A biopsy may be needed to find out the cause of the ONJ. ONJ is not a common condition. It occurs more often in patients who receive bisphosphonates or denosumab by injection than in patients who take them by mouth. Taking bisphosphonates, denosumab, or angiogenesis inhibitors increases the risk of ONJ. The risk of ONJ is much greater when angiogenesis inhibitors and bisphosphonates are used together. Patients with bone metastases may decrease their risk of ONJ by getting screened and treated for dental problems before bisphosphonate or denosumab therapy is started.
- Late Effects Program.
- Long-Term Survivors of Childhood Cancer: The Late Effects of Therapy.
- Children’s Hospital New Orleans Hematology & Oncology.
- Managing Radiation Therapy Side Effects | Cancer Council NSW.
- Explication des ouvrages de peinture et dessins, sculpture, architecture et gravure, des artistes vivans (French Edition).
- Qualifying Exam for Initial Certification.
During treatment for ONJ, you should continue to brush and floss after meals to keep your mouth very clean. It is best to avoid tobacco use while ONJ is healing. You and your doctor can decide whether you should stop using medicines that cause ONJ, based on the effect it would have on your general health. The social problems related to oral complications can be the hardest problems for cancer patients to cope with. Oral complications affect eating and speaking and may make you unable or unwilling to take part in mealtimes or to dine out.
Patients may become frustrated, withdrawn, or depressed, and they may avoid other people. Some drugs that are used to treat depression cannot be used because they can make oral complications worse. See the following PDQ summaries for more information:. Education, supportive care , and the treatment of symptoms are important for patients who have mouth problems that are related to cancer treatment. Patients are watched closely for pain, ability to cope, and response to treatment. Supportive care from health care providers and family can help the patient cope with cancer and its complications.
Children who received high-dose chemotherapy or radiation therapy to the head and neck may not have normal dental growth and development. New teeth may appear late or not at all, and tooth size may be smaller than normal. The head and face may not develop fully. The changes are usually the same on both sides of the head and are not always noticeable. Orthodontic treatment for patients with these dental growth and development side effects is being studied. The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
- General Information About Oral Complications;
- Radiation therapy!
- Late and long-term effects of treatment - Canadian Cancer Society.
- Immortels (Nouvelles) (French Edition).
- Oral Complications and Their Causes.
- The Craft of Information Visualization: Readings and Reflections (Interactive Technologies).
The PDQ summaries are based on an independent review of the medical literature. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care. Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer.
The summaries are reviewed regularly and changes are made when there is new information. The date on each summary "Updated" is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Supportive and Palliative Care Editorial Board. A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another.
Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard. Some clinical trials are open only to patients who have not started treatment. Clinical trials can be found online at NCI's website.
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It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3, scientific images. The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer. More information about contacting us or receiving help with the Cancer. Questions can also be submitted to Cancer. Menu Contact Dictionary Search.
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Late effects of childhood cancer treatment on different areas of the body
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Ending Trials Early. Deciding to Take Part in a Trial. Questions to Ask about Treatment Clinical Trials. Drugs Approved for Different Types of Cancer. Drugs Approved for Conditions Related to Cancer. Access to Experimental Drugs. Key Points Oral complications are common in cancer patients, especially those with head and neck cancer. Preventing and controlling oral complications can help you continue cancer treatment and have a better quality of life.
Patients receiving treatments that affect the head and neck should have their care planned by a team of doctors and specialists. Chemotherapy and radiation therapy slow or stop the growth of new cells. Radiation therapy may directly damage and break down oral tissue, salivary glands , and bone. Chemotherapy and radiation therapy upset the healthy balance of bacteria in the mouth. Oncology nurse. Dental specialists.
Speech therapist. Social worker. Before cancer treatment, the goal is to prepare for cancer treatment by treating existing oral problems. During cancer treatment, the goals are to prevent oral complications and manage problems that occur. After cancer treatment, the goals are to keep teeth and gums healthy and manage any long-term side effects of cancer and its treatment.
Oral mucositis inflamed mucous membranes in the mouth. Salivary gland problems. Change in taste. Key Points Cancer treatment can cause mouth and throat problems. Complications of chemotherapy Complications of radiation therapy Complications caused by either chemotherapy or radiation therapy Oral complications may be caused by the treatment itself directly or by side effects of the treatment indirectly. Complications may be acute short-term or chronic long-lasting.
Inflammation and ulcers of the mucous membranes in the stomach or intestines. Easy bleeding in the mouth. Nerve damage. Fibrosis growth of fibrous tissue in the mucous membrane in the mouth. Tooth decay and gum disease. Breakdown of tissue in the area that receives radiation. Breakdown of bone in the area that receives radiation. Fibrosis of muscle in the area that receives radiation. Inflamed mucous membranes in the mouth. Infections in the mouth or that travel through the bloodstream. These can reach and affect cells all over the body. Taste changes. Dry mouth.
Changes in dental growth and development in children. Malnutrition not getting enough of the nutrients the body needs to be healthy caused by being unable to eat. Dehydration not getting the amount of water the body needs to be healthy caused by being unable to drink. Tooth decay. Problems in the mouth and jaw caused by loss of tissue and bone. Problems in the mouth and jaw caused by the growth of benign tumors in the skin and muscle.
Key Points Finding and treating oral problems before cancer treatment begins can prevent oral complications or make them less severe. Prevention of oral complications includes a healthy diet, good oral care, and dental checkups. Patients receiving high-dose chemotherapy, stem cell transplant, or radiation therapy should have an oral care plan in place before treatment begins. It is important that patients who have head or neck cancer stop smoking.
Eat a well-balanced diet. Healthy eating can help the body stand the stress of cancer treatment, help keep up your energy, fight infection, and rebuild tissue. Keep your mouth and teeth clean. This helps prevent cavities, mouth sores, and infections. Have a complete oral health exam. A preventive oral health exam will check for the following: Mouth sores or infections.
Gum disease. Dentures that do not fit well. Problems moving the jaw. Problems with the salivary glands. Specific needs of the patient. The radiation dose. The part of the body treated. How long the radiation treatment lasts. Specific complications that occur. Everyday oral care for cancer patients includes keeping the mouth clean and being gentle with the tissue lining the mouth. Oral Mucositis Oral mucositis is an inflammation of mucous membranes in the mouth. Care of mucositis during chemotherapy and radiation therapy includes cleaning the mouth and relieving pain.
Pain There can be many causes of oral pain in cancer patients. Oral pain in cancer patients may be caused by the cancer. Oral pain may be a side effect of treatments. Certain anticancer drugs can cause oral pain. Teeth grinding may cause pain in the teeth or jaw muscles. Pain control helps improve the patient's quality of life. Infection Damage to the lining of the mouth and a weakened immune system make it easier for infection to occur.
Infections may be caused by bacteria, a fungus, or a virus. Bleeding Bleeding may occur when anticancer drugs make the blood less able to clot. Most patients can safely brush and floss while blood counts are low. Dry Mouth Dry mouth xerostomia occurs when the salivary glands don't make enough saliva. Salivary glands usually return to normal after chemotherapy ends.
Salivary glands may not recover completely after radiation therapy ends. Careful oral hygiene can help prevent mouth sores, gum disease, and tooth decay caused by dry mouth. Tooth Decay Taste Changes Changes in taste dysguesia are common during chemotherapy and radiation therapy. Fatigue Malnutrition Loss of appetite can lead to malnutrition. Nutrition support may include liquid diets and tube feeding. Mouth and Jaw Stiffness Swallowing Problems Pain during swallowing and being unable to swallow dysphagia are common in cancer patients before, during, and after treatment.
Trouble swallowing increases the risk of other complications. Whether radiation therapy will affect swallowing depends on several factors. Swallowing problems sometimes go away after treatment Swallowing problems are managed by a team of experts. Tissue and Bone Loss.
Brushing teeth Brush teeth and gums with a soft-bristle brush 2 to 3 times a day for 2 to 3 minutes. Be sure to brush the area where the teeth meet the gums and to rinse often. Rinse the toothbrush in hot water every 15 to 30 seconds to soften the bristles, if needed. Use a foam brush only if a soft-bristle brush cannot be used. Brush 2 to 3 times a day and use an antibacterial rinse. Rinse often. Let the toothbrush air-dry between brushings. Use a fluoride toothpaste with a mild taste. Flavoring may irritate the mouth, especially mint flavoring. Rinsing Use a rinse every 2 hours to decrease soreness in the mouth.
An antibacterial rinse may be used 2 to 4 times a day for gum disease. Rinse for 1 to 2 minutes. If dry mouth occurs, rinsing may not be enough to clean the teeth after a meal. Brushing and flossing may be needed. Flossing Floss gently once a day. Lip care Use lip care products, such as cream with lanolin , to prevent drying and cracking.
Denture care Brush and rinse dentures every day. Use a soft-bristle toothbrush or one made for cleaning dentures. Clean with a denture cleaner recommended by your dentist. Keep dentures moist when not being worn. Place them in water or a denture soaking solution recommended by your dentist. Do not use hot water, which can cause the denture to lose its shape. Oral mucositis is an inflammation of mucous membranes in the mouth. It usually appears as red, burn-like sores or as ulcer -like sores in the mouth. Stomatitis is an inflammation of mucous membranes and other tissues in the mouth.
These include the gums, tongue, roof and floor of the mouth, and the inside of the lips and cheeks. Mucositis caused by chemotherapy will heal by itself, usually in 2 to 4 weeks if there is no infection. Mucositis caused by radiation therapy usually lasts 6 to 8 weeks, depending on how long the treatment was. In patients receiving high-dose chemotherapy or chemoradiation for stem cell transplant: Mucositis usually begins 7 to 10 days after treatment begins, and lasts for about 2 weeks after treatment ends.
Bleeding, in patients receiving chemotherapy. Patients receiving radiation therapy usually do not have bleeding. Trouble breathing and eating. Clean your teeth and mouth every 4 hours and at bedtime. Do this more often if the mucositis becomes worse. Use a soft-bristle toothbrush. Replace your toothbrush often. Use lubricating jelly that is water- soluble , to help keep your mouth moist. Use mild rinses or plain water. Frequent rinsing removes pieces of food and bacteria from the mouth, prevents crusting of sores, and moistens and soothes sore gums and the lining of the mouth. If mouth sores begin to crust over, the following rinse may be used: Three percent hydrogen peroxide mixed with an equal amount of water or saltwater.
Try topical medicines for pain. Rinse your mouth before putting the medicine on the gums or lining of the mouth. Wipe mouth and teeth gently with wet gauze dipped in saltwater to remove pieces of food. Painkillers may help when topical medicines do not. Nonsteroidal anti-inflammatory drugs NSAIDS, aspirin -type painkillers should not be used by patients receiving chemotherapy because they increase the risk of bleeding.
Zinc supplements taken during radiation therapy may help treat pain caused by mucositis as well as dermatitis inflammation of the skin.
Treatment of late sequelae after radiotherapy for head and neck cancer.
Povidone- iodine mouthwash that does not contain alcohol may help delay or decrease mucositis caused by radiation therapy. The cancer. Side effects of cancer treatments. Other medical conditions not related to the cancer. A medical history. Physical and dental exams. X-rays of the teeth. The tumor presses on nearby areas as it grows and affects nerves and causes inflammation.
Leukemias and lymphomas , which spread through the body and may affect sensitive areas in the mouth. Multiple myeloma can affect the teeth. Brain tumors may cause headaches. Cancer may spread to the head and neck from other parts of the body and cause oral pain. With some cancers, pain may be felt in parts of the body not near the cancer. This is called referred pain. Tumors of the nose, throat , and lungs can cause referred pain in the mouth or jaw. Physical therapy. TENS transcutaneous electrical nerve stimulation.
Applying cold or heat. See the PDQ summary on Acupuncture. Relaxation therapy or imagery. Cognitive behavioral therapy. Music or drama therapy. Using medicated and peroxide mouth rinses. Brushing and flossing. Wearing dentures as little as possible. Medicines to reduce blood flow and help clots form. Topical products that cover and seal bleeding areas. The mixture should have 2 or 3 times the amount of saltwater than hydrogen peroxide.
This helps clean wounds in the mouth. Rinse carefully so clots are not disturbed. Thick, stringy saliva. Increased thirst. Changes in taste, swallowing, or speech. A sore or burning feeling especially on the tongue. Cuts or cracks in the lips or at the corners of the mouth. Changes in the surface of the tongue. Problems wearing dentures. Clean the mouth and teeth at least 4 times a day. Floss once a day. Brush with a fluoride toothpaste. Apply fluoride gel once a day at bedtime, after cleaning the teeth.
Avoid foods and liquids that have a lot of sugar in them. Sip water often to relieve mouth dryness. Some begin during treatment. Others may occur months or even years later. Your provider may be able to suggest a hospital social worker, patient navigator, psychologist or support group to help ease anxiety related to radiation therapy or breast cancer. Learn more about support groups. Most often, side effects from radiation therapy begin within a few weeks of starting treatment and go away within 2 weeks after treatment ends [ 10 ]. Let your radiation oncologist or nurse know how the sessions are making you feel.
They may be able to treat or prevent many side effects, or change your treatment plan to reduce them. During and just after treatment, your treated breast may be sore. Talk with your health care provider about using mild pain relievers such as ibuprofen, naproxen or acetaminophen to ease breast tenderness. The treated breast may also be rough to the touch, red like a sunburn and swollen. Sometimes the skin may peel, as if sunburned. Your provider may suggest special creams to ease this discomfort. Sometimes the skin peels further and the area may become tender and sensitive called a moist reaction.
This is most common in the skin folds and the underside of the breast. If a moist reaction occurs, let your provider know.
Radiation therapy - Wikipedia
Your provider can give you creams and pads to make the area more comfortable until it heals. Learn more about easing pain related to radiation therapy. Learn about long-term skin changes due to radiation therapy. Learn more about fatigue. You may also have mild tanning of the skin where the breast was treated or red discoloration, especially around the surgical scar s. These changes may be permanent. Women who have radiation therapy to the lymph nodes in the underarm area axillary nodes or who have axillary nodes removed may develop lymphedema.
Lymphedema is a condition in which fluid collects in the arm or other areas such as the hand, fingers, chest or back , causing it to swell. The chances of getting lymphedema are greater if your treatment includes both [ 4,11 ]:. Being overweight also increases the risk of lymphedema [ 4,11 ]. However, you may lose some hair under your arm or on the breast or chest area getting radiation this may be a concern for some men with breast cancer. Although rare with modern treatment, the conditions below may occur a few months or years after radiation therapy.
Rib fracture can occur when the radiation weakens the rib cage near the treatment area. This is rare with modern treatment.
Easing worries about radiation therapy
If radiation therapy is given to the left side of the chest, heart problems may develop years later. Many techniques are now used to limit this risk and with modern radiation therapy, the risk of heart problems is almost always very small [ 12 ]. Radiation pneumonitis is an inflammation of the lungs that can cause shortness of breath, a dry cough and low-grade fever. It's rare with modern treatment and almost always goes away with time. Brachial plexopathy can happen when radiation damages nerves in the upper chest.