Cancer and your mouth

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It's tempting to begin this blog with some kind of pun about putting some teeth into cancer, but as someone who has had issues with gum disease and root canals, I find nothing funny about the challenges our teeth can present. And when we are dealing with cancer, those challenges can get complicated, which is why it amazes me that so little is said about dental issues and people with cancer. I guess it's because when you are diagnosed, your teeth and mouth and gums seem way down on the list, but let me tell you, a case of oral mucositis will get you thinking about your mouth really fast. If you have ever had a canker sore in your mouth, imagine a whole mouth of those, that's what mucositis feels like, and it's one of the side effects of some cancer treatments. Cancer brings up a number of other issues with your teeth and mouth. In fact, the National Institute of Dental and Craniofacial Research says one-third of people treated for cancer develop complications that affect the mouth, and many of the these problems may interfere with cancer treatment and diminish a patient's quality of life. Last winter we did a story on Dennis Abbott DDS, a specialist in dental oncology, and the response has been amazing. Dr. Abbott is now a national consultant to the ACS and is working with another of our favorite interviewees, Sam LaMonte MD, to create new standards of care and guidelines for post-treatment cancer survivors. Dr. LaMonte, a retired head and neck surgeon who is a survivor of head and neck cancer, was the focus of the story I wrote in 2010 on late effects of radiation. Despite being an expert on head and neck cancer, Dr. LaMonte, who had extensive head and neck radiation, spent thousands trying to keep his teeth to no avail. After the story we did on Dr. Abbott, he had patients and healthcare professionals reachout to him from around the country, including one patient who comes from Utah for treatment. We also did our first facebook chat with Dr. Abbott and had one patient contact us from Australia. I just got a note from Dr. Abbott that he has added a pre-therapy link with basic recommendations for cancer patients to his website. So, if you are preparing for treatment or in treatment, check out these suggestions under patient services.

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For patients with cancer, the ongoing chemotherapy shortage may cause some anxiety as they wonder how they will receive their drugs. However, measuring drugs “down to the minutiae of the milligrams” helped patients receive the drugs they needed, said Alison Tray. Tray is an advanced oncology certified nurse practitioner and current vice president of ambulatory operations at Rutgers Cancer Institute in New Jersey.  If patients are concerned about getting their cancer drugs, Tray noted that having “an open conversation” between patients and providers is key.  “As a provider and a nurse myself, having that conversation, that reassurance and sharing the information is a two-way conversation,” she said. “So just knowing that we're taking care of you, we're going to make sure that you receive the care that you need is the key takeaway.” In June 2023, many patients were unable to receive certain chemotherapy drugs, such as carboplatin and cisplatin because of an ongoing shortage. By October 2023, experts saw an improvement, although the “ongoing crisis” remained.  READ MORE: Patients With Lung Cancer Face Unmet Needs During Drug Shortages “We’re really proud of the work that we could do and achieve that through a critical drug shortage,” Tray said. “None of our patients missed a dose of chemotherapy and we were able to provide that for them.” Tray sat down with CURE® during the 49th Annual Oncology Nursing Society Annual Congress to discuss the ongoing chemo shortage and how patients and care teams approached these challenges. Transcript: Particularly at Hartford HealthCare, when we established this infrastructure, our goal was to make sure that every patient would get the treatment that they need and require, utilizing the data that we have from ASCO guidelines to ensure that we're getting the optimal high-quality standard of care in a timely fashion that we didn't have to delay therapies. So, we were able to do that by going down to the minutiae of the milligrams on hand, particularly when we had a lot of critical drug shortages. So it was really creating that process to really ensure that every patient would get the treatment that they needed. For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.
Yuliya P.L Linhares, MD, an expert on CLL
Yuliya P.L Linhares, MD, and Josie Montegaard, MSN, AGPCNP-BC, experts on CLL
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