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Holistic Supportive Care in Oral Cancer: Principles and Practice

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Abstract

Life turns turbulent with the onset of cancer. The journey is physically and emotionally draining. From the shock of diagnosis through the ups and downs of treatment, the interminable tests and procedures, the pangs and ambiguity of remission, the recurrence or advancement, the progression of one alarming symptom after another and the unwelcome reality of unresponsiveness to treatment, each demands the utmost in human endurance. Health professionals are often the only sources of trust, clarity and guidance that patients and family have. It is our prerogative to recognise and empathise with the suffering of patients, physical or otherwise, and be effective in our roles.

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Notes

  1. 1.

    This questionnaire consists of 11 items assessing perceived difficulties in mandibular function during social activities, speaking, taking a large bite, chewing hard food, chewing soft food, work and/or daily activities, drinking, laughing, chewing resistant food, yawning and kissing. Besides this, there was assessment of perceived difficulties in mandibular function when eating foods of differing sizes and consistencies, e.g. apple, raw carrot, peanut, meat, large French bread, etc. Scores were 0–4 with increasing grade of difficulty. Total score range was 0–68.

  2. 2.

    Cyclooxygenase.

  3. 3.

    Oral morphine is available in hospitals and centres which have been authorised as “recognised medical institutions” [RMI] by the state drug controller. Please refer to www.palliumindia.org for details.

  4. 4.

    The SR preparations may be costlier. They lose their SR property if broken or powdered and hence not to be used for tube feeding patients.

  5. 5.

    For the whole of India, there are 250 centres with regular availability of oral morphine and over two-thirds of those are situated in the state of Kerala.

  6. 6.

    To know more about how to get the training to use strong opioids and understand the licence procedure to acquire and store morphine at your centre, please visit the website of the national bodies for palliative care www.palliumindia.org or www.palliativecare.in.

  7. 7.

    http://www.doep.org Oral Health in Cancer Therapy: A Guide for Health Care Professionals.

  8. 8.

    K Y Jelly, Oral Balance Gel, Biotene and Gelclair.

  9. 9.

    http://onlinelibrary.wiley.com/doi/10.1002/cncr.28592/full.

  10. 10.

    Miracle mouthwash 1:50 ml 2 % lignocaine solution + 100 ml 1 mEq/L soda bicarbonate + 50 ml of 12.5 mg/5 ml diphenhydramine (or 50 ml of magnesium/aluminium hydroxide – Gelusil) + 500 ml normal saline = total volume 500 ml.

  11. 11.

    Granulocyte macrophage-colony stimulating factor.

  12. 12.

    Candida glabrata, Candida tropicalis, Candida krusei, Candida famata, Candida lusitaniae, Candida guilliermondii, Candida dubliniensis.

  13. 13.

    The Infectious Diseases Society of America for oropharyngeal candidiasis treatment.

  14. 14.

    Catabolic mediators, pro-inflammatory cytokines produced by the tumour or host cells (TNF-α, interleukins 6 and 1 and interferon-ϒ, lipolytic hormones, proteolysis-inducing factor).

  15. 15.

    Percutaneous endoscopic gastrostomy.

  16. 16.

    Selective serotonin reuptake inhibitors.

  17. 17.

    Eastern Cooperative Oncology Group.

  18. 18.

    Selective serotonin reuptake inhibitor.

  19. 19.

    Dr. MR Rajagopal, Director of WHO Collaborating Centre for training and access to pain relief medications, Trivandrum – through personal communication.

  20. 20.

    http://weill.cornell.edu/deans/pdf/hippocratic_oath.pdf.

  21. 21.

    Basic life support/advanced cardiovascular life support.

  22. 22.

    Indian Society of Critical Care Medicine-Indian Association of Palliative Care.

  23. 23.

    http://www.goldstandardsframework.org.uk/.

  24. 24.

    Total parenteral nutrition.

  25. 25.

    Easy to teach to the family caregiver in case of home-based care.

  26. 26.

    NSAID, sustained-release morphine 30 mg twice/day with breakthrough doses for pain with plain morphine 10 mg, pregabalin 150 mg at night, a weaning dose of dexamethasone and prokinetic laxative and proton pump inhibitor prophylactically for side effects of the drugs prescribed.

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Authors and Affiliations

  1. Trivandrum Institute of Palliative Sciences -the WHO Collaborating Centre for Training and Policy on access to Pain Relief, Trivandrum, India

    Nandini Vallath (Consultant, Project Director)

  2. Academic and Strategy Consultant, Indo American Cancer Association, Houston, USA

    Nandini Vallath (Consultant, Project Director)

  3. Department of Palliative Medicine, Tata Memorial Hospital, Mumbai, India

    Naveen Salins (Associate Professor and Consultant)

  4. Editor - Indian Journal of Palliative Medicine, Tata Memorial Hospital, Mumbai, India

    Naveen Salins (Associate Professor and Consultant)

Authors
  1. Nandini Vallath
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  2. Naveen Salins
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Correspondence to Nandini Vallath .

Editor information

Editors and Affiliations

  1. Department of Head and Neck Plastic and Reconstructive Surgery, Roswell Park Cancer Institute, Buffalo, USA

    Moni Abraham Kuriakose

Appendix 5.1

Appendix 5.1

Intake form to facilitate integration of supportive care within the comprehensive care plan

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Vallath, N., Salins, N. (2017). Holistic Supportive Care in Oral Cancer: Principles and Practice. In: Kuriakose, M.A. (eds) Contemporary Oral Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-43857-3_5

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