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Oral health is an important issue in end-of-life cancer care

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Abstract

Purpose

This study aims to assess the prevalence of oral morbidity in patients receiving palliative care for cancers outside the head and neck region and to investigate if information concerning oral problems was given.

Methods

Patients were recruited from two Norwegian palliative care inpatient units. All patients went through a face-to-face interview, completed the Edmonton Symptom Assessment System (ESAS) covering 10 frequent cancer-related symptoms, and went through an oral examination including a mouth swab to test for Candida carriage.

Results

Ninety-nine of 126 patients (79 %) agreed to participate. The examined patients had a mean age of 64 years (range, 36–90 years) and 47 % were male. Median Karnofsky score was 40 (range, 20–80) and 87 % had metastatic disease. Estimated life expectancy was <3 months in 73 %. Dry mouth was reported by 78 %. The highest mean scores on the modified 0–10 ESAS scale were 4.9 (fatigue), 4.7 (dry mouth), and 4.4 (poor appetite). Clinical oral candidiasis was seen in 34 % (86 % positive cultures). Mouth pain was reported by 67 % and problems with food intake were reported by 56 %. Moderate or rich amounts of dental plaque were seen in 24 %, and mean number of teeth with visible carious lesions was 1.9. One patient was diagnosed with bisphosphonate-related osteonecrosis of the jaw. Overall, 78 % said they had received no information about oral adverse effects of cancer treatment.

Conclusion

Patients in palliative care units need better mouth care. Increased awareness among staff about the presence and severity of oral problems is necessary. Systematic information about oral problems is important in all stages of cancer treatment.

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Acknowledgments

We would like to thank the physicians and nurses at the Cancer Center, OUS and Lovisenberg Hospice for their aid in making this study possible through letting us be a part of their palliative team for the duration of this study. Special thanks go to Dr. Are Normann for his help in evaluating the patients’ health status and eligibility to the study. We also want to thank Prof. Leiv Sandvik for his help with the statistical aspects of this study.

Conflict of interest

There are no financial benefits or conflicts of interest that might bias this work. The corresponding author has full control of all primary data and agrees to allow the journal to review the data if requested.

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Authors and Affiliations

  1. Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo (UiO), P.O. Box 1109, Blindern, 0317, Oslo, Norway

    Petter Wilberg, Stig Ottesen & Bente B. Herlofson

  2. Regional Centre for Excellence in Palliative Care, Oslo University Hospital, Ullevaal, Oslo, Norway

    Marianne J. Hjermstad & Stig Ottesen

  3. European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway

    Marianne J. Hjermstad

  4. Department of Maxillofacial Surgery and Hospital Odontology, Cancer Clinic, Oslo University Hospital, Oslo, Norway

    Bente B. Herlofson

Authors
  1. Petter Wilberg
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  2. Marianne J. Hjermstad
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  3. Stig Ottesen
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  4. Bente B. Herlofson
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Corresponding author

Correspondence to Bente B. Herlofson.

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Wilberg, P., Hjermstad, M.J., Ottesen, S. et al. Oral health is an important issue in end-of-life cancer care. Support Care Cancer 20, 3115–3122 (2012). https://doi.org/10.1007/s00520-012-1441-8

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  • DOI: https://doi.org/10.1007/s00520-012-1441-8

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