10 Jun 2011

Secondary Oral Cancer

This article reveals the stunning news that long-term use of chemotherapy drug doxorubicin (PLD) is linked to secondary oral cancer.  PLD is very commonly and widely used in the management of ovarian cancer. 
It is known by oncologists, not generally known by dentists, and virtually unknown by cancer patients that chemotherapy drugs exit the body through channels other than urine.  In fact, the second most common route - up to 35% of the drugs - can dissipate through the salivary system - in other words through your saliva glands.
Do you wonder why foods suddenly taste differently when you're undergoing chemo?  Do you wonder why your saliva turns to sludge? 
You are instructed to drink copious amounts of liquids the day before, the days of and for ten days following chemotherapy.  You understand the reason for this to be protecting your liver and kidneys as well as assisting the chemo in its exit.  In addition to these directives,  you  need to pay attention to what it is that you're drinking and when.
Under our tab Coping With Chemo - section on Mouth Sores - I mention a few tricks that will help you activate your saliva glands.  Your saliva glands become very sluggish from chemo so stimulating them with something acidic such as sour lemon drops is an excellent way of  keeping your saliva flowing.  Drinking an unsweetened juice such as cranberry accomplishes the same thing.  (Caffeinated beverages such as coffee and black/green teas do not count in your daily totals as they are diuretics.)   Following up with a neutralizing mouthwash or a simple baking soda solution is essential to prevent tooth decay.    Drinking water throughout the night for the first five days after your chemo treatment is critical...if you find this task difficult, please imagine letting the drugs sit in your mouth overnight and think about the consequences.
While we're on the subject of how chemo leaves your body, you might also be reminded of some other favorite areas of departure - perspiration, nasal passages and importantly - tear ducts.
It's unfortunate that it takes an announcement of this gravity to highlite the very much overlooked subject of oral health and complication prevention while undergoing chemo.  I have more than a passing knowledge of what oral cancer entails - having once been married to someone who died from complications of the disease.  I'm not suggesting that lemon drops nor cranberry juice will prevent oral cancer but avoiding mouthsores - which are no doubt the start of what could develop into oral cancer - is very possible.

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