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Oral health conditions affect functional and social activities of terminally ill cancer patients

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Abstract

Purpose

Oral conditions are established complications in terminally ill cancer patients. Yet despite significant morbidity, the characteristics and impact of oral conditions in these patients are poorly documented. The study objective was to characterize oral conditions in terminally ill cancer patients to determine the presence, severity, and the functional and social impact of these oral conditions.

Methods

This was an observational clinical study including terminally ill cancer patients (2.5–3-week life expectancy). Data were obtained via the Oral Problems Scale (OPS) that measures the presence of subjective xerostomia, orofacial pain, taste change, and the functional/social impact of oral conditions and a demographic questionnaire. A standardized oral examination was used to assess objective salivary hypofunction, fungal infection, mucosal erythema, and ulceration. Regression analysis and t test investigated the associations between measures.

Results

Of 104 participants, most were ≥50 years of age, female, and high-school educated; 45 % were African American, 43 % Caucasian, and 37 % married. Oral conditions frequencies were: salivary hypofunction (98 %), mucosal erythema (50 %), ulceration (20 %), fungal infection (36 %), and other oral problems (46 %). Xerostomia, taste change, and orofacial pain all had significant functional impact; p < .001, p = .042 and p < .001, respectively. Orofacial pain also had a significant social impact (p < .001). Patients with oral ulcerations had significantly more orofacial pain with a social impact than patients without ulcers (p = .003). Erythema was significantly associated with fungal infection and with mucosal ulceration (p < .001).

Conclusions

Oral conditions significantly affect functional and social activities in terminally ill cancer patients. Identification and management of oral conditions in these patients should therefore be an important clinical consideration.

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Acknowledgments

The authors thank Jan Durham from Horizon Hospice & Palliative Care and Hope Engeseth and Julie Vecchio from University of Illinois at Chicago for subject referral and data collection. We also thank Nicola Solomon, Ph.D. from the City of Hope National Medical Center for assistance in writing and editing the manuscript. We are grateful to the leadership and staff of Horizon Hospice & Palliative Care and Rainbow Horizon Hospice and Palliative Care for their support of this research and to patients who participated. This publication was made possible by grant number P30 NR010680 (DJW) from the National Institutes of Health, National Institute of Nursing Research (NINR). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NINR.

Conflict of interest

The authors do not have a financial relationship with the National Institutes of Health, National Institute of Nursing Research, the organization that sponsored the research. DW serves as a grant reviewer for NIH and DF now works at NIH, National Institute of Dental and Craniofacial Research (NIDCR), but this employment started after the data were collected. We have full control of all primary data and agree that the journal can have access to review our data if requested.

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Authors and Affiliations

  1. Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA

    D. J. Fischer

  2. Samual Oschin Comprehensive Cancer Institute, Cedars-Sinai Health System, Los Angeles, CA, USA

    J. B. Epstein

  3. Division of Otolaryngology and Head and Neck Surgery, City of Hope National Medical Center, Duarte, CA, USA

    J. B. Epstein

  4. Department of Biobehavioral Health Science and Center of Excellence for End-of-Life Transition Research, College of Nursing, University of Illinois at Chicago, 845 S Damen Ave (MC802), Chicago, IL, 60612, USA

    Y Yao & D. J. Wilkie

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  1. D. J. Fischer
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  2. J. B. Epstein
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  3. Y Yao
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  4. D. J. Wilkie
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Correspondence to D. J. Wilkie.

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Fischer, D.J., Epstein, J.B., Yao, Y. et al. Oral health conditions affect functional and social activities of terminally ill cancer patients. Support Care Cancer 22, 803–810 (2014). https://doi.org/10.1007/s00520-013-2037-7

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  • DOI: https://doi.org/10.1007/s00520-013-2037-7

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