment for head, neck and mouth cancers face patients with a catalogue of problems. The following details the main issues that you may see in general practice and outlines how you can help manage them.

Oral Mucositis

Oral mucositis, also called stomatitis, is a common, debilitating complication of chemotherapy and radiotherapy. It occurs in 40% of patients and results from cytotoxic chemotherapy agents and the local effects of radiation. Oral mucositis is inflammation of the oral mucosa and leaves patients prone to opportunistic infections of the mouth. Symptoms can range from redness to sever ulceration and pain. It can affect the patient's gum and dental condition, speech and self-esteem.

Oral Mucositis can be managed with the following protocol:-

  • Clean teeth and gums using a soft toothbrush after meals and before sleeping.
  • Rinse the mouth regularly with a mouthwash recommended by a consultant oncologist.
  • Remove and clean dentures daily and leave out when resting and sleeping.
  • Advise a patient to regularly inspect their mouth for redness, sores and/or tenderness of the lips or mouth and report to their consultant and/or GP.
  • Avoid food and drinks that may be painful stimuli such as spicy food, alcohol, hot food and drinks and smoking.
  • Provide relief by suggesting lubrication of the lips, topical anaesthesia and analgesics.

Psychological Support.

Treatment for cancer is a harrowing process that can affect a patient mentally as well as physically. Management of the mouth cancer patient requires sensitivity, emotional support and ability for the dental team to communicate in a supportive and empathetic way.

Psychological interventions are available to augment pharmacological treatment. Techniques such as cognitive behavioural therapy, relaxation, hypnosis and therapist support are available. If you identify a need for further support it would be appropriate to contact the patient's consultant or GP to request it.