The core function of a multidisciplinary team (MDT) is to bring together a group of healthcare professionals from different fields in order to determine patients' treatment plan. Most of head and neck cancer (HNC) units are currently led by MDTs that at least include ENT and maxillofacial surgeons, radiation and medical oncologists. HNC often compromise relevant structures of the upper aerodigestive tract involving functions such as speech, swallowing and breathing, among others. The impairment of these functions can significantly impact patients' quality of life and psychosocial status, and highlights the crucial role of specialized nurses, dietitians, psycho-oncologists, social workers, and onco-geriatricians, among others. Hence, these professionals should be integrated in HNC MDTs. In addition, involving translational research teams should also be considered, as it will help reducing the existing gap between basic research and the daily clinical practice. The aim of this comprehensive review is to assess the role of the different supportive disciplines integrated in an MDT and how they help providing a better care to HNC patients during diagnosis, treatment and follow up.

/pdf/the-multidisciplinary-team-mdt-approach-and-quality-of-care-3d8d31c741.pdf

The Multidisciplinary Team (MDT) Approach and Quality of Care.

With cancer survival rate climbing up over the past three decades, quality of life for cancer patients has become an issue of major concern. Oral health plays an important part in one's overall quality of life. However, oral health status can be severely hampered by side effects of cancer therapies including surgery, chemotherapy, radiotherapy, and hematopoietic stem cell transplantation. Moreover, prevention and treatment of these complications are often overlooked in clinical practice. The present paper aims at drawing health care professionals' attention to oral complications associated with cancer therapy by giving a comprehensive review. Brief comments on contemporary cancer therapies will be given first, followed by detailed description of oral complications associated with cancer therapy. Finally, a summary of preventive strategies and treatment options for common oral complications including oral mucositis, oral infections, xerostomia, and dysgeusia will be given.

/pdf/oral-complications-and-management-strategies-for-patients-1byag59wm3.pdf

Oral Complications and Management Strategies for Patients Undergoing Cancer Therapy

Good oral health is of major importance for general health and well-being. Several innovative drug delivery systems have been developed for the local treatment and prevention of various diseases in the oral cavity. However, there are currently few optimal systems and many therapeutic challenges still remain, including low drug efficacy and retention at targeted site of action. The present review provides an insight into the latest drug delivery strategies for the local treatment and prevention of the four most common oral pathologies, namely, dental caries, periodontitis, oral mucosal infections and oral cancer. The potential of bioadhesive formulations, nanoparticulate platforms, multifunctional systems and photodynamic methodologies to improve therapy and prophylaxis in future local applications for the oral cavity will be discussed.

https://www.future-science.com/doi/pdf/10.4155/tde.15.5

Advanced drug delivery systems for local treatment of the oral cavity

Pacientes com câncer em cabeca e pescoco tem de lidar com o impacto de seu tratamento sobre aspectos funcionais e esteticos e seu autorrelato permite aprimorar medidas de suporte clinico e social. OBJETIVO: Avaliar a qualidade de vida de pacientes em tratamento de carcinoma de celulas escamosas em cabeca e pescoco. METODO: Estudo analitico prospectivo. Vinte e nove pacientes com idade media de 57 anos responderam em tres momentos: inicio, metade e final do tratamento, aos questionarios: Quality of Life Core Questionnaire - Cancer 30 e ao Quality of Life Questionnaire - Head and Neck, European Organization for the Research and Treatment of Cancer. Foi realizado teste de Friedman, significância: 0,05. RESULTADO: Houve altas medias para as funcoes fisica, cognitiva, social; melhora no estado de saude geral e declinio da funcao social ao longo do tratamento e diferenca significativa para gosto e cheiro (p = 0,020), degluticao (p = 0,040), tosse (p = 0,013), e perda de peso (p = 0,011). CONCLUSAO: Houve reducao significativa da qualidade de vida em relacao a alguns sintomas comuns decorrentes do tratamento do câncer, que nao ocorreu na avaliacao das dimensoes relacionadas as funcoes fisica, cognitiva, social e ao estado geral de saude.

/pdf/quality-of-life-of-patients-with-head-and-neck-cancer-3rsy60rjf6.pdf

Quality of life of patients with head and neck cancer

Introduction: Antineoplastic chemotherapy remains one of the most widely used management strategies in cancer, either alone or in combination with other types of treatment. The main inconvenience of chemotherapy is its lack of selectivity, since it acts upon both tumor cells and rapidly multiplying normal cells such as bone marrow cells, hair follicle cells and oral and gastrointestinal mucosal cells. Material and method: An exhaustive search was made of the main oral toxic effects of chemotherapy in the PubMed-Medline, Cochrane Library and Scopus databases. A total of 1293 articles were identified, of which 333 met the study inclusion criteria. Results: The toxic effects of chemotherapy at oral mucosal level comprise mucositis, osteonecrosis of the jaws secondary to bisphosphonate use, susceptibility to infections, dental alterations, salivary and neurological disorders, dysgeusia and bleeding tendency. These complications have a negative impact upon patient quality of life, and in some cases can prove life-threatening. Conclusions: Evaluation of patient oral and dental health is essential before administering chemotherapy, in order to minimize the risk of oral and systemic complications of such treatment. 

Key words:Chemotherapy, oral complications, dental, saliva and osteonecrosis jaw.

/pdf/oral-toxicity-produced-by-chemotherapy-a-systematic-review-2t15maa1t4.pdf

Oral toxicity produced by chemotherapy: A systematic review.

Oral Diseases (2011) 17, 550–559



While treatment for cancer in terms of chemotherapy and radiation therapy have evolved significantly since their inception, both of these cancer treatment modalities, especially if used in combination (e.g., as with head and neck cancers), have a very real potential to result in painful and debilitating adverse effects that clearly decrease quality of life and, potentially, increase mortality due to cancer. Herein, we discuss the prevalence and etiology of three broad categories of oral complications found during the treatment of cancer patients: mucositis, dysgeusia, and infectious disease. Lastly, we present therapeutic options that may be helpful in ameliorating these uncomfortable and, sometimes, life-threatening oral complications.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1601-0825.2011.01788.x

Oral complications in the treatment of cancer patients.

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Oral complications in the treatment of cancer patients.