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For Breast Cancer

  • Q.

    My sister has stage four breast cancer, which is now gone to her bones and other places. My question is, I would like to see her remaining months happy and would like to see her smile, though with her bad teeth from the chemo her teeth are all broken or dead, she can't afford to get them fixed. Do you know where we could get help for her?

    A.

    I am sorry to hear of the impact chemotherapy had on your sister’s teeth. Dental health is important both during and after cancer treatment, but lack of dental insurance and high out-of-pocket costs can make even a routine dental visit a hardship for individuals already burdened by medical bills. There may be ways to obtain dental procedures or check-ups at a more manageable cost. First, local dental schools often run low-cost or sliding-scale fee clinics for routine dental call or minor procedures; if there is a dental school near your sister, they may be a good first point of contact. The American Dental Association provides an online dental school locator. Second, the Dental Lifeline Network offers an online database of free or reduced cost dental services in each state. Keep in mind that because of limited resources and often high demand, the availability of programs can vary and there may be a waiting list.

    Additionally, the U.S. Health and Human Services Department maintains a list of local health clinics in each state that provide sliding-scale fee health services. While the main focus of these clinics is on primary medical care, some centers have oral health/dental services available. Utilize the online map to locate programs in your sister’s area, and then contact them directly to inquire about dental services.

    Finally, if your sister had a general dentist she’s seen in the past, it may be worthwhile to contact that provider and see if he/she has any recommendations. Offices are sometimes willing to work out a payment plan for more costly services that would potentially allow your sister to get the procedures she needs.

    Additional Resources:

    Connect Education Workshop Podcasts on Dental Hygiene:

For Head and Neck Cancer

  • Q.

    What are the long term permanent side effects in my throat from radiation?

    A.

    Depending on exactly where you receive radiation, a number of side effects can occur either on a temporary, long-term, or delayed basis. They include changes in sensation (the ability to feel), secretions (dry mouth), taste, and range of motion (when tissue hardening restricts movement and posture). These side effects can then affect key physical functions associated with the mouth and throat, such as speech and, especially after radiation, swallowing.

    Whether these side effects turn into a chronic condition (or lead to other problems) often depends on how soon they are recognized and treated. Certain precautions such as addressing dental issues, can be taken before treatment begins to reduce—if not outright prevent—long-term side effects. A publication from the National Cancer Institute, Oral Complications of Chemotherapy and Head/Neck Radiation, provides an overview of possible treatment side effects and how to manage them.

    Other helpful resources include these CancerCare podcasts:

  • Q.

    I underwent a modified radical neck dissection. I lost feeling on the left side of my neck, head, tongue and shoulder. I have no sense of taste and have difficulty swallowing. Will the feeling and sense of taste return?

    A.

    There are a number of changes after treatment similar to what you’ve described, some of which can be permanent. Rehabilitation, however, can ease the side effects of treatment, and there are ways to cope with these effects over the long term.

    Given the complexities of treating head and neck cancer, a team approach which utilizes a variety of different specialists is essential to minimizing the complications and maximizing the chances for recovery. In addition to the treating physicians—an oral or ear, nose and throat surgeon, a medical and/or radiation oncologist, a plastic surgeon, prosthodontist, and a dentist among them—a number of other health care professionals can assist with your recovery. These other team members include dietitians, social workers, nurses, physical therapists, and speech-language therapists.

    Check with your surgeon regarding the loss of feeling on the side of neck. While nerves may have been cut in the area during the node dissection, you should not rule out at least some sensation returning over time. Have your taste and swallowing problems evaluated using tests such as the modified barium swallow (a kind of x-ray) or fiberoptic endoscopy. A speech-language pathologist can provide advice and guide you with therapeutic exercises to improve swallowing ability. There are also medications (both prescription and over the counter) that can help with saliva problems and dietary changes (such as avoiding foods that are made up of small particles) to ensure you continue to obtain sufficient nutrition.

    Consider joining a peer support group at your local medical center or through organizations such as Support for People with Oral and Head and Neck Cancer (SPOHNC) or CancerCare.

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