https://www.healthnews.com.tw/blog/article/17751

Head and neck cancer talks about "electricity"

頭頸癌談「電」色變口乾症副作用最擾人

大都會接受藥物治療和搭配使用口乾舒緩噴劑，以及補充營養品，來減少副作用，若沒有積極治療，往往會疼痛難耐、嚴重口乾、免疫力下降甚至體重減輕。

Most of these patients will receive medication and a combination of dry mouth soothing sprays and supplements to reduce side effects. If not actively treated, they will often suffer from pain, severe dry mouth, decreased immunity and even weight loss.

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Cancer treatment often has many side effects. For example, head and neck cancer (including oral cancer) often has dry mouth when performing electrotherapy (radiation therapy), and even oral mucositis caused by oral ulcers, which is greatly reduced due to the large amount of saliva secretion. Cancer patients cause tooth decay and periodontal disease, which in turn affects the chewing function of the patient and nutrient intake; therefore, how to care for oral health is a matter of great concern for cancer patients.

Why is there a dry mouth disease when treating head and neck cancer?Zheng Shirong, director of the Oral Surgery Ward Hospital of National Taiwan University Hospital, said that head and neck cancer and oral cancer patients will have dry mouth, mainly because the surgery will remove some of the salivary glands, and some patients after surgery should receive the side effects caused by electrotherapy and chemotherapy. In addition, chemotherapy drug stimulation and electrotherapy damage further cause mucosal inflammation and tissue ulceration. Because saliva (saliva) can increase the resistance, once there is no saliva, the immunity will decrease, and the mouth will change from alkaline to acidic, as if the teeth are soaked in hydrochloric acid, it is easy to cause tooth decay due to decalcification and antibacterial activity. Periodontal disease.

Therefore, Director Zheng Shirong believes that to avoid stem and mouth disease in patients with head and neck cancer and oral cancer, on the one hand, relying on the advancement of medical technology, on the other hand, relying on effective treatment. He pointed out that if the wounds removed during surgery are healed faster, the electrotherapy is more precise, the protection is done well, and the side effects of chemotherapy are less, the oral mucosa can be broken and the chance of dry mouth can be reduced to about seven. Eighty percent, even hair loss, nausea and vomiting can not be alleviated.

However, what should I do if the head and neck cancer patient and the oral cancer patient have had dry mouth? Zheng Shirong said that in an outpatient clinic, about 70 to 80 patients with head and neck cancer and oral cancer, if after surgery and electrotherapy and chemotherapy, about 90% will have dry mouth problems, and even combined with oral broken skin and swallowing pain. Most of these patients will receive medication and a combination of dry mouth soothing sprays and supplements to reduce side effects. If not actively treated, they will often suffer from pain, severe dry mouth, decreased immunity and even weight loss.

Because of the relief of dry mouth, it often takes a long time to work. Therefore, in addition to the use of dry mouth medicine, Zheng Shirong also recommends the use of dry mouth soothing toothpaste and dry mouth soothing spray. The preferred characteristics of dry mouth soothing sprays include products based on natural hot springs, slightly alkaline with high oxygen content, and minerals that stimulate saliva secretion and bactericidal function, and are more suitable for long-term use.

Director Zheng Shirong also pointed out that in addition to the above-mentioned dry mouth medicine and dry mouth soothing toothpaste and spray for treating dry mouth; in addition, it can be combined with nutritional supplements and vitamins B, C and anesthetic water to repair oral epithelial cells and reduce pain as soon as possible. . Also, you should pay attention to your diet. You should eat soft and liquid foods. You should not eat spicy food. You should exercise and massage the parotid glands to stimulate the secretion of saliva. These are mainly symptomatic treatments, which take about three months. Symptoms adjust the time of use.

癌症治療常會有很多副作用，例如頭頸癌（包括口腔癌）在進行電療（放射治療）時，往往會有口乾症，甚至會出現口腔潰瘍所造成的口腔黏膜炎，因唾液分泌大量減少極易使癌友導致蛀牙及牙周病，進而影響病友的咀嚼功能，以及營養攝取；因此，如何照護好口腔健康，是癌友們在做治療時極需注意的事項。

為何頭頸癌治療時會出現口乾症？台大醫院口腔顎面外科病房主任鄭世榮表示，頭頸癌與口腔癌病人會出現口乾症，主要在於手術會切除部份唾液腺，及手術後部份病友須接受電療與化療所造成的副作用。除此之外，化療藥物刺激及電療傷害更進一步造成黏膜發炎及組織潰瘍。由於唾液（口水）可以增加抵抗力，一旦沒有口水，免疫力會下降，而且口腔會由鹼性變為酸性，就好像將牙齒泡在鹽酸之中，容易因脫鈣及抗菌力降低造成蛀牙與牙周病。

所以，鄭世榮主任認為，要避免頭頸癌與口腔癌病人出現口乾症，一方面要仰賴醫療技術的進步，另一方面則仰賴有效緩解的治療。他指出，如果手術時切除的傷口癒合快，電療做的更精準，防護做得好，化療的副作用少，就可以使口腔黏膜破皮的情形減少，並可減少口乾症機率大約達七至八成，甚至掉髮、噁心與嘔吐與吃不下的情形都可以減輕。

然而，若是頭頸癌病人與口腔癌病人已發生口乾症時該怎麼辦？鄭世榮說，一個門診中，大約70~80位頭頸癌與口腔癌病人，若經過手術及電療化療後，約有9成會出現口乾症問題，甚至合併有口腔破皮及吞嚥疼痛。這些病友大都會接受藥物治療和搭配使用口乾舒緩噴劑，以及補充營養品，來減少副作用，若沒有積極治療，往往會疼痛難耐、嚴重口乾、免疫力下降甚至體重減輕。

因口乾的緩解，常常是需要長時間的努力，所以除口乾藥物之使用外，鄭世榮也會建議口乾舒緩牙膏、口乾舒緩噴劑的使用。而口乾舒緩噴劑的優先選擇特點，包括以天然溫泉為基底、微鹼性具高含氧量，且具礦物質可刺激唾液分泌與殺菌功能的產品，更適合長時期的使用。

鄭世榮主任並指出，除上述口乾藥物及口乾舒緩牙膏及噴劑治療口乾症外；另外，可搭配營養補充品和維生素B、C及麻醉藥水，以儘速修復口腔上皮細胞並減少疼痛。而且飲食上也須注意，得攝取軟質與流質的食物，不可吃辛辣，並應運動及按摩耳前腮腺，使刺激唾液分泌；而這些主要為症狀治療，大約需進行三個月，並依症狀調整使用時間。