Care of Head and Neck Cancer Patients for Dental Hygienists and Dental Therapists

Cover
Title Page
Copyright Page
Contents
List of Contributors
Foreword
Preface
Section 1 Primary Setting
Chapter 1 The Early Detection of Mouth Cancer: An Initiative for the Whole Dental Team
Counselling
Carrying Out the Examination
Some Areas of Palpation
Chapter 2 Detection and Prevention of Skin Cancer for Dental Hygienists
The Role of Hygienists in the Early Recognition and Management of Skin Cancers
Skin Anatomy and Physiology
What are Skin Cancers?
Common Benign Skin Lesions
The Diagnosis of a Skin Cancer
How to Manage a Suspected Skin Cancer at a Hygienist Appointment
Prevention of Skin Cancer and Promotion of Skin Health
Conclusion
References
Chapter 3 Lip Cancer
Signs and Symptoms
Prevention
References
Chapter 4 Smoking and Vaping
Smoking
Supporting Patients Who Wish to Give Up Smoking
The Changing Landscape of Tobacco Use
Electronic Cigarettes
Types of E-Cigarettes
Cariogenic Potential
Respiratory Damage
References
Chapter 5 The Impact of Substance Dependence on Oral Health
Introduction: Dependency, Substances, and Prevalence
Oral Health: Risk Factors and Complications of Substance Use
Dental Professionals: Support for Patients Who Use Substances
References
Chapter 6 Human Papillomavirus as a Risk Factor for Oropharyngeal Squamous Cell Carcinoma
HPV in Head and Neck Cancer
Risk Factors for HPV-Positive OPSCC
Gender
Sexual Behaviours
Smoking
Alcohol Use
HPV-Positive OPSCC
Implications for Treatment
The Role of Vaccination
References
Further Reading and Resources
Chapter 7 Pathologists: The Cornerstone of Head and Neck Cancer Diagnosis and Treatment
Introduction
The Initial Diagnosis
Journey of a Cancer Biopsy
Tissue Processing
Examination and Diagnosis
Potentially Malignant Lesions
Multidisciplinary Team Meeting
Cancer Resection Specimen
Primary Tumour
Lymph Nodes
The Pathology Report
Postoperative Care
Digital Pathology and Artificial Intelligence
References
Chapter 8 Mental Health and Well-Being Pretreatment
Reference
Further Reading and Resources
Chapter 9 Flowchart
Section 2 Specialists, Roles, and Departments
Chapter 10 The Multidisciplinary Team
The Team
References
Chapter 11 History of Oral and Maxillofacial Surgery
OMFS and the Multidisciplinary Team
The Cancer Patient’s Journey: Clinical History and Examination, Imaging, and Biopsy
The MDT Discussion
Head and Neck Surgery: Removal of the Cancer
Head and Neck Surgery: Reconstruction of the Defect
Patient Recovery
Adjuvant Treatment for Cancer
Cancer Patient Follow-Up
Chapter 12 Head and Neck Cancer: Clinical Nurse Specialist Role
References
Chapter 13 The Role of the Dietitian in the Care of Head and Neck Cancer Patients
What Is a Dietitian?
What Is the Role of a Head and Neck Oncology Dietitian?
Dietetic Review Pathway For Individuals With Head And Neck Cancer
Barriers to Implementing Dietetic Advice
Should Patients Be Eating Sugar?
Feeding Routes
Nasogastric Tubes
Tracheoesophageal Tubes
Gastrostomy Tube
Jejunal Tube
Ways Enteral Nutrition Can be Given
Home Enteral Feeding Team
Tube Removals
Parenteral Nutrition
References
Chapter 14 Speech and Language Therapy
Patient Pathway
Communication
Assessment
Treatment
Swallowing
Assessment
Management
Trismus
Altered Airways
Dietitians
Training
References
Chapter 15 The Role of the Restorative Dentist in the Management of Head and Neck Cancer Patients
Introduction
Problems Related to Rehabilitation of Head and Neck Cancer Patients
Restoring Function
The Head and Neck Cancer Multidisciplinary Meeting and the Contribution Made by the Restorative Dentistry Consultant
The Workings of the Head and Neck Cancer MDM
Interventions Provided by the Restorative Dentist for Head and Neck Cancer Patients
Supporting Patients’ Psychological Well-Being
Long-Term Prevention and Maintenance
Ongoing Cancer Surveillance
References
Chapter 16 The Role of the Dental Nurse in an Oral and Maxillofacial Unit
Section 3 Types of Head and Neck Cancer Treatment
Chapter 17 Chemotherapy: An Overview
What Is Chemotherapy?
How Does It Work?
Neoadjuvant Chemotherapy
Concurrent Chemotherapy
Adjuvant Chemotherapy
Palliative Chemotherapy
Types of Chemotherapy in Head and Neck Cancer
Common Side Effects of Chemotherapy
How Is Chemotherapy Administered?
Considerations When Treating Patients Undergoing/Having Had Chemotherapy
Considerations for Patients during Treatment
Summary
References
Chapter 18 Radiotherapy in Head and Neck Cancer
Radiotherapy
Radiotherapy Techniques
IMRT
Head and Neck Cancers
Pre-RT Preparation and Planning
Dental Assessment
Nutrition
SLT Assessment
Immobilisation Device
RT Planning
Toxicities
Acute Effects
Late Toxicities
Follow-Up
References
Chapter 19 The Role of Immunotherapy in Head and Neck Cancer Management
Background
How Do Immune Checkpoint Inhibitors Work?
When Is Immunotherapy Used in HNSCC?
Benefits in HNSCC
How Is Immunotherapy Administered?
Side Effects of Immunotherapy
Management of Immunotherapy-Related Adverse Events
Future Use of Immunotherapy in HNSCC
References
Chapter 20 Proton Therapy in the UK
Introduction
The Evolution of Precision Radiotherapy
Why Protons?
The Cost of PT
Clinical Trials of PT
Current Indications for PT
Challenges for PT in the UK
Conclusion
References
Chapter 21 Transoral Robotic Surgery
Introduction
Robotic Surgical System
Patient-Side Cart
Surgeon’s Console
Vision Cart
TORS Surgical Setup
The Clinical Indications and Contraindications
Which Patients are Suitable for TORS?
What Characteristics of a Tumour Make It Amenable to TORS?
The TORS Procedure
Postoperative Care and Complications
Outcomes of TORS
Surgical Margins and Cancer Outcomes
Functional Outcomes
Training for TORS and Challenges
Conclusion
Acknowledgement
References
Chapter 22 Photobiomodulation Therapy for Management of Oral Complications Induced by Head and Neck Cancer Treatments
Introduction
Photobiomodulation
What Is Photobiomodulation and Does It Work (Mechanism of Action)?
How Do Photons Interact with Biological Tissue (Laser–Tissue Interaction)?
Essential Laser Terminology
What are PBM Effects on Clinical Outcomes?
What are the Oral and Dental Complications Induced by CT and RT in Patients with HNC?
What Is the Role of PBM Therapy in Management of Complications?
Oral Mucositis
Hyposalivation (Reduction in Saliva) or Xerostomia (Dry Mouth)
Radiation Dental Caries
Periodontal Diseases
Dysphagia (Difficulty in Swallowing)
Dysgeusia (Alteration in Taste)
Candida (Fungal Infection)
Medication-Related Osteonecrosis of the Jaws
Trismus
Safety and Cautions for Consideration
How Can DHTs Contribute in Management of RT- or CT-Induced Oral Complications?
Where Can You Learn More About Laser Therapy?
Academic Training Courses
Journals and Textbooks
Scientific Associations
Summary and Future Directions
References
Chapter 23 The Hologram, a New Imaging Modality in Head and Neck Cancer
Chapter 24 Laryngectomy Care: What Is Required?
A Voice Prosthesis and Stoma Care
Baseplates and HMEs
Equipment
Protection
Summary
References
Chapter 25 Mental Health and Well-Being during Treatment
Reference
Section 4 Head and Neck Cancer Treatment Complications
Chapter 26 Chemotherapy and Risk Assessment in Dental Treatment Planning
General Side Effects
References
Chapter 27 Xerostomia, from the Greek (Xero = Dry, Stoma = Mouth) = Dry Mouth
Saliva and Its Role in Oral Health
Comparison of Stimulated and Unstimulated Saliva Flow in Healthy and Xerostomic Individuals
Assessment
Treatment
Oral Health Care for HNC Patients with Xerostomia
Patient Education
Home Self-Care
Toothbrushing
Toothpaste
Interdental Cleaning
Tongue Cleaning
Use of Disclosing Agents
Prosthesis Care
After Use Care
Use of Adjuncts
Food and Drink
Dry Mouth Relief
Alternative Therapies
Summary
References
Further Reading
Chapter 28 The Role of Acupuncture in Radiotherapy-Induced Xerostomia
Background
Patient Assessment
Treatment
Needle Position
Reference
Chapter 29 Oral Ulceration, Viral Infection, and Candidosis
Oral Ulceration
Recurrent Herpes Simplex Infection
Pseudomembranous Candidosis (Thrush)
Chronic Erythematous Candidosis
Angular Cheilitis
Further Reading
Chapter 30 Halitosis
Introduction
Halitosis
Epidemiology
Aetiopathogenesis and Classification
Origin
Diagnosis
Extraoral Causes
Management of Oral Causes and the Dental Professional’s Role
Lifestyle
Physiological Halitosis
Patient-BasedOutcomes
Gingivitis and Periodontitis Disease
Oral Hygiene Aids
Tongue Biofilm
Toothpaste
Mouthwash
Oral Malodour Counteractives
Emerging Treatments
COVID-19 and Halitosis
Summary
References
Chapter 31 Oral Mucositis
Introduction
OM Risk Factors
OM Assessment and Diagnosis
Definition of Oral Mucositis by Grading Scale
Prevention and Management
Oral Health and Hygiene
Pain Management
Nutrition
Healing
Additional Prevention and Management Options
References
Chapter 32 Nausea and Tooth Erosion
Pathophysiology
Treatment for Nausea
Dental Erosion
Dental Management
References
Chapter 33 Osteoradionecrosis
Symptoms
Grading
Management of ORN
Prior to Radiotherapy
During and After Radiotherapy
Treatment and Management of ORN
Surgery
Hyperbaric Oxygen Therapy
References
Chapter 34 Mucus Secretions and Hypersalivation
Mucus Secretions
Management of Thickened Mucus
Hypersalivation
Management of Sialorrhea
References
Chapter 35 Mouth Care and Quality of Life for Patients Living with Head and Neck Cancer
Considerations for the Dental Professional Before Treatment Begins
During and Beyond Treatment Complications
Practicalities of Treating Head and Neck Cancer Patients
Holistic Care and Ongoing Financial Burden for the Patient Long Term
References
Chapter 36 Obturators
Defects Without Obturation
Developmental Defects
Head and Neck Cancer
Mouth Care for Patients with Obturators
Quality of Life (QoL)
Summary
References
Chapter 37 Physiotherapy for Head and Neck Cancer Patients: An Overview
Chapter 38 Radiotherapy: The Treatment That Keeps on Giving!
What Is a Late Effect?
Radiotherapy Late Effects
How Can We Help?
References
Chapter 39 Management of Intraoral Hair Growth After Flap Reconstruction
Postoperative Intraoral Hair Removal
Lasers
Electrolysis
Cutting
Plucking
Summary
References
Chapter 40 Lifestyle Factors in Oral Cancer
Sleep
Possible Reasons for Poor Sleep
What Will Help?
Exercise
Components of an Exercise Programme
When Should Cancer Patients Start an Exercise Programme?
Diet
Vicious vs Virtuous Cycles: Sleep, Eat, Rave Repeat vs Sleep, Eat, Train Repeat?
References
Chapter 41 Pain Management for Head and Neck Cancer Patients
Introduction
Pain Management in Oral Cancer
Analgesic Preparations
Paracetamol
Nonsteroidal Anti-Inflammatory Drugs
Opiates and Opioids
Adjuvant Medications
Topical Analgesics
Nonmedical Pain Management
References
Section 5 Further Considerations, Patient Experiences and Support
Chapter 42 Mental Health and Well-Being Post-treatment
References
Further Reading and Resources
Chapter 43 Intimacy: Advice for the Patient from a Psychologist
Chapter 44 What Is Palliative Care?
What Symptoms are Seen with Head and Neck Cancers?
What are the Effects of HNC Treatment?
Common Post-treatment Symptoms
Communicating with People Who Have Experienced HNC
References
Chapter 45 My Cancer, My Journey
Chapter 46 Life 2.0: How My Life Has Changed Since My Cancer Diagnosis
Life 1.0
Life 2.0
References
Chapter 47 Steve’s Story
Chapter 48 Living with the Legacy
Chapter 49 Look Good Feel Better
Appendix A Head and Neck Cancer Charities UK
Index
EULA