Oral Complications In Second Cancers
Cancersurvivors who received chemotherapy or a transplant or who underwent radiation therapy are at risk of developing a second cancer later in life. Oralsquamous cell cancer is the most common second oral cancer in transplant patients. The lips and tongue are the areas that are affected most often.
Second cancers are more common in patients treated for leukemia or lymphoma, Multiple myeloma patients who received a stem cell transplant using their own stem cells sometimes develop an oral plasmacytoma.
How Fertility Might Be Affected
For women: Talk to your cancer care team about how radiation might affect your fertility . Its best to do this before starting treatment so you are aware of possible risks to your fertility.
Depending on the radiation dose, women getting radiation therapy in the pelvic area sometimes stop having menstrual periods and have other symptoms of menopause. Report these symptoms to your cancer care and ask them how to relieve these side effects.Sometimes menstrual periods will return when radiation therapy is over, but sometimes they do not.
See Fertility and Women With Cancer to learn more.
For men: Radiation therapy to an area that includes the testicles can reduce both the number of sperm and their ability to function. If you want to father a child in the future and are concerned about reduced fertility, talk to your cancer care team before starting treatment. One option may be to bank your sperm ahead of time.
See Fertility and Men With Cancer to learn more.
What Are The Risk Factors For Laryngeal Cancer
Smoking or using other tobacco products greatly increases your risk of developing laryngeal cancer. Drinking alcohol, especially a lot of it, also raises your risk. And using alcohol and tobacco together increases the risk even more.
Other risk factors for laryngeal cancer include:
- Age: Laryngeal cancer happens more in people age 55 and older.
- Gender: Men are more likely to develop this cancer, possibly because smoking and heavy alcohol consumption happen more among men.
- History of head and neck cancer: About one in four people who have had head and neck cancer will get it again.
- Job: People who have exposure to certain substances at work are at higher risk. These substances include sulfuric acid mist, wood dust, nickel, asbestos or manufacturing mustard gas. People who work with machines are also at higher risk.
Sore Throat And Difficulty Swallowing
The lining of your throat may become swollen, sore and inflamed. This may make it difficult to swallow. Your doctor can prescribe liquid painkillers to help with this. Try to take these before meals to make eating easier.
Your speech and language therapist will talk to you about any swallowing or eating problems you may have. It is important to try to keep eating and drinking for as long as possible during your treatment.
You may cough when you eat and drink. Sometimes this can be a sign that food and drink is going down the wrong way . This can cause a chest infection.
Side Effects Of Radiotherapy For Laryngeal Cancer
Radiotherapy can cause some side effects, such as a sore mouth, throat or skin. Side effects can be mild or more severe. This depends on the size of the area being treated and the length of your treatment. They are usually more severe if you have radiotherapy combined with chemotherapy .
Side effects usually begin to develop after 2 weeks of radiotherapy. They may continue for about 2 weeks after treatment ends before starting to get better. Most people notice that their side effects have improved about 4 to 6 weeks after treatment finishes.
Radiotherapy can cause some side effects after treatment has finished. These are called late effects and can be temporary or permanent.
Before you start radiotherapy, someone from your healthcare team will discuss your treatment with you so you know what to expect. This could be your cancer doctor, nurse, speech and language therapist , dietitian or radiographer. Tell them about any side effects you have during,
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Oral Complications Of Chemotherapy And Radiation Therapy In Children
Children who received high-dose chemotherapy or radiation therapy to the head and neck may not have normal dental growth and development. New teeth may appear late or not at all, and tooth size may be smaller than normal. The head and face may not develop fully. The changesare usually the same on both sides of the head and are not always noticeable.
Orthodontic treatment for patients with these dental growth and development side effects is being studied.
Different Treatment Schedules For Ebrt
Standard EBRT for oral cavity or oropharyngeal cancers is usually given in daily fractions 5 days a week for about 7 weeks. But sometimes other schedules might be used:
- Hyperfractionation radiation is a slightly lower radiation dose given more than once a day .
- Accelerated fractionation radiation is the standard dose of radiation given each day but over a shorter time instead of the usual 7 weeks .
- Hypofractionation radiation is a slightly higher radiation dose given each day to lessen the number of treatments .
Hyperfractionation and accelerated fractionation schedules may reduce the risk of cancer coming back in or near the place it started and might help some people live longer compared to standard EBRT. The drawback is that treatments given on these schedules also tend to have more severe side effects. Adding chemotherapy to these treatment schedules doesn’t appear to improve outcomes more.
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Different Types Of Ebrt
There are also more advanced EBRT techniques that help doctors focus the radiation more precisely.
Three-dimensional conformal radiation therapy uses special computers to precisely map the location of the tumor. Several radiation beams are then shaped and aimed at the tumor from different directions, which makes it less likely to damage normal tissues.
Intensity modulated radiation therapy is a form of 3D-CRT. It uses a computer-driven machine that actually moves around the patient as it delivers radiation. Along with shaping the beams and aiming them at the tumor from several angles, the intensity of the beams can be adjusted to limit the dose reaching nearby normal tissues. This may let the doctor deliver a higher dose to the tumor.
Proton beam radiation therapy focuses beams of protons instead of x-rays on the cancer. Unlike x-rays, which go through the patient and release radiation both before and after they hit the tumor, protons only travel a certain distance, so the tissues behind the tumor are exposed to very little radiation. Even the tissues in front of the tumor see less radiation than the tumor itself. This means that proton beam radiation can deliver radiation to the cancer while doing less damage to nearby normal tissues. Because there are so many critical structures close by, proton beam radiation can be used to treat certain tumors of the oral cavity or oropharynx. Proton therapy can be a safe option in certain cases when using x-rays is not.
Taste And Swallowing Changes
You may have thick phlegm in your throat, or a lump-like feeling that makes it hard to swallow. Food may also taste different. Normal taste usually returns in time. Sometimes, swallowing may be affected for months after treatment, but it is rare for problems to be permanent.
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How Long Do Side Effects Last
Remember that the type of radiation side effects you might have depends on the prescribed dose and schedule. Most side effects go away within a few months of ending treatment. Some side effects may continue after treatment ends because it takes time for the healthy cells to recover from radiation.
Side effects might limit your ability to do some things. What you can do will depend on how you feel. Some patients are able to go to work or enjoy leisure activities while they get radiation therapy. Others find they need more rest than usual and cant do as much. If you have side effects that are bothersome and affecting your daily activities or health, the doctor may stop your treatments for a while, change the schedule, or change the type of treatment youre getting. Tell your cancer care team about any side affects you notice so they can help you with them.
Treatment Of Onj Usually Includes Treating The Infection And Good Dental Hygiene
Treatment of ONJ may include the following:
- Removing the infected tissue, which may include bone. Laser surgery may be used.
- Smoothing sharp edges of exposed bone.
- Using antibiotics to fight infection.
- Using medicated mouth rinses.
- Using pain medicine.
During treatment for ONJ, you should continue to brush and floss after meals to keep your mouth very clean. It is best to avoid tobacco use while ONJ is healing.
You and your doctor can decide whether you should stop using medicines that cause ONJ, based on the effect it would have on your general health.
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Strategies For Good Nutrition During Treatment
While dietary fat or added sugars are generally not restricted during treatment, there are many nutritious ways of increasing calories to prevent excess weight loss.
Eat small, frequent meals:
- Instead of three large meals a day, eat small amounts frequently throughout the day.
- Carry food with you at all times, so you can snack in the car, while waiting for treatment or to see your doctor, and at other opportunities.
Eat calorie-dense foods:
- Pick foods that pack a lot of nutrition into every bite, and include protein several times a day.
- Eat a variety of foods with many colors, textures and flavors. It’s important to include fruits and vegetables in addition to high-calorie and high-protein foods.
Avoid plain food:
- Before you eat or drink anything, ask yourself, “What can I add to give this more calories or protein?” Make each bite count.
Concentrate on soft and liquid foods:
- Soft and liquid foods are easier and less time-consuming to eat. For example, stirring in one tablespoon of creamy almond or peanut butter into hot cereal an add 90 calories to your meal.
Use supplemental nutrition drinks:
- Liquid supplements can increase your calorie and protein intake. They require no preparation and are easy to carry with you. You can also make your own shakes at home.
Weigh yourself regularly:
- Keep a weight log. If your weight goes down, increase your calorie and protein intake. For accuracy, always use the same scale.
Have a good attitude:
How Do I Breathe After A Laryngectomy
After a laryngectomy, you breathe by taking air in through a stoma, an opening made in your neck. Care for your stoma to keep it moist and free of mucus. Make sure to protect your trachea as well.
After surgery, youll be fitted with a stoma cover and filter . This allows you to breath warmed and moisturized air, using your bodys own power. Youll find this causes you to have less mucus and debris in the windpipe and minimizes coughing after surgery.
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Quit Smoking Before Laryngeal And Hypopharyngeal Cancer Treatment
If you smoke, you should quit. Your cancer might not shrink as well if you smoke during radiation treatment, you might have more side effects, and your benefit from radiation treatment might be less . Smoking after treatment can also increase the chance of getting another new cancer. Quitting smoking for good is the best way to improve your chances of survival. It is never too late to quit. For help, see How To Quit Using Tobacco.
If Youre Getting Radiation Therapy To The Head Or Neck
People who get radiation to the head and neck might have side effects such as:
- Soreness in the mouth or throat
How to care for your mouth during treatment
If you get radiation therapy to the head or neck, you need to take good care of your teeth, gums, mouth, and throat. Here are some tips that may help you manage mouth problems:
- Avoid spicy and rough foods, such as raw vegetables, dry crackers, and nuts.
- Dont eat or drink very hot or very cold foods or beverages.
- Dont smoke, chew tobacco, or drink alcohol these can make mouth sores worse.
- Stay away from sugary snacks.
- Ask your cancer care team to recommend a good mouthwash. The alcohol in some mouthwashes can dry and irritate mouth tissues.
- Rinse your mouth with warm salt and soda water every 1 to 2 hours as needed.
- Sip cool drinks often throughout the day.
- Eat sugar-free candy or chew gum to help keep your mouth moist.
- Moisten food with gravies and sauces to make it easier to eat.
- Ask your cancer care team about medicines to help treat mouth sores and control pain while eating.
If these measures are not enough, ask your cancer care team for advice. Mouth dryness may be a problem even after treatment is over. If so, talk to your team about what you can do.
How to care for your teeth during treatment
Radiation treatment to your head and neck can increase your chances of getting cavities. This is especially true if you have dry mouth as a result of treatment.
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Purpose Of This Summary
This PDQ cancer information summary has current information about the causes and treatment of oral complications of chemotherapy and head/neck radiation. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Care Of The Teeth And Gums Is Important During Chemotherapy Or Stem Cell Transplant
Talk to your medical doctor or dentist about the best way to take care of your mouth during high-dose chemotherapy and stem cell transplant. Careful brushing and flossing may help prevent infection of oral tissues. The following may help prevent infection and relieve discomfort of oral in tissues:
- Brush teeth with a soft-bristle brush 2 to 3 times a day. Be sure to brush the area where the teeth meet the gums.
- Rinse the toothbrush in hot water every 15 to 30 seconds to keep the bristles soft.
- Rinse your mouth 3 or 4 times while brushing.
- Avoid rinses that have alcohol in them.
- Use a mild-tasting toothpaste.
- Let the toothbrush air-dry between uses.
- Floss according to your medical doctor’s or dentist’s directions.
- Clean the mouth after meals.
- Use foam swabs to clean the tongue and roof of the mouth.
- Avoid the following:
- Foods that are spicy or acidic.
- “Hard” foods that could irritate or break the skin in your mouth, such as chips.
- Hot foods and drinks.
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What Is Throat Cancer
In general, cancer occurs in the body at the cellular level, caused by a disruption in cellular activity when normal cell reproduce uncontrollably or dont die as they should. Throat cancer mostly originates in squamous cells, which are thin, flat cells that line the pharynx and larynx.
Throat cancer can affect either the pharynx or larynx and there are a variety of different types, based on where the cancer is found. Squamous cell cancer of the throat can spread to other areas of the body including the lungs, bone and liver.
The pharynx is a 5-inch hollow tube that starts behind your nose and mouth, and ends at the top of the trachea . Cancer in any part of the pharynx is known as pharyngeal cancer. There are three parts to the pharynx that can further classify the type of pharyngeal cancer a person has. Going from top to bottom, these are the nasopharynx , the oropharynx , and the hypopharynx .
The larynx contains your vocal cords, which are used to speak, and also helps to support the processes of breathing and swallowing. Cancer in any part of the larynx is known as laryngeal cancer. Like the pharynx, the larynx has three parts. From upper to lower, these are the supraglottis , glottis , and subglottis .
Radiation Therapy For Laryngeal Cancer
Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is usually used to treat laryngeal cancer. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You may also receive other treatments.
Radiation therapy is often combined with chemotherapy to treat laryngeal cancer. This is called chemoradiation. The 2 treatments are given during the same time period.
Radiation therapy is given for different reasons. You may have radiation therapy or chemoradiation:
- as a primary treatment for early stage laryngeal cancer or if you are not healthy enough to have surgery
- as a primary treatment, along with chemotherapy , to treat large tumours or tumours that have spread to nearby lymph nodes
- to destroy cancer cells left behind after surgery, with or without chemotherapy, to reduce the risk that the cancer will come back
- after surgery if the tumour is hard to remove, cant be completely removed or has spread to nearby tissues or lymph nodes
- to relieve pain or control the symptoms of advanced laryngeal cancer
People who have radiation therapy to treat laryngeal cancer need an immobilization mask. The mask is worn when planning treatment and during all radiation treatments. It helps you stay in the same position each time radiation is given.
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