When I Hear My Mom Needs a Treatment I’ve Never Heard About
I live a long ways from the rest of my family. I grew up in Oakland, Maine, a small town where my parents, brother, and many relatives still live. Puyallup, WA where I live is about as far away as is possible and still be in the continental US. As the only physician in the family, I sometimes try to help other family members by helping them understand the medical issues they and others are facing. If nothing else this helps me feel a little closer to home, trying to be helpful even though I’m so far away. Usually as a family doctor I am ideally trained to easily understand what’s going on, and interpret the sometimes confusion medical jargon and issues. I was surprised recently to get a call about something that I knew nearly nothing about. Thankfully as a family physician I am also experienced in learning quickly about things I may not have prior experience with.
I got a call from my brother, that my Mom was going to start hyperbaric oxygen therapy so she would not “lose her jaw” from necessary dental extractions after radiation therapy to her head and neck for tongue cancer. She had seemingly had great results, with no cancer known to remain. I had never heard of this therapy, so I was skeptical. I was reassured to find this is pretty standard therapy in the circumstances, and was pleased her physicians were being proactive and providing state of the art care.
A complication of radiation therapy of the head and neck can be osteonecrosis of the jaw. This is a condition where the ionizing radiation used to treat cancer of the tongue, throat, mouth, etc. can cause such severe injury to the blood vessels of the bone of the jaw that the bone is at risk to die. This is a big problem for these patients, because they often also have injury to the salivary glands, reducing their saliva production leading to severe tooth decay. They often need to have teeth extracted, and doing this in the face of weakened bone of the mandible can lead to fracture and sometimes non-healing of the jaw. Needless to say, this is a very undesirable outcome.
Treating these patients with 100% oxygen therapy under 2-3 atmospheres of pressure can significantly improve their chances of allowing the radiation injured tissues to heal. This is explained very nicely in an article on the Oral Cancer Foundation’s website called:
Hyperbaric Oxygen and Osteoradionecrosis
My thanks go out for the excellent physicians Mom has, and for the availability of first rate care she is getting.
Great addition to the discussion. Thanks. Ed
The Oral Cancer Foundation is a big proponent of O2 treatments (dives) for patients that have had radiation. I wish that the dental community was more informed about the nature of radiated bone in particular, and the caution which must be exercised when considering anything that they think simple in a normal patient, such an extraction of an unrestorable tooth. Radiated patients can sometimes be restored with dental implants, and though the long-term success rate of osseointegration of the implant is lower in that population, O2 treatments prior to the surgical placement and during the 3 month integration period have been shown to increase implant success.
Obviously nothing new, but a treatment that fills a niche need nicely that I had not stumbled across.
Ed, my father also had cancer, but his was of the tongue. He had a portion of his tongue removed as well as parts of his mouth and neck. He then had radiation therapy of his neck and jaw. He had very compromised blood flow and could not heal his wounds from all of the resections. He went to Harborview for hyperbaric therapy several times and finally healed. This was nearly 15 years ago! Fascinating!!