Oral health care for patients undergoing therapy for head and neck cancer in KwaZulu-Natal, South Africa - A qualitative study
DOI:
https://doi.org/10.17159/2519-0105/2020/v75no7a1Keywords:
oral therapy, head cancer, neck cancer, cancer therapyAbstract
BACKGROUND: There is limited published evidence in KwaZulu-Natal on access to oral health care for patients undergoing cancer therapy in the head and neck region. OBJECTIVES: This study aimed to assess patients' oral health-related perceptions, practices and needs during cancer therapy. METHODS: This was a descriptive case study. A semi-structured face-to-face interview was conducted with volunteers (n=12) undergoing cancer therapy in head and neck region. Purposive sampling was used to select study participants who were recruited from a public tertiary central referral hospital in KwaZulu-Natal. A semi-structured interview was also conducted with the eThekwini district coordinator for oral health services to gain better insight into oral health service delivery for patients with special needs. RESULTS: The results indicated that oral health care in the sample population was not prioritised. Some of the emergent themes included: participants' knowledge and oral health self-care practices, support for participants to cope with head and neck cancer, barriers in accessing facility-based oral health care (poor access to dental services, failure of the local clinic to provide appropriate care), lack of referral by oncology care practitioners for patients to access dental care, and existing gaps in oral health service delivery The reported non-existence of a specific oral health policy to address cancer and the absence of a risk factor intervention program highlighted some of the shortcomings for quality oral health service delivery in this population group. CONCLUSION: The results indicated that oral health care is important for patients undergoing cancer therapy. There is an urgent need for oral health planning in the province to take into account the specific oral health needs of this vulnerable population.
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Adeola H, Afrogheh A, Hille J. The burden of head and neck cancer in Africa: the status quo and research prospects. South African Dent J. 2018; 73(8): 3-5, https://doi.org/10.17159/2519-0105/2018/v73no8a1.
Warnakulasuriya S. Global epidemiology of oral and oropha-ryngeal cancer. Oral Oncol. 2009; 45(4-5) 309-16, https://doi.org/10.1016/j.oraloncology.2008.06.002.
Globocan Cancer Today - World Glob. Cancer Obs. 2019.
Farmer P, Frenk J, Knaul FM, et al. Expansion of cancer care and control in countries of low and middle income: A call to action. Lancet. 2010; 376(9747): 1186-93. https://doi. org/10.1016/S0140-6736(10)61152-X.
Joshi P, Dutta S, Chaturvedi P, Nair S. Head and Neck Cancers in Developing Countries. Rambam Maimonides Med J. 2014; 5((2):e0009): 1-6. https://doi.org/10.5041/RMMJ.10143.
World Health Organization. Pathology and Genetics of Head and Neck Tumours. 2005.
Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008; 371: 1695-709, https://doi.org/10.1016/S0140-6736(08)60728-X.
Chen YJ, Chang JTC, Liao CT, et al. Head and neck cancer in the betel quid chewing area: Recent advances in molecular carcinogenesis. Cancer Sci. 2008; 99(8): 1507-14, https://doi.org/10.1111/j.1349-7006.2008.00863.x.
Ouyang Y-H. Skin Cancer of the Head and Neck. Semin Plast Surg. 2010; 24(2): 117-26, https://doi.org/10.1055/s-0030-1255329.
Romesser PB, Riaz N, Ho AL, Wong RJ, Lee NY. Cancer of the Head and Neck. 2012; 1037-70, https://doi.org/}10.1016/B978-1-4557-2865-7.00068-0.
Erovic BM, Goldstein DP, Kim D, et al. Sebaceous gland carcinoma of the head and neck: The Princess Margaret Hospital experience. Head Neck. 2013; 35(3): 316-20, https://doi.org/10.1002/hed.22964.
Rettig EM, D'Souza G. Epidemiology of Head and Neck Cancer. Surg Oncol. Clin N Am. 2015; 24(3): 379-96, https://doi.org/10.1016/j.soc.2015.03.001.
Stewart B, Kleihues P. Human cancers by organ site World Cancer Rep. 2003; 232.
Korir A, Okerosi N, Ronoh V, Mutuma G, Parkin M. Incidence of cancer in Nairobi, Kenya (2004-2008). Int J Cancer. 2015; 137: 2053-59, https://doi.org/10.1002/ijc.29674.
Glick M, Johnson MW. Oral and oropharyngeal cancer: What are the next steps? J Am Dent Assoc. 2011; 142(8): 892-94, https://doi.org/10.14219/jada.archive.2011.0280.
Sekee TR, Burt FJ, Goedhals D, Goedhals J, Munsamy Y, & Seedat RY. Human Papillomavirus in Head and Neck Squamous Cell Carcinomas in a South African Cohort. Papillomavirus Res. 2018; 6: 58-62, https://doi.org/10.1016/j.pvr.2018.10.006.
Hille J, Johnson NW. The burden of oral cancer in sub-Saharan Africa. Transl Res Oral Oncol. 2017; 2: 1-13. https://doi.org/10.1177/2057178x17721094.
Ayo-Yusuf O, Lalloo R, Johnson N. Trends and ethnic disparities in oral and oro-pharyngeal cancers in South Africa (1992-2001). South African Dent J. 2013; 68(4): 168-73.
Jawad H, Hodson NA, Nixon PJ. A review of dental treatment of head and neck cancer patients, before, during and after radiotherapy: part 1. Br Dent J. 2015; 218(2): 65-8, https://doi.org/10.1038/sj.bdj.2015.28.
Lawrence M, Aleid W, McKechnie A. Access to dental services for head and neck cancer patients. Br J Oral Maxillofac Surg. 2013; 51(5): 404-7, https://doi.org/10.1016/j.bjoms.2012.10.004.
Matsuzaki H, Tanaka-Matsuzaki K, Miyazaki F, et al. The role of dentistry other than oral care in patients undergoing radiotherapy for head and neck cancer. Jpn Dent Sci Rev. 2017; 53(2): 46-52, https://doi.org/10.1016/j.jdsr.2016.09.003.
Schultz C, Goffi-Gomez MVS, Liberman PHP, Pellizzon AC de A, Carvalho AL. Hearing Loss and Complaint in Patients With Head and Neck Cancer Treated With Radiotherapy Arch Otolaryngol Head Neck Surg. 2010; 136(11): 1065-9, https://doi.org/10.1001/archoto.2010.180.
Frydrych A, Slack-Smith L, Park J, Smith A. Expertise Regarding Dental Management of Oral Cancer Patients Receiving Radiation Therapy Among Western Australian Dentists. Open Dent J. 2012; 6: 197-207, https://doi.org/10.2174/1874210601206010197.
McCaul L. Oral and dental management for head and neck cancer patients treated by chemotherapy and radiotherapy Dent Updat. 2012; 39(2): 135-8,140.
Mawardi H., Al-Mohaya M., Treister N. Oral health considerations in cancer survivors Saudi Med J. 2013; 34(5): 461-9.
Hartnett E. Integrating oral health throughout cancer care. Clin J Oncol Nurs. 2015; 19(5): 615-9, https://doi.org/10.1188/15.CJON.615-619.
Bertl K, Loidl S, Kotowski U, et al. Oral health status and dental care behaviours of head and neck cancer patients: a cross-sectional study in an Austrian tertiary hospital. Clin Oral Investig. 2016; 20(6): 1317-27, https://doi.org/10.1007/s00784-015-1618-x.
Mainali A, Sumanth K, Ongole R, Denny C. Dental consultation in patients planned for/undergoing/post radiation therapy for head and neck cancers: A questionnaire-based survey. Indian J Dent Res. 2011. https://doi.org/10.4103/0970-9290.93454.
Murphy BA, Deng J. Advances in Supportive Care for Late Effects of Head and Neck Cancer. J Clin Oncol. 2015; 33(29):3314-21. https://doi.org/10.1200/JCO.2015.61.3836.
Turato ER. Qualitative and quantitative methods in health: Definitions, differences and research subjects. Rev Saude Publica. 2005; 39(3): 507-14, https://doi.org/10.1590/s0034-89102005000300025.
Guest G, Bunce A, Johnson L. How Many Interviews Are Enough?: An Experiment with Data Saturation and Variability Field methods. 2006; 18(1): 59-82, https://doi.org/10.1177/1525822X05279903.
Braun V, Clarke V. Using thematic analysis in psychology Qual Res Psychol. 2006; 3:2: 77-101, https://doi.org/http://dx.doi.org/10.1191/1478088706qp063oa.
Saunders B, Sim J, Kingstone T, et al. Saturation in qualitative research: exploring its conceptualization and operationalization Qual Quant. 2017; 1893-907, https://doi.org/10.1007/s11135-017-0574-8.
Cognetti DM, Weber RS, Lai SY. Head and Neck Cancer: An Evolving Treatment Paradigm Cancer. 2008; 113(70): 1911-32, https://doi.org/10.1002/cncr.23654.
Tulunay-Ugur OE, McClinton C, Young Z, et al. Functional Outcomes of Chemoradiation in Patients with Head and Neck Cancer. Otolaryngol Neck Surg. 2013; 148(1): 64-8, https://doi.org/10.1177/0194599812459325.
Varelas X, Kukuruzinska MA. Head and neck cancer: From research to therapy and cure. Ann NY Acad Sci. 2014; 1333: 1-32. https://doi.org/10.1111/nyas.12613.
Pateman KA, Ford PJ, Batstone MD, Farah CS. Coping with an altered mouth and perceived supportive care needs following head and neck cancer treatment. Support Care Cancer 2015; 23(8): 2365-73, https://doi.org/10.1007/s00520-015-2607-y.
Sheiham A. Oral health, general health and quality of life. Bull World Health Organ. 2005; 83(9): 644.
Bueno AC, Ferreira RC, Cota LOM, et al. Comparison of different criteria for periodontitis case definition in head and neck cancer individuals. Support Care Cancer. 2015; 23(9): 2599 -604, https://doi.org/10.1007/s00520-015-2618-8.
Samim F, Epstein JB, Zumsteg ZS, Ho AS, Barasch A. Oral and dental health in head and neck cancer survivors. Cancers Head Neck. 2016. https://doi.org/10.1186/s41199-016-0015-8.
O'Brien KM, Timmons A, Butow P, et al. Associations between neighbourhood support and financial burden with un met needs of head and neck cancer survivors. Oral Oncol. 2017; 65: 57-64. https://doi.org/10.10167j.oraloncology.2016.12.019.
Zaidi AA, Ansari TZ, Khan A. The financial burden of cancer: Estimates from patients undergoing cancer care in a tertiary care hospital. Int J Equity Health. 2012; 11: 60, http://doi.org/10.1186/1475-9276-11-60.
Mesquita AC, Chaves ÉDCL, Avelino CCV, et al. The use of religious/spiritual coping among patients with cancer under going chemotherapy treatment. Rev Latino-Am Enferm. 2013; 21(2): 539-45, https://doi.org/10.1590/S0104-11692013-000200010.
Carvalho CC, Chaves E de CL, Iunes DH, et al. Effectiveness of prayer in reducing anxiety in cancer patients. Rev da Esc Enferm da USP. 2014; 48(4): 684-90, https://dx.doi.org/10.1590/S0080-623420140000400016.
Ramphoma KJ. Oral Health in South Africa: Exploring the role of dental public health specialists. South African Dent J. 2016; 71(9): 402-3.
Singh S, Myburgh NG, Lalloo R. Policy analysis of oral health promotion in South Africa. Glob Health Promot. 2010; 17(1): 16-24. https://doi.org/10.1177/1757975909356631.
Bhayat A, Chikte U. The changing demographic profile of dentists and dental specialists in South Africa: 2002-2015. Int Dent J. 2017; 1-6, https://doi.org/10.1111/idj.12332.
Abed H, Reilly D, Burke M, Daly B. Patients with head and neck cancers' oral health knowledge, oral health-related quality of life, oral health status, and adherence to advice on discharge to primary dental care: A prospective observational study. Spec Care Dent. 2019; 39(6): 593-602, https://doi.org/10.1111/scd.12418.
Pai R, Ongole R. Nurses' Knowledge and Education about Oral Care of Cancer Patients Undergoing Chemotherapy and Radiation Therapy. Indian J Palliat Care. 2015; 21(2): 225-30, https://doi.org/10.4103/0973-1075.156507.
Ingram SS, Seo PH, Sloane R, et al. The association between oral health and general health and quality of life in older male cancer patients. J Am Geriatr Soc. 2005; 53(9): 1504-9, https://doi.org/10.1111/j.1532-5415.2005.53452.x.
Molete MP, Daly B, Hlungwani TM. Oral health promotion in Gauteng: a qualitative study. Glob Health Promot. 2013; 20(1) 50-8, https://doi.org/10.1177/1757975913476906.
Nemoto R, Victorino A, Pessoa G, et al. Oral cancer preventive campaigns: Are we reaching the real target? Braz J Otorhinolaryngol. 2015; 81(1): 44-9, https://doi.org/10.1016/j.bjorl.2014.03.002.
Mol RP. The role of dentist in palliative care team. Indian J Palliat Care. 2010; 16(2): 74-8. https://doi.org/10.4103/0973-1075.68408.
Yi Mohammadi J, Franks K, Hines S. Effectiveness of professional oral health care intervention on the oral health of residents with dementia in residential aged care facilities: a systematic review protocol. JBI Database Syst Rev. Implement Reports. 2015; 13(10): 110-22, https://doi.org/10.11124/jbisrir-2015-2330.
Dionne KR, Warnakulasuriya S, Zain RB, Cheong SC. Potentially malignant disorders of the oral cavity: Current practice and future directions in the clinic and laboratory. Int J Cancer. 2015; 136: 503-15, https://doi.org/10.1002/ijc.28754.
Petersen PE. World Health Organization global policy for improvement of oral health - World Health Assembly 2007. Int Dent J. 2008; 58: 115-21. doi:10.1111/j.1875-595X.2008.tb 00185.x, https://doi.org/10.1922/IDJ_1930Petersen07.
Hertrampf K, Wenz HJ, Koller M, et al. Assessing dentists' knowledge about oral cancer: Translation and linguistic validation of a standardized questionnaire from American English into German. Oral Oncol. 2009; 45(10): 877-82, https://doi.org/10.1016/j.oraloncology.2009.02.010.
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