Patients with solid cancers, such as carcinoma of the breast, prostate, lung, stomach, pancreas, hepatic carcinoma, intestinal, ovarian and gynecological cancer and other carcinomas, and different sarcomas, who receive chemotherapy, may develop oral complications. Biological targeted therapies and immunotherapies may be related to oral complications, too.
Patients, who receive bone antiresorptive medications, to prevent skeletal-related events and bone pain may develop problems of the jaws.
Our aim is to inform patients to recognize any possible problem in the mouth, related to therapy and to seek early medical help. This will result in early diagnosis and effective management of the problem.
Oral mucositis: It presents with pain and ulcerations. In patients who have low white blood cell counts, oral mucositis may significantly increase the risk of systemic infection.
Oral infections: Candidiasis and herpes are the most often infections. Dental and periodontal abscesses, mostly related to teeth that were not treated before chemotherapy, are the most common bacterial infections.
Taste disturbances and xerostomia: The patient has difficulties in food intake and drinking and cannot have a good night sleep, while feeling tired and unhappy.
Biological, targeted therapies
Stomatitis, with pain, ulcers, gingival bleeding, taste alterations, xerostomia, burning sensation, painful tongue and dental pain, has been described in patients, who receive inhibitors of angiogenesis or other targeted therapies.
Stomatitis, which presents as aphthous-like ulcers, is characteristic for the inhibitors of the mammalian target of rapamycin (mTOR).
In patients, who receive inhibitors of the BRAF, white plaques have been described on the oral mucosa.
Clinical conditions which resemble Sjogren-like syndrome, lichen planus and xerostomia have been described in case reports in patients who receive immunohterapies.
Inhibitors of bone resorption-antiresorptives
The use of bone antiresorptive medications to prevent skeletal-related events, in cancer patients with bone metastasis or osteoporosis, is a significant contribution in Oncology.
A new complication, the osteonecrosis of the jaw bones was, however, described in relation to those drugs. Several biological, targeted therapies, mainly inhibitors of angiogenesis have also been related to the development of osteonecrosis of the jaw. In rare cases osteonecrosis of the jaw was reported in relation to chemotherapy and immunotherapy.
Good oral hygiene, keeping the oral mucosa moist and clean, will reduce the severity of oral complications.