Chemotherapy-associated oral sequelae in patients with cancers outside the head and neck region

J Pain Symptom Manage. 2014 Dec;48(6):1060-9. doi: 10.1016/j.jpainsymman.2014.02.009. Epub 2014 Apr 18.

Abstract

Context: Chemotherapy induces a wide array of acute and late oral adverse effects that makes symptom alleviation and information important parts of patient care.

Objectives: To assess the prevalence and intensity of acute oral problems in outpatients receiving chemotherapy for cancers outside the head and neck region and to investigate if information about possible oral adverse effects was received by the patients.

Methods: In this cross-sectional study, outpatients aged 18 years or older were invited to participate and included if they fulfilled the inclusion criteria. All patients completed the Edmonton Symptom Assessment System, participated in a semistructured interview, and underwent an oral examination by a dentist.

Results: Of 226 eligible patients, 155 (69%) participated. Mean age was 57 years, and 34% were males. The most prevalent diagnoses were breast (45%) and gastrointestinal cancers (37%). Xerostomia was reported by 59%, taste changes by 62%, oral discomfort by 41%, and 27% had problems eating. Fatigue (3.4) and xerostomia (3.1) received the highest intensity scores on the Edmonton Symptom Assessment System. Oral candidiasis confirmed by positive cultures was seen in 10%. Twenty-seven percent confirmed that they had received information on oral adverse effects of cancer treatment.

Conclusion: Oral sequelae were frequently reported, and health care providers should be attentive to the presence and severity of these problems. Less than one-third of the patients remembered having received information about oral sequelae associated with chemotherapy. A continuous focus on how to diagnose, manage, and inform about oral cancer-related complications is advisable.

Keywords: Neoplasms; drug therapy; health literacy; mucositis; oral health; xerostomia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Cross-Sectional Studies
  • Female
  • Humans
  • Interviews as Topic
  • Karnofsky Performance Status
  • Male
  • Middle Aged
  • Mouth Diseases / chemically induced*
  • Mouth Diseases / epidemiology*
  • Multivariate Analysis
  • Neoplasms / drug therapy*
  • Neoplasms / epidemiology*
  • Norway / epidemiology
  • Prevalence
  • Surveys and Questionnaires

Substances

  • Antineoplastic Agents