Introduction

“India is witnessing a disturbing rise in oral cancer cases, with males who chew tobacco and Betel nuts being disproportionately affected. These individuals often downplay the risks, unaware of the devastating consequences that await them. With a nonchalant attitude, they continue their habits, oblivious to the fact that oral cancer treatment will drastically alter the trajectory of their lives. The harsh reality is that treatment involves a gruelling regimen of surgery, radiotherapy, and chemotherapy, and even after completion, there’s a risk of relapse or recurrence. Moreover, the side effects of radiotherapy, which we’ll explore in this blog, can persist for a lifetime, impacting daily life in profound ways. If only they could glimpse the future, they’d realise that their seemingly harmless habits hold the power to forever change their existence.”

 

The Importance of Pre-Radiotherapy Evaluation

Given the significant risks and the often harsh realities of oral cancer treatment, including radiotherapy, it becomes paramount for patients to proactively engage in every step of the process to mitigate potential complications. One of the most crucial, yet often overlooked, stages is the pre-radiotherapy evaluation. This proactive approach can significantly influence the patient’s experience and long-term well-being by minimizing the likelihood and severity of side effects.

Despite receiving information from their healthcare providers, a significant number of oral cancer patients do not prioritize pre-radiotherapy evaluation. This critical step, however, has the potential to reduce side effects by as much as 80%. Close collaboration with an oral physician during this phase can substantially lower the risk of complications and lead to improved overall treatment outcomes.

 

Acute Side Effects of Radiotherapy

Patients undergoing radiotherapy may experience several acute side effects, including:

• Oral Mucositis: Inflammation and the formation of ulcers on the mucous membranes lining the mouth.
• Dry Mouth (Xerostomia): A reduction in saliva production resulting from the impact of radiation on the salivary glands.
• Radiation Caries: Tooth decay that develops due to decreased saliva, which is essential for neutralizing acids in the mouth.
• Osteoradionecrosis: Damage to the jawbone and adjacent arteries, leading to compromised blood supply and subsequent bone necrosis.
• Difficulty Swallowing (Dysphagia): trouble swallowing food, liquids, or medications due to radiation’s impact on the throat and esophagus, potentially leading to nutritional deficiencies and discomfort

 

Long-Term Side Effects of Radiotherapy

In addition to acute effects, patients may also encounter long-term side effects of radiotherapy:

• Trismus: Limited ability to open the mouth due to the development of fibrosis and scar tissue.
• Chronic Dry Mouth: Persistent xerostomia, which elevates the risk of ongoing tooth decay and other oral health problems.
• Radiation-Related Caries: Continued tooth decay stemming from the long-term reduction in saliva production and changes in the oral environment.
• Osteoporosis: An increased susceptibility to bone fractures and the development of osteoporosis in the jaw and surrounding areas.
• Changes in Taste and Smell: Altered sensory perception that can affect nutrition and overall quality of life.

 

The Need for Lifelong Care

For individuals who have undergone radiotherapy for oral cancer, managing chronic side effects becomes a lifelong endeavor. The emotional impact of living with these effects can be considerable, influencing daily routines, interpersonal relationships, and overall well-being. Consistent follow-up appointments with their oral physician, diligent adherence to preventive care measures, and access to emotional support are vital in navigating this new reality. Recognizing the long-term implications of radiotherapy empowers patients to better cope with the challenges ahead and actively work towards maintaining their oral health and quality of life.