For patients suffering from oral and oropharyngeal cancer, a study published March 17 in Head & Neck shows that a treatment called submandibular gland transfer can assist in preventing radiation-induced xerostomia.
The authors liken the feeling of xerostomia to the after-effects of having surgery and anesthetic -- but the feeling is permanent. While the importance of healthy saliva glands may be an afterthought for some patients when battling cancer, the long-lasting effects create a number of problems for them when they are in remission, according to lead author Jana Rieger, PhD, a speech language pathologist in the Faculty of Rehabilitation Medicine at the University of Alberta.
The study looked at functional outcomes -- speech changes, swallowing habits, and quality of life -- of patients with oral and oropharyngeal cancers as they received two different types of treatments prior to and during radiation.
The first group of patients underwent a submandibular gland transfer, a method pioneered by Hadi Seikaly and Naresh Jha at the University of Alberta in 1999. The transfer involves moving the saliva gland from under the angle of the mandible to under to the chin. Prior to this procedure, the saliva gland was in the line of radiation.
The second group in the study took the oral drug Salagen. Previous studies have shown that if this drug is taken during radiation, it may protect the cells in the salivary glands, Rieger noted.
According to the study findings, both groups had the same results in terms of being able to speak properly, but the group taking Salagen had more difficulty swallowing.
"This group needed to swallow more, and it took a longer time to get food completely out of their mouth and into the esophagus," Rieger said. "Because they had trouble eating, they may become nutritionally compromised."
Rieger found that quality of life for most of these patients had decreased significantly.
"People suffering from xerostomia no longer want to go out to eat and be in social settings," she said. "Consuming water to quench dry mouth means they have difficulty in getting a good night's sleep. Some become depressed and avoid going out."
Based on this study, the authors hope to encourage patients to have the submandibular gland transfer as a preventative treatment for xerostomia prior to radiation for mouth and throat cancers.
