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Health advisor facilitated mouth care regime for patients with head and neck cancers undergoing intensity-modulated radiotherapy

Published online by Cambridge University Press:  30 July 2015

J. Stringer ,
R. Knowles ,
C. Finchett ,
P. Mackereth ,
J. Mannan  and
N. Slevin
J. Stringer
Affiliation:
The Christie NHS Foundation Trust, Withington, Manchester, UK
R. Knowles*
Affiliation:
The Christie NHS Foundation Trust, Withington, Manchester, UK
C. Finchett
Affiliation:
The Christie NHS Foundation Trust, Withington, Manchester, UK
P. Mackereth
Affiliation:
The Christie NHS Foundation Trust, Withington, Manchester, UK
J. Mannan
Affiliation:
The Christie NHS Foundation Trust, Withington, Manchester, UK
N. Slevin
Affiliation:
The Christie NHS Foundation Trust, Withington, Manchester, UK
*
Correspondence to: Rebecca Knowles, Complementary Therapy Department, The Christie NHS Foundation Trust, 550 Wilmslow Road, Withington, Manchester, Greater Manchester M20 4BX, UK. Tel: 0161 918 7027. Fax: 0161 446 3940. E-mail: rebecca.knowles@christie.nhs.uk
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Abstract

Aim

To develop a regime of care for patients with head and neck cancers undergoing intensity-modulated radiotherapy (IMRT), with the support of a health advisor (HA) and temporary access to the mouth care product Caphosol™.

Materials and methods

A HA was temporarily employed to assess, monitor and refer patients as appropriate and ensure patients received and utilised supplies of Caphosol™. A retrospective audit was undertaken to provide a gap analysis of current service. The data were used to develop a pro forma for documenting assessments and monitoring lifestyle factors for IMRT patients. Assessments referrals and compliance, plus hospital admissions owing to treatment-related issues, were documented during the baseline audit and the temporary HA service and provision of Caphosol™.

Results

The presence of a HA facilitated 100% compliance with appropriate assessments, referrals and adherence to treatment. The data suggests that the additional provision of Caphosol™ may have reduced levels of mucositis and associated pain.

Conclusion

It is recommended that a HA role be established within radiotherapy departments to facilitate lifestyle assessments, referrals and compliance with positive behaviour changes (e.g., stopping smoking). The use of Caphosol™ as a routine part of mouth care regime for IMRT patients also warrants further investigation.

Keywords

head and neckintensity-modulated radiotherapymouth carenasaloral
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 14 , Issue 4 , December 2015 , pp. 353 - 361
Copyright
© Cambridge University Press 2015 

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References

1.Lee, N, Puri, D R, Blanco, A I, Chao, K S. Intensity‐modulated radiation therapy in head and neck cancers: an update. Head Neck 2007; 29 (4): 387–400.CrossRefGoogle ScholarPubMed
2.McCaul, L K. Oral and dental management for head and neck cancer patients treated by chemotherapy and radiotherapy. Dent Update 2012; 39 (2): 135–138.CrossRefGoogle ScholarPubMed
3.National Institute for Clinical Excellence. Guidance on cancer services: improving outcomes in head and neck cancers–the manual. 2004. http://www.nice.org.uk/guidance/csghn/evidence/improving-outcomes-in-head-and-neck-cancers-the-manual2. Accessed on 10th December 2014.Google Scholar
4.Miyamoto, C T, Wobb, J, Micaily, B, Li, S, Achary, M P. A retrospective match controlled study of supersaturated calcium phosphate oral rinse vs. supportive care for radiation induced oral mucositis. J Cancer Ther 2012; 3 (5): 630–636.CrossRefGoogle Scholar
5.Quinn, B. Efficacy of a supersaturated calcium phosphate oral rinse for the prevention and treatment of oral mucositis in patients receiving high‐dose cancer therapy: a review of current data. Eur J Cancer Care 2013; 22 (5): 564–579.CrossRefGoogle ScholarPubMed
6.UK Oral Mucositis in Cancer Group. Mouth care guidance and support in cancer and palliative care, UKOMiC. 2012. http://www.ukomic.co.uk/pdf/UK_OM_Guidelines_v3.pdf. Accessed on18th November 2014.Google Scholar
7.Rosenthal, D I, Trotti, A. Strategies for managing radiation-induced mucositis in head and neck cancer. Semin Radiat Oncol 2009; 19 (1): 29–34.CrossRefGoogle ScholarPubMed
8.Tromp, D M, Brouha, X D R, De Leeuw, J R J, Hordijk, G J, Winnubst, J A M. Psychological factors and patient delays in patients with head and neck cancer. Eur J Cancer 2004; 40 (10): 1509–1516.CrossRefGoogle ScholarPubMed
9.Sharp, L, Johansson, H, Fagerstom, K, Rutqvist, L E. Smoking cessation among patients with head and neck cancer: cancer as a ‘teachable moment’. Eur J Cancer Care 2008; 17: 114–119.CrossRefGoogle ScholarPubMed
10.Haman, K L. Psychologic distress and head and neck cancer: part 1—review of the literature. J Support Oncol 2008; 6 (4): 155–163.Google ScholarPubMed
11.Duffy, S A, Ronis, D L, Valenstein, Met al. A tailored smoking, alcohol and depression intervention for head and neck cancer patients. Cancer Epidemiol Biomarkers Prev 2006; 15 (11): 2203–2208.CrossRefGoogle ScholarPubMed
12.Hashibe, M, Brennan, P, Chuang, Set al. Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidemiol Biomarkers Prev 2009; 18 (2): 541–550.CrossRefGoogle ScholarPubMed
13.Gillison, M L, Zhang, Q, Jordan, Ret al. Tobacco smoking and increased risk of death and progression for patients with p16-positive and p16-negative oropharyngeal cancer. J Clin Oncol 2012; 30 (17): 2102–2111.CrossRefGoogle ScholarPubMed
14.Hoff, C M, Grau, C, Overgaard, J. Effect of smoking on oxygen delivery and outcome in patients treated with radiotherapy for head and neck squamous cell carcinoma – a prospective study. Radiother Oncol 2012; 103 (1): 38–44.CrossRefGoogle ScholarPubMed
15.Snaith, R P. The hospital anxiety and depression scale. Health Qual Life Outcomes 2003; 1 (1): 29.CrossRefGoogle ScholarPubMed
16.Bush, K, Kivlahan, D R, McDonell, M B, Fihn, S D, Bradley, K A. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Arch Intern Med 1998; 158 (16): 1789–1795.CrossRefGoogle ScholarPubMed
17.McGuire, D B, Fulton, J S, Park, Jet al. Systematic review of basic oral care for the management of oral mucositis in cancer patients. Support Care Cancer 2013; 21 (11): 3165–3177.CrossRefGoogle ScholarPubMed