Post-Surgery Rehabilitation for Oral Cancer: Managing Complications and Nutrition

Q: Post-Surgery Rehabilitation for Oral Cancer: Managing Complications and Nutrition

Hello： 1. <br>Accept the reality： Currently, bone necrosis requires hyperbaric oxygen therapy. <br>There is no need to worry about the possibility of recurrence in the future, as excessive concern can create stress for the entire family. <br>2. <br>Nutritional care： Consider a li

Rehabilitation after Oral Cancer Surgery

Dear Dr.
Chen,
My father is fifty-nine years old.
Last July, he underwent surgery for stage II tongue cancer, followed by thirty sessions of radiation therapy a little over a month after the surgery.
Unfortunately, during a PET scan this year, it was unexpectedly discovered that he has osteoradionecrosis in the oral cavity due to the radiation.
He has since started hyperbaric oxygen therapy and underwent a second surgery to debride the necrotic bone.
He is still continuing hyperbaric oxygen therapy to promote wound healing.

I would like to ask you, I have heard that hyperbaric oxygen therapy can potentially reactivate any residual cancer cells.
Is this true? Furthermore, how can we provide nutritional care for my father, who is increasingly having difficulty eating? I came across "photodynamic therapy" online; is this treatment available in our country?

Mr. Lin, 50~59 year old female. Ask Date: 2005/06/01

Dr. Chen Sirong reply Oncology

Hello: 1.
Accept the reality: Currently, bone necrosis requires hyperbaric oxygen therapy.
There is no need to worry about the possibility of recurrence in the future, as excessive concern can create stress for the entire family.
2.
Nutritional care: Consider a liquid diet, high-protein milk powder, nutritional injections, enteral feeding via a nasogastric tube, or even gastrostomy feeding if necessary.
3.
Photodynamic therapy: Since there has been no recurrence, there is no need to treat cancer at this time, and this method is not yet fully developed.
There is no rush to become a test subject; even in the event of recurrence, standard treatments such as surgery and radiation should be attempted first before considering alternative methods.
Sincerely, Dr.
Chen, Oncology.

Reply Date: 2005/06/01

More Info

Post-surgery rehabilitation for oral cancer, particularly after treatments such as surgery and radiation therapy, can be quite complex and requires a multifaceted approach. Your father's situation, involving tongue cancer and subsequent complications like osteoradionecrosis (bone death due to radiation), is not uncommon. The management of such cases involves addressing both the physical rehabilitation and nutritional needs of the patient.

High-Pressure Oxygen Therapy and Cancer Recurrence
Regarding your concern about hyperbaric oxygen therapy (HBOT) potentially reviving residual cancer cells, current evidence does not strongly support this claim. HBOT is primarily used to enhance wound healing and manage conditions like osteoradionecrosis. It works by increasing oxygen supply to the affected tissues, promoting healing and reducing the risk of infection. While there is some theoretical concern about the effects of oxygen on tumor cells, the consensus in the medical community is that the benefits of HBOT in treating radiation-induced complications outweigh the risks. It is crucial to continue following your oncologist's recommendations and monitoring your father's condition closely.

Nutritional Management
As your father is experiencing difficulties with eating, it is essential to focus on his nutritional intake to support healing and overall health. Here are some strategies to consider:
1. Liquid Diet: Transitioning to a liquid diet can help ease the difficulty of swallowing. Nutritional shakes or smoothies can provide essential nutrients and calories.
2. High-Protein Supplements: Incorporating high-protein supplements can help maintain muscle mass and support healing. Products like protein powders or ready-to-drink nutritional shakes can be beneficial.

3. Enteral Feeding: If oral intake is insufficient, consider discussing the possibility of a feeding tube (nasogastric or PEG tube) with your healthcare team. This can ensure that your father receives adequate nutrition without the stress of swallowing.

4. Soft Foods: If he can tolerate some solid foods, focus on soft, easy-to-chew options like mashed potatoes, yogurt, and pureed fruits and vegetables.

5. Hydration: Ensure he stays well-hydrated, as dehydration can complicate recovery.
6. Consult a Dietitian: A registered dietitian specializing in oncology can provide tailored advice and meal plans to meet your father's specific needs.

Photodynamic Therapy
As for photodynamic therapy (PDT), it is a treatment that uses light-sensitive drugs and a light source to destroy cancer cells. While it has shown promise in certain types of cancers, its application in oral cancers is still being researched. The availability of PDT may vary by region and institution, so it would be best to consult with your father's oncologist or a specialist in oral oncology to see if this treatment is appropriate and available in your area.

Conclusion
In summary, managing post-surgery rehabilitation for oral cancer involves a comprehensive approach that includes monitoring and addressing complications like osteoradionecrosis, ensuring adequate nutrition, and exploring available treatment options like photodynamic therapy. It is essential to maintain open communication with your father's healthcare team to navigate these challenges effectively. Your father's recovery journey may be difficult, but with the right support and interventions, it is possible to improve his quality of life and health outcomes.

Similar Q&A

Managing Oral Cancer Recovery: Skin Grafts, Prevention, and Rehabilitation

Hello doctor, my father has just undergone surgery for oral malignancy. I have a few questions: What are the differences between using a skin graft from a donor site versus using his own skin for the oral reconstruction? How can we prevent recurrence? What foods can he eat? After...

Dr. Zeng Guanghui reply Dentistry
Hello Sir: Thank you for your inquiry. I would like to address your question and provide the following suggestions: After the resection of oral malignancies, due to the loss of soft and hard tissues, artificial skin grafts or autologous skin grafts are needed to restore aesthetic...

Managing Nutrition and Diabetes During Stage IV Oral Cancer Chemotherapy

Hello Doctor, my father is 50 years old, does not smoke, drink, or chew betel nut, and does not have dentures, yet he was recently diagnosed with stage IV oral cancer that has spread to the lymph nodes. I searched online and found that chemotherapy requires sufficient nutrition a...

Dr. Chen Yunfang reply Oncology
Hello: For my cancer patients, I do not expect them to maintain perfect blood sugar levels; keeping it below 200 is sufficient. There is no need for strict control, as the cancer itself and the treatment process often lead to decreased appetite. By the end of the treatment, most ...

Post-Surgery Complications of Mandibular Amputation for Malignant Tumors

Complications after amputation surgery due to osteonecrosis caused by chemotherapy and radiation therapy for malignant tumors of the mandible.

Dr. Chen Shunsheng reply Rare Disease
Please consult with the oncology or radiation therapy department.

Understanding Oral Health: Addressing Tongue Issues and Concerns

Hello Dr. Chuang, thank you for patiently answering my questions. Recently, I've been feeling uneasy about my health. I tend to scrutinize even minor physical issues, and with the abundance of information available, I often come across news reports about young people who app...

Dr. Zhuang Suhui reply Dentistry
A-Zhe: Hello, it depends on the progression of the condition. If there is no smoking, alcohol, or betel nut consumption, the risk of developing oral cancer is lower. Additionally, regular exercise can boost immunity and reduce cancer risk. It is recommended to exercise at least 3...