Easing the Side Effects of Oral Cancer Treatment

Your daily life can be affected when you are receiving treatment for oral cancer. Before treatment starts, your health care team will explain the possible side effects. Here is a list of some along with tips on how to alleviate them.

Mouth Dryness

Radiation to your head or neck can cause changes in your saliva and in the amount you produce. Because saliva protects your teeth, tooth decay can be a problem after treatment.

Dry mouth can make it difficult for you to eat, talk, and swallow.

To moisten your mouth, do the following:

• Drink plenty of water.¹

• Suck ice chips or sugar-free hard candy.¹

• Use a saliva substitute.¹

Recent research shows that the drug amifostine can help reduce this side effect by limiting radiation damage to salivary glands.²

Tooth Decay

Radiation can cause major tooth decay problems. Good oral care can help you keep your teeth and gums healthy.¹

• Gently brush your teeth, gums, and tongue with an extra-soft toothbrush and fluoride toothpaste after every meal and before bed. If brushing hurts, you can soften the bristles in warm water.

• Use fluoride gel before, during, and after radiation treatment.

• Rinse your mouth several times a day with a solution made from 1/4 teaspoon baking soda and 1/8 teaspoon salt in one cup of warm water. After you rinse with this solution, follow with a plain water rinse.

Sore Throat or Mouth

Radiation can cause painful ulcers and inflammation.^1,2 Your doctor may suggest pain relievers and special rinses to numb the throat and mouth to help relieve the soreness.

Sore or Bleeding Gums

It is important to brush and floss teeth gently.¹ You may want to avoid areas that are sore or bleeding. To protect your gums from damage, avoid using toothpicks.

Infection

Dry mouth and damage to the lining of the mouth from radiation therapy can cause an infection to develop.¹ It helps to examine your mouth daily for sores or other changes and to tell your doctor about any problems.

Delayed Healing After Dental Care

Radiation treatment may make it hard for tissues in the mouth to heal.¹ It helps to have a thorough dental exam and complete all needed dental treatment well before radiation therapy begins.

Jaw Stiffness

Radiation can affect the chewing muscles and make it difficult for you to open your mouth.¹ Prevent or reduce jaw stiffness by exercising your jaw muscles. Health care providers often suggest opening and closing the mouth as far as possible (without causing pain) 20 times in a row, three times a day.

Denture Problems

Radiation therapy can change the tissues in your mouth so that dentures do not fit anymore.¹ Because of soreness and dry mouth, some people may not be able to wear dentures for as long as one year after radiation therapy. After the tissues heal completely and your mouth is no longer sore, your dentist may need to refit or replace your dentures.

Changes in Voice Quality

Your voice may be weak at the end of the day.¹ It also may be affected by changes in the weather. Radiation directed at the neck may cause your larynx to swell, causing voice changes and the feeling of a lump in your throat. Your doctor may suggest medicine to reduce this swelling.

Thyroid Changes

Radiation treatment can affect your thyroid.¹ If your thyroid does not make enough thyroid hormone, you may feel tired, gain weight, feel cold, and have dry skin and hair. Your doctor can check the level of thyroid hormone with a blood test. If the level is low, you may need to take thyroid hormone pills.

Skin Changes

Radiation treatment can cause dry or red skin in the area being treated.¹

• Protect your skin from sun exposure by wearing sunscreen of at least 15 SPF.

• Avoid using any lotion, soap, deodorant, sun block, cologne, cosmetics, or powder on your skin within 2 hours after treatment because they may cause irritation.

• Wear loose, soft clothing over the treated area.

• Don’t scratch, rub, or scrub treated skin. After washing, gently blot dry.

• Do not bandage skin with tape. If you must bandage it, use paper tape, and ask your nurse to help you place the dressings so that you can avoid irritation.

• Bathe only with lukewarm water.

• Avoid shaving.

¹ “Side Effects of Cancer Treatment.” National Cancer Institute. National Institutes of Health, September 8, 2004. www.cancer.gov/cancertopics/wyntk/oral/page10 Accessed 2010.

² “Coping With the Side Effects and Complications of Treatment.” American Cancer Society, September 24, 2009. our.cancer.org/docroot/CRI/content/CRI_2_4_4X_Summary_of_Side_Effects_and_Complications_of_Treatment_60.asp?sitearea= Accessed 2010.