Oral health-related concerns, behavior, and communication with health care providers of patients with breast cancer: impact of different treatments

Beyond cancer treatment: dermo-aesthetic and other wellness recommendations for breast cancer patients

Breast cancer, a prevalent malignancy among women, has various physical and psychological impacts. This comprehensive review offers an in-depth look at multidisciplinary dermo-aesthetic intervention approaches, emphasizing the balance between oncological therapies and the management of these effects. The information presented spans specialties such as aesthetic medicine, plastic surgery, dermatology, physiotherapy, nutrition, odontology, and gynecology. This review, which serves as a clinical guide, aims to establish a safe protocol for non-medical interventions involving oncologists, physicians, and specialists from various areas in patients with breast cancer focused on improving their quality of life. This work offers personalized and integrative care strategies for the eradication of cancer. However, it is still necessary for patients to consult with their oncologist before undergoing any dermo aesthetic treatment. However, it is still necessary for patients to consult with their oncologist before undergoing any dermo aesthetic treatment.

Knowledge, attitudes, barriers and practices concerning cancer therapy-associated oral mucositis amongst oncology nurses: A mixed methods systematic review

Objectives

To evaluate oncology nurses' knowledge, attitudes, barriers and practices regarding the prevention and management of cancer therapy-associated oral mucositis.

Methods

A systematic review was conducted by ​mixed-methods; searches were conducted in PubMed, EMBASE, Medline, CINAHL, Cochrane Library and Web of Science databases. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed for the systematic review. Searched relevant literature ​published in English between January 2000 and December 2023. The Mixed Methods Appraisal Tool was used to evaluate the quality of the studies.

Results

A total of 15 studies were included: 10 cross-sectional studies, 4 non-randomized controlled trials, and one qualitative study. This review provides an overview of the studies: nurses had limited knowledge of cancer therapy-associated oral mucositis; generally positive attitudes towards oral care; there is a slight difference in oral care practices. The main barriers of nurses' prevention and management of cancer therapy-associated oral mucositis were lack of time, lack of knowledge, and lack of staff.

Conclusions

Our results highlight the importance of training for oncology nurses regarding the management of cancer therapy-associated oral mucositis. It is suggested that oncology nurses should focus on strengthening and continuing education in oral care, adopting evidence-based practice and evaluation systems, implementing institution-specific written standards for oral care protocols, and promoting multidisciplinary team cooperation.

Evaluation of periodontal health in breast cancer patients undergoing tamoxifen or aromatase inhibitors drugs therapy: A cross-sectional study

AIM

To study the dental and periodontal status of women with breast cancer (BCa) having tamoxifen or aromatase inhibitors (AIs) treatment in comparison with control healthy women.

METHODS

Fifty-one women on tamoxifen therapy, 52 women on AIs therapy and 52 systemically healthy controls were included in the study. The total number of teeth, the number of teeth indicated for extraction, the number of decayed teeth, and the duration of medication were recorded. Periodontal status was evaluated with gingival index (GI); plaque index (PI); bleeding on probing (BOP); probing depth (PD) and clinical attachment loss (CAL).

RESULTS

The lowest number of teeth and decayed teeth was found in AIs users (P < .001 and P = .003 respectively). The highest CAL value was seen in AIs users (P = .042) whereas no significant difference was found between the groups in terms of PI, GI, and PD (P = .102, P = .233, and P = .306, respectively). Lower PI was observed in patients using AIs for less than 2 years (P = .048).

CONCLUSIONS

While tamoxifen did not affect the dental and periodontal condition, AIs medication adversely affected the dental and periodontal condition by more tooth loss and higher CAL.

Oral mucosal changes induced by adjuvant endocrine therapies in breast cancer patients: clinical aspects and proposal for management

Adjuvant systemic treatments in breast cancer are indicated to reduce the risk of relapse. Their systemic side effects have been well documented and include menopausal symptoms such as impaired libido and vaginal dryness, increased risk of endometrial cancer, stroke, musculoskeletal symptoms including arthralgia and myalgia, osteopenia and fractures, skin rashes, and hypercholesterolemia. However, few articles have focused on the oral mucosal reactions related to adjuvant endocrine therapies (AETs) which clearly differ from those reported with chemotherapies or other targeted therapies used for breast cancer. AETs primarily expose patient to a higher risk of worsened periodontal health, salivary flow modifications, taste disturbance, and global deterioration of oral health-related quality of life. Although the rate of permanent discontinuation of AETs because of oral mucosal changes remains low, an interdisciplinary approach to evaluate oral health and to optimize oral supportive care appears essential to ensure an appropriate management and limit dose adjustment in treated patients. In this respect and based on our clinical experience, we propose recommendations to allow oncologists, nurses, and attending practitioners to implement appropriate measures rapidly and/or refer patients to dentists.

Phenome-Wide Scan Finds Potential Orofacial Risk Markers for Cancer

Cancer is a disease caused by a process that drives the transformation of normal cells into malignant cells. The late diagnosis of cancer has a negative impact on the health care system due to high treatment cost and decreased chances of favorable prognosis. Here, we aimed to identify orofacial conditions that can serve as potential risk markers for cancers by performing a phenome-wide scan (PheWAS). From a pool of 6,100 individuals, both genetic and epidemiological data of 1,671 individuals were selected: 350 because they were previously diagnosed with cancer and 1,321 to match to those individuals that had cancer, based on age, sex, and ethnicity serving as a comparison group. Results of this study showed that when analyzing the individuals affected by cancer separately, tooth loss/edentulism is associated with SNPs in AXIN2 (rs11867417 p = 0.02 and rs2240308 p = 0.02), and leukoplakia of oral mucosa is associated with both AXIN2 (rs2240308 p = 0.03) and RHEB (rs2374261 p = 0.03). These phenotypes did not show the same trends in patients that were not diagnosed with cancer, allowing for the conclusion that these phenotypes are unique to cases with higher cancer risk.

Associated factors for oral health problems in a sample of Saudi cancer patients

Purpose

Oral health in cancer patients was known to influence the quality of life. However, the knowledge of possible factors associated with oral health in cancer patients is seriously lacking in Saudi Arabia. In this study, we aimed to determine the burden of adverse oral health in cancer patients and identify the associated factors for oral health problems.

Materials and methods

A cross-sectional study design was used to recruit a total of 375 cancer patients who attended oncology outpatient clinics at King Abdulaziz Medical City - Riyadh (KAMC-R) by using a consecutive sampling technique. A self-reporting questionnaire was used to collect the sociodemographic information, clinical symptoms, and lifestyle factors of cancer patients. Furthermore, depression, anxiety, and stress were assessed by using Depression Anxiety and Stress Scale. The authors assessed the oral health complaints based on seven common conditions (bleeding gums, toothache, mouth ulcers, bruxism, xerostomia, problems affecting speech, and satisfactory dietary intake). Unadjusted and adjusted risk ratios (aRR) and 95% CIs for the factors associated with the number of oral complaints experienced were computed using Poisson regression model.

Results

The prevalence of oral health conditions experienced by cancer patients was 86.1% (95% CI: 82.2%-89.5%). Female sex (aRR=1.37, 95% CI: 1.05-1.78), low income (aRR=1.58, 95% CI: 1.23-2.04), smoking (aRR=1.29, 95% CI: 1.02-1.64), anxiety (aRR=1.75, 95% CI: 1.36-2.24), and stress (aRR=1.25, 95% CI: 1.00-1.55) were associated with increased risk of oral health problems in cancer patients (p≤0.05), whereas breast cancer patients experienced reduced risk (aRR=0.72, 95% CI: 0.56-0.93).

Conclusion

Our study highlighted the significant burden of oral health problems in Saudi cancer patients at KAMC-R and identified several key associated factors for oral health to aid healthcare practitioners in improving cancer management practices.