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Most people are familiar with the more common side effects of radiation and chemotherapy, two treatments used to fight cancer: hair loss, fatigue, and changes in the skin, to name just a few.
But for head, neck and throat cancer patients, there’s often another side effect: damage to the salivary gland, and consequently, the teeth. KSMU’s Jennifer Moore reports on a Springfield program that provides dental care to cancer patients who can’t otherwise afford it.
Diana Race says she had a mild sore throat on and off for a couple of months. It was March of 2008—Spring was just around the corner—so she waived it off as sinus problems or allergies. It was easy to ignore, she said.
“Then, when the gland on the left side began to swell, I thought I had an infection,” she recalls.
She had neither health nor dental insurance. After putting it off for as long as she could, she finally went to see a doctor. On March 25 of that year, she was told her earth-shattering news.
“I was diagnosed with stage four throat cancer. The tumor was on the left tonsil, went through the base of the tongue, and metastasized to the lymph gland on the left side,” she said.
From there, it was a whirlwind: treatment was to begin in two weeks at the Hulston Cancer Center, part of CoxHealth. She would take part in clinical trials for the chemotherapy, and radiation was scheduled for five days a week. She learned how the inside of her mouth would experience burns, and how her hair might start coming out in tufts on her pillow.
On top of it all, she learned she was at high risk for dental problems, since patients with head, and neck cancer receive radiation concentrated in the oral cavity area. She was told she needed a full dental evaluation with panorama x-rays of her mouth before she could begin treatment.
“It was important to make sure there were no infections or cavities that could complicate or postpone treatment,” she said.The only problem was, she didn’t have the money for the dental evaluation. It just so happened, however, that the Hulston Cancer Center had just received a grant from the Ozarks Health Advocacy Foundation for $3,000 that would cover it.
[Sound: elevator beep, elevator doors opening at Hulston Cancer Center]
“That grant was specifically to be used for cancer patients that were diagnosed with head and neck cancers,” said Karen Hahn, a nurse coordinator for lung, head and neck cancer programs at the Hulston Cancer Center.
She said the first grant in 2008 helped Diana Race and at least a dozen others receive dental care they needed before they could begin treatment.
Some had x-rays and evaluations; others needed cleanings, fillings, or complete extractions.
[Sound: papers of book rustling]
In her office, she flips through an illustrated medical book to show me how the mouth is affected by radiation and chemo.
“So, this would be a picture of the areas of oral cancer…and it’s usually like the lip, or tongue, tonsil, larynx, parotid gland, those kinds of things,” Hahn said.
Hahn says when radiation hits the salivary gland—that’s the gland that provides saliva to the mouth—the gland is almost always affected.
“Saliva has a normal cleansing effect on the mouth. So if a patient has cavities or problems already, then when they don’t have the saliva, they can really have tooth decay happen very quickly,” she said.
That’s why it’s critical, she says, for those patients to be looked at by a dentist before they ever start treatment.
Diana Race went through her grueling treatment, and survived her cancer. Today, she’s doing well. But she carries her water bottle everywhere now, including to this interview, because of the damage to her salivary gland. She says the dental care program made a big difference in her life.
“I’m grateful that I had the opportunity under difficult circumstances to experience the kindness of other organizations or individuals that were involved in an effective and successful treatment for cancer,” Race says.
The Hulston Cancer Center has just re-applied for and received an additional grant for $4,000 dollars, which will continue to go toward dental care for cancer patients who are unable to afford it.
For KSMU News, I’m Jennifer Moore.
