Podcast
Questions and Answers
What is the role of a Speech Therapist in a Multi-Disciplinary Team (MDT) for cancer treatment?
What is the role of a Speech Therapist in a Multi-Disciplinary Team (MDT) for cancer treatment?
- Administering chemotherapy.
- Providing surgical interventions.
- Managing communication and swallowing difficulties. (correct)
- Prescribing dietary plans.
Which of the following is NOT typically included as part of the Multi-Disciplinary Team (MDT) approach in oncology?
Which of the following is NOT typically included as part of the Multi-Disciplinary Team (MDT) approach in oncology?
- Cardiologists (correct)
- Radiologists
- Surgeons
- Oncologists
What is the process by which cancer cells move away from the primary tumor and invade other parts of the body?
What is the process by which cancer cells move away from the primary tumor and invade other parts of the body?
- Angiogenesis
- Local invasion
- Metastasis (correct)
- Cellular differentiation
What is the term for the process by which tumors create their own blood vessels to support growth?
What is the term for the process by which tumors create their own blood vessels to support growth?
Which of these options is not a standard treatment modality for cancer?
Which of these options is not a standard treatment modality for cancer?
Which of the following is typically the first step in evaluating a patient for oral cancer?
Which of the following is typically the first step in evaluating a patient for oral cancer?
What does 'EUA' stand for in the context of evaluating oral cancer?
What does 'EUA' stand for in the context of evaluating oral cancer?
In the TNM staging system for oral cancer, what does 'T' refer to?
In the TNM staging system for oral cancer, what does 'T' refer to?
According to the TNM classification for oral cancer, what is the defining characteristic of a T2 tumor?
According to the TNM classification for oral cancer, what is the defining characteristic of a T2 tumor?
In the context of the TNM staging system, what does N1 indicate?
In the context of the TNM staging system, what does N1 indicate?
In oral cancer staging, a patient diagnosed with T1N0M0 would be classified as which stage?
In oral cancer staging, a patient diagnosed with T1N0M0 would be classified as which stage?
A patient with a T4, N2, M0 oral cancer would be classified as which stage according to the oral cancer staging?
A patient with a T4, N2, M0 oral cancer would be classified as which stage according to the oral cancer staging?
What is the primary distinction between curative and palliative treatment planning?
What is the primary distinction between curative and palliative treatment planning?
Which of the following factors is LEAST likely to be considered in treatment planning for cancer?
Which of the following factors is LEAST likely to be considered in treatment planning for cancer?
Which of the following is NOT considered a significant risk factor for developing cancer?
Which of the following is NOT considered a significant risk factor for developing cancer?
What is cachexia, as it relates to general signs and symptoms of cancer?
What is cachexia, as it relates to general signs and symptoms of cancer?
Which of the general signs and symptoms of cancer is often a late manifestation of the disease?
Which of the general signs and symptoms of cancer is often a late manifestation of the disease?
What is meant by 'adjuvant' chemotherapy?
What is meant by 'adjuvant' chemotherapy?
What is induction chemotherapy?
What is induction chemotherapy?
Which of the following best describes the principle behind how chemotherapy works, assuming that it is effective?
Which of the following best describes the principle behind how chemotherapy works, assuming that it is effective?
In the context of tumor cell growth, what occurs during the G1 phase of the cell cycle?
In the context of tumor cell growth, what occurs during the G1 phase of the cell cycle?
How do non-phase dependent chemotherapy drugs kill cells?
How do non-phase dependent chemotherapy drugs kill cells?
Which of the following chemotherapy drugs is classified as phase-dependent?
Which of the following chemotherapy drugs is classified as phase-dependent?
Which of the following is classified as an antimetabolite?
Which of the following is classified as an antimetabolite?
Which of the following is a common route of administration for chemotherapy?
Which of the following is a common route of administration for chemotherapy?
Within a Multi-Disciplinary Team (MDT) for cancer, which surgical specialists might be involved in the treatment of oral cancer?
Within a Multi-Disciplinary Team (MDT) for cancer, which surgical specialists might be involved in the treatment of oral cancer?
In the context of cancer development, which process describes the creation of new blood vessels to supply a tumor with nutrients and oxygen?
In the context of cancer development, which process describes the creation of new blood vessels to supply a tumor with nutrients and oxygen?
A patient's biopsy results show a tumor that is 3.5 cm in size without any signs of spread to nearby lymph nodes or distant sites. According to the TNM staging system, how would this tumor be classified?
A patient's biopsy results show a tumor that is 3.5 cm in size without any signs of spread to nearby lymph nodes or distant sites. According to the TNM staging system, how would this tumor be classified?
A patient presents with a tumor that has spread to one ipsilateral (same side) mobile lymph node, which is less than 3 cm in size. There is no evidence of distant metastasis. According to the TNM classification, what is the appropriate 'N' stage?
A patient presents with a tumor that has spread to one ipsilateral (same side) mobile lymph node, which is less than 3 cm in size. There is no evidence of distant metastasis. According to the TNM classification, what is the appropriate 'N' stage?
A patient is diagnosed with a T2N1M0 oral cancer. Based on the oral cancer staging guidelines, which overall stage would this cancer be classified as?
A patient is diagnosed with a T2N1M0 oral cancer. Based on the oral cancer staging guidelines, which overall stage would this cancer be classified as?
A patient presents with an oral tumor infiltrating deep structures, with mobile nodes on the opposite side of the neck, ranging from 3-6cm, but no distant metastases. According to the TNM staging, which stage is this?
A patient presents with an oral tumor infiltrating deep structures, with mobile nodes on the opposite side of the neck, ranging from 3-6cm, but no distant metastases. According to the TNM staging, which stage is this?
What is the primary aim of palliative treatment in cancer care?
What is the primary aim of palliative treatment in cancer care?
Which of the following considerations is most crucial when determining between surgery and radiotherapy as a cancer treatment?
Which of the following considerations is most crucial when determining between surgery and radiotherapy as a cancer treatment?
Which dietary factor is associated with an increased risk of developing cancer?
Which dietary factor is associated with an increased risk of developing cancer?
What systemic effect of cancer is characterized by loss of muscle mass, weight loss, and overall weakness?
What systemic effect of cancer is characterized by loss of muscle mass, weight loss, and overall weakness?
A patient with parotid cancer exhibits sensory/motor dysfunction affecting the trigeminal nerve. What might this indicate about the tumor's progression?
A patient with parotid cancer exhibits sensory/motor dysfunction affecting the trigeminal nerve. What might this indicate about the tumor's progression?
Which of the following scenarios describes the use of 'neo-adjuvant' chemotherapy?
Which of the following scenarios describes the use of 'neo-adjuvant' chemotherapy?
What distinguishes induction chemotherapy from adjuvant chemotherapy in cancer treatment?
What distinguishes induction chemotherapy from adjuvant chemotherapy in cancer treatment?
Which of the following best describes the ideal mechanism of action for chemotherapy drugs?
Which of the following best describes the ideal mechanism of action for chemotherapy drugs?
During which phase of the cell cycle does DNA synthesis primarily occur?
During which phase of the cell cycle does DNA synthesis primarily occur?
How does the cell-killing mechanism of non-phase dependent chemotherapy drugs differ from that of phase-dependent drugs?
How does the cell-killing mechanism of non-phase dependent chemotherapy drugs differ from that of phase-dependent drugs?
Methotrexate exerts its cytotoxic effects during which phase of the cell cycle, making it a phase-dependent drug?
Methotrexate exerts its cytotoxic effects during which phase of the cell cycle, making it a phase-dependent drug?
Which of the following is an example of an antimetabolite chemotherapy drug?
Which of the following is an example of an antimetabolite chemotherapy drug?
What is the significance of considering the cell cycle when selecting chemotherapy drugs?
What is the significance of considering the cell cycle when selecting chemotherapy drugs?
A patient is receiving chemotherapy through a 'Hickman line.' What does this imply about the route of administration?
A patient is receiving chemotherapy through a 'Hickman line.' What does this imply about the route of administration?
When is it most appropriate to consider inserting a pump mechanism into the common hepatic artery for chemotherapy administration?
When is it most appropriate to consider inserting a pump mechanism into the common hepatic artery for chemotherapy administration?
A patient is diagnosed with melanoma, and imaging reveals multiple metastases throughout both lungs. Which of the following statements best describes this situation?
A patient is diagnosed with melanoma, and imaging reveals multiple metastases throughout both lungs. Which of the following statements best describes this situation?
What role do MacMillan nurses play within the Multi-Disciplinary Team (MDT) approach to cancer care?
What role do MacMillan nurses play within the Multi-Disciplinary Team (MDT) approach to cancer care?
What is the role of restorative dentistry in the context of oral cancer treatment and the Multi-Disciplinary Team (MDT)?
What is the role of restorative dentistry in the context of oral cancer treatment and the Multi-Disciplinary Team (MDT)?
What is the relationship between genetic inheritance and the risk of developing cancer?
What is the relationship between genetic inheritance and the risk of developing cancer?
Why is regular monitoring with a full blood count (FBC) and differential essential during chemotherapy?
Why is regular monitoring with a full blood count (FBC) and differential essential during chemotherapy?
When local toxicity occurs due to chemotherapy administration, what is the primary concern?
When local toxicity occurs due to chemotherapy administration, what is the primary concern?
What is the most likely cause of nausea and vomiting as an acute toxicity during chemotherapy?
What is the most likely cause of nausea and vomiting as an acute toxicity during chemotherapy?
Why would sucking on ice cubes be recommended for a patient prone to stomatitis during chemotherapy, especially with 5-FU?
Why would sucking on ice cubes be recommended for a patient prone to stomatitis during chemotherapy, especially with 5-FU?
What is the primary reason for avoiding aspirin in patients undergoing chemotherapy with methotrexate?
What is the primary reason for avoiding aspirin in patients undergoing chemotherapy with methotrexate?
How does long-term exposure to alkylating agents potentially lead to carcinogenesis?
How does long-term exposure to alkylating agents potentially lead to carcinogenesis?
Which of the following interventions is most appropriate for managing established mucositis during chemotherapy?
Which of the following interventions is most appropriate for managing established mucositis during chemotherapy?
Why is it critical to aggressively treat infections in patients undergoing chemotherapy?
Why is it critical to aggressively treat infections in patients undergoing chemotherapy?
What dental consideration is most important before commencing a patient on chemotherapy?
What dental consideration is most important before commencing a patient on chemotherapy?
Why would a dentist consult a patient's full blood count (FBC) before performing a surgical procedure?
Why would a dentist consult a patient's full blood count (FBC) before performing a surgical procedure?
A patient undergoing chemotherapy has a platelet count of 40x10^9/litre. What implications does this have for dental surgery?
A patient undergoing chemotherapy has a platelet count of 40x10^9/litre. What implications does this have for dental surgery?
If a patient's granulocyte count is less than 2x10^9/litre during chemotherapy, what preventative measure is typically required?
If a patient's granulocyte count is less than 2x10^9/litre during chemotherapy, what preventative measure is typically required?
What is the main target of radiotherapy in cancer treatment?
What is the main target of radiotherapy in cancer treatment?
Why is radiotherapy typically given in fractions over a period of 4-6 weeks?
Why is radiotherapy typically given in fractions over a period of 4-6 weeks?
Which phase of the cell cycle is most susceptible to damage from radiotherapy?
Which phase of the cell cycle is most susceptible to damage from radiotherapy?
What is the primary purpose of neoadjuvant radiotherapy?
What is the primary purpose of neoadjuvant radiotherapy?
What is the key goal of adjuvant radiotherapy?
What is the key goal of adjuvant radiotherapy?
Why is multi-field technique used in radical external beam irradiation?
Why is multi-field technique used in radical external beam irradiation?
A patient is scheduled for a surgical procedure, and their full blood count reveals a platelet count of 60x10^9/litre. What dental management is generally appropriate??
A patient is scheduled for a surgical procedure, and their full blood count reveals a platelet count of 60x10^9/litre. What dental management is generally appropriate??
Why are patients undergoing head and neck radiotherapy at increased risk of oral infections and ulcerations?
Why are patients undergoing head and neck radiotherapy at increased risk of oral infections and ulcerations?
Which of the following tissues is considered highly radiosensitive, increasing its risk of damage during radiotherapy?
Which of the following tissues is considered highly radiosensitive, increasing its risk of damage during radiotherapy?
Which malignancy listed is typically considered relatively insensitive to radiotherapy?
Which malignancy listed is typically considered relatively insensitive to radiotherapy?
In a patient undergoing chemotherapy, which oral complication is specifically associated with Methotrexate?
In a patient undergoing chemotherapy, which oral complication is specifically associated with Methotrexate?
How does scalp cooling aim to minimize alopecia during chemotherapy?
How does scalp cooling aim to minimize alopecia during chemotherapy?
When herpetic infections occur during chemotherapy, which antiviral medication is typically prescribed?
When herpetic infections occur during chemotherapy, which antiviral medication is typically prescribed?
Why do patients undergoing chemotherapy need regular full blood counts (FBC) and differentials?
Why do patients undergoing chemotherapy need regular full blood counts (FBC) and differentials?
What is the primary reason tissue destruction occurs when chemotherapy drugs are injected outside the vessel?
What is the primary reason tissue destruction occurs when chemotherapy drugs are injected outside the vessel?
What is a common gastrointestinal (GI) side effect of chemotherapy, and what physiological process causes this?
What is a common gastrointestinal (GI) side effect of chemotherapy, and what physiological process causes this?
Which specific oral complication is commonly associated with Methotrexate?
Which specific oral complication is commonly associated with Methotrexate?
How does scalp cooling reduce alopecia during chemotherapy?
How does scalp cooling reduce alopecia during chemotherapy?
Approximately when does hair loss typically begin after the first chemotherapy injection?
Approximately when does hair loss typically begin after the first chemotherapy injection?
What potential long-term effect is associated with prolonged exposure to alkylating agents used in chemotherapy?
What potential long-term effect is associated with prolonged exposure to alkylating agents used in chemotherapy?
Beyond carcinogenesis, what other potential long-term toxicity is directly associated with chemotherapy?
Beyond carcinogenesis, what other potential long-term toxicity is directly associated with chemotherapy?
Which of the following is a dental-related oral complication associated with chemotherapy?
Which of the following is a dental-related oral complication associated with chemotherapy?
What is one of the most important aspects of dental management before a patient starts chemotherapy?
What is one of the most important aspects of dental management before a patient starts chemotherapy?
Why is aspirin typically avoided in patients undergoing chemotherapy, particularly those taking methotrexate?
Why is aspirin typically avoided in patients undergoing chemotherapy, particularly those taking methotrexate?
Why might suxamethonium be used with caution in patients also taking methotrexate?
Why might suxamethonium be used with caution in patients also taking methotrexate?
Why might sucking on ice cubes or drinking cold water be recommended to patients prone to stomatitis during chemotherapy, especially with 5-FU?
Why might sucking on ice cubes or drinking cold water be recommended to patients prone to stomatitis during chemotherapy, especially with 5-FU?
What is a suitable initial approach for managing established mucositis during chemotherapy?
What is a suitable initial approach for managing established mucositis during chemotherapy?
If a patient undergoing chemotherapy develops candidiasis, which antifungal medication is typically prescribed?
If a patient undergoing chemotherapy develops candidiasis, which antifungal medication is typically prescribed?
If a patient undergoing chemotherapy develops a herpetic infection, which medication is typically used?
If a patient undergoing chemotherapy develops a herpetic infection, which medication is typically used?
Why is aggressive treatment of infections critical in patients undergoing chemotherapy?
Why is aggressive treatment of infections critical in patients undergoing chemotherapy?
What is a primary dental management consideration prior to commencing a patient on chemotherapy?
What is a primary dental management consideration prior to commencing a patient on chemotherapy?
What dental management is generally appropriate if a patient's platelet count is >50x10^9/litre before a surgical procedure?
What dental management is generally appropriate if a patient's platelet count is >50x10^9/litre before a surgical procedure?
What action is typically required if a patient’s granulocyte count is less than 2x10^9/litre during chemotherapy before invasive dental treatment?
What action is typically required if a patient’s granulocyte count is less than 2x10^9/litre during chemotherapy before invasive dental treatment?
Why is radiotherapy typically delivered in fractions over 4-6 weeks rather than a single high dose?
Why is radiotherapy typically delivered in fractions over 4-6 weeks rather than a single high dose?
According to the information provided, in which phase of the cell cycle does radiotherapy cause the most damage?
According to the information provided, in which phase of the cell cycle does radiotherapy cause the most damage?
Radiation can cause collateral damage, what does collateral damage mean in the context of radiotherapy?
Radiation can cause collateral damage, what does collateral damage mean in the context of radiotherapy?
Why is a full blood count (FBC) with differential regularly monitored in patients undergoing chemotherapy?
Why is a full blood count (FBC) with differential regularly monitored in patients undergoing chemotherapy?
Why might sucking on ice chips or drinking cold water be recommended for a patient prone to stomatitis during chemotherapy, especially with 5-FU?
Why might sucking on ice chips or drinking cold water be recommended for a patient prone to stomatitis during chemotherapy, especially with 5-FU?
What is the potential long-term consequence of exposure to alkylating agents during chemotherapy?
What is the potential long-term consequence of exposure to alkylating agents during chemotherapy?
A patient undergoing chemotherapy develops oral ulcerations that are attributed to methotrexate. Which of the following interventions is most appropriate?
A patient undergoing chemotherapy develops oral ulcerations that are attributed to methotrexate. Which of the following interventions is most appropriate?
What is the rationale for aggressive treatment of infections in patients undergoing chemotherapy?
What is the rationale for aggressive treatment of infections in patients undergoing chemotherapy?
What is a critical dental consideration before commencing a patient on chemotherapy?
What is a critical dental consideration before commencing a patient on chemotherapy?
Why would a dentist need to consult a patient's full blood count (FBC) before performing a surgical procedure?
Why would a dentist need to consult a patient's full blood count (FBC) before performing a surgical procedure?
Which of the following statements best describes the acute side effect of 'local toxicity' from chemotherapy?
Which of the following statements best describes the acute side effect of 'local toxicity' from chemotherapy?
Why is radiotherapy typically administered in fractions over a period of 4-6 weeks?
Why is radiotherapy typically administered in fractions over a period of 4-6 weeks?
Which oral complication is specifically associated with Methotrexate?
Which oral complication is specifically associated with Methotrexate?
What is the primary reason why a dentist should avoid prescribing aspirin to patients undergoing chemotherapy, particularly those on methotrexate?
What is the primary reason why a dentist should avoid prescribing aspirin to patients undergoing chemotherapy, particularly those on methotrexate?
What is the primary mechanism by which osteoradionecrosis (ORN) develops following radiotherapy?
What is the primary mechanism by which osteoradionecrosis (ORN) develops following radiotherapy?
Before initiating head and neck radiotherapy, how does removing poor prognosis teeth help prevent complications?
Before initiating head and neck radiotherapy, how does removing poor prognosis teeth help prevent complications?
Which intervention would be most appropriate for managing xerostomia following radiotherapy involving the salivary glands?
Which intervention would be most appropriate for managing xerostomia following radiotherapy involving the salivary glands?
What is the rationale for using silver markers in brachytherapy seeds, as shown in the image?
What is the rationale for using silver markers in brachytherapy seeds, as shown in the image?
Why are children more susceptible to craniofacial defects following radiotherapy?
Why are children more susceptible to craniofacial defects following radiotherapy?
Which long-term effect is associated with radiotherapy due to damage to the vasculature?
Which long-term effect is associated with radiotherapy due to damage to the vasculature?
If a patient who has undergone radiotherapy to the jaws requires dental extractions, what is the most appropriate management approach?
If a patient who has undergone radiotherapy to the jaws requires dental extractions, what is the most appropriate management approach?
A patient reports a persistent loss of taste after receiving radiotherapy for oral cancer. What is the most likely cause?
A patient reports a persistent loss of taste after receiving radiotherapy for oral cancer. What is the most likely cause?
Why is fluoride supplementation particularly important for patients undergoing head and neck radiotherapy?
Why is fluoride supplementation particularly important for patients undergoing head and neck radiotherapy?
A patient undergoing radiotherapy complains of skin soreness (erythema) at the site of beam entry. What is the underlying mechanism?
A patient undergoing radiotherapy complains of skin soreness (erythema) at the site of beam entry. What is the underlying mechanism?
What is the purpose of liaison with other clinicians (MDT) in the dental care of a head and neck radiotherapy patient?
What is the purpose of liaison with other clinicians (MDT) in the dental care of a head and neck radiotherapy patient?
How might radiotherapy contribute to the development of dental hypersensitivity?
How might radiotherapy contribute to the development of dental hypersensitivity?
What preventative measure can be taken to minimize radiation caries in patients undergoing radiotherapy?
What preventative measure can be taken to minimize radiation caries in patients undergoing radiotherapy?
Why is optimizing dental treatment prior to starting chemotherapy or radiotherapy important?
Why is optimizing dental treatment prior to starting chemotherapy or radiotherapy important?
Radiotherapy can affect the blood vessels in the jaw, and increase the risk of osteoradionecrosis (ORN). What is this effect on blood vessels called?
Radiotherapy can affect the blood vessels in the jaw, and increase the risk of osteoradionecrosis (ORN). What is this effect on blood vessels called?
Why is dental management, including the removal of poor prognosis teeth, particularly crucial before a patient undergoes head and neck radiotherapy?
Why is dental management, including the removal of poor prognosis teeth, particularly crucial before a patient undergoes head and neck radiotherapy?
A patient who has undergone radiotherapy involving the salivary glands is experiencing a drastically reduced salivary flow. Which of the following strategies is MOST appropriate for managing this condition, known as xerostomia?
A patient who has undergone radiotherapy involving the salivary glands is experiencing a drastically reduced salivary flow. Which of the following strategies is MOST appropriate for managing this condition, known as xerostomia?
What is the underlying mechanism by which osteoradionecrosis (ORN) develops following radiotherapy to the head and neck region?
What is the underlying mechanism by which osteoradionecrosis (ORN) develops following radiotherapy to the head and neck region?
Following head and neck radiotherapy, a patient exhibits signs of rampant caries, particularly at the cervical margins of the teeth. What is the MOST likely contributing factor to this condition?
Following head and neck radiotherapy, a patient exhibits signs of rampant caries, particularly at the cervical margins of the teeth. What is the MOST likely contributing factor to this condition?
Why are silver markers incorporated into brachytherapy seeds, as depicted in the diagram?
Why are silver markers incorporated into brachytherapy seeds, as depicted in the diagram?
After radiation therapy, what vascular change directly contributes to the development of osteoradionecrosis?
After radiation therapy, what vascular change directly contributes to the development of osteoradionecrosis?
Why are children especially vulnerable to developing craniofacial defects following radiotherapy involving the head and neck area?
Why are children especially vulnerable to developing craniofacial defects following radiotherapy involving the head and neck area?
A patient who underwent radiotherapy now presents with a complete loss of taste sensation. What is the MOST likely underlying cause of this sensory deficit?
A patient who underwent radiotherapy now presents with a complete loss of taste sensation. What is the MOST likely underlying cause of this sensory deficit?
A patient undergoing head and neck radiotherapy reports that their skin in the irradiated area has become intensely sore and red (erythematous). What is the primary mechanism behind this skin reaction?
A patient undergoing head and neck radiotherapy reports that their skin in the irradiated area has become intensely sore and red (erythematous). What is the primary mechanism behind this skin reaction?
What is the MOST important reason for maintaining close communication and collaboration with other healthcare professionals within a Multi-Disciplinary Team (MDT) when managing the dental care of a patient undergoing head and neck radiotherapy?
What is the MOST important reason for maintaining close communication and collaboration with other healthcare professionals within a Multi-Disciplinary Team (MDT) when managing the dental care of a patient undergoing head and neck radiotherapy?
Radiation can cause collateral damage, in the context of radiotherapy, what does collateral damage mean?
Radiation can cause collateral damage, in the context of radiotherapy, what does collateral damage mean?
Why is optimizing dental treatment prior to starting chemotherapy or radiotherapy so critical for patients with cancer?
Why is optimizing dental treatment prior to starting chemotherapy or radiotherapy so critical for patients with cancer?
Why is it crucial to consult a patient's full blood count (FBC) before proceeding with a dental extraction, especially in patients undergoing chemotherapy or radiotherapy?
Why is it crucial to consult a patient's full blood count (FBC) before proceeding with a dental extraction, especially in patients undergoing chemotherapy or radiotherapy?
What is the primary mechanism by which radiotherapy leads to osteoradionecrosis (ORN)?
What is the primary mechanism by which radiotherapy leads to osteoradionecrosis (ORN)?
Why is it crucial to extract teeth with a poor prognosis before initiating head and neck radiotherapy?
Why is it crucial to extract teeth with a poor prognosis before initiating head and neck radiotherapy?
A patient undergoing radiotherapy involving the salivary glands reports a persistent dry mouth. Which of the following is the MOST appropriate initial management strategy?
A patient undergoing radiotherapy involving the salivary glands reports a persistent dry mouth. Which of the following is the MOST appropriate initial management strategy?
What is the likely cause of radiation caries following radiotherapy?
What is the likely cause of radiation caries following radiotherapy?
What is the role of silver markers in the brachytherapy seeds?
What is the role of silver markers in the brachytherapy seeds?
Why are children considered more susceptible to craniofacial defects following radiotherapy to the head and neck region?
Why are children considered more susceptible to craniofacial defects following radiotherapy to the head and neck region?
What vascular change associated with radiotherapy increases the risk of osteoradionecrosis?
What vascular change associated with radiotherapy increases the risk of osteoradionecrosis?
Following radiotherapy for oral cancer, a patient reports a complete loss of taste. What is the MOST probable underlying cause?
Following radiotherapy for oral cancer, a patient reports a complete loss of taste. What is the MOST probable underlying cause?
A patient undergoing head and neck radiotherapy reports skin soreness (erythema) in the irradiated area. What is the primary cause of this reaction?
A patient undergoing head and neck radiotherapy reports skin soreness (erythema) in the irradiated area. What is the primary cause of this reaction?
What is the MOST crucial reason for maintaining close coordination with the Multi-Disciplinary Team (MDT) in the dental management of a patient undergoing head and neck radiotherapy?
What is the MOST crucial reason for maintaining close coordination with the Multi-Disciplinary Team (MDT) in the dental management of a patient undergoing head and neck radiotherapy?
Following radiotherapy, a patient exhibits rampant caries, particularly at the cervical margins of the teeth. What is the MOST likely contributing factor to this condition?
Following radiotherapy, a patient exhibits rampant caries, particularly at the cervical margins of the teeth. What is the MOST likely contributing factor to this condition?
Collateral damage is a potential side effect of radiotherapy. In this context, what does 'collateral damage' refer to?
Collateral damage is a potential side effect of radiotherapy. In this context, what does 'collateral damage' refer to?
Why is fluoride supplementation an important part of dental care for patients undergoing head and neck radiotherapy?
Why is fluoride supplementation an important part of dental care for patients undergoing head and neck radiotherapy?
What is the primary underlying cause of osteoradionecrosis (ORN) following radiotherapy?
What is the primary underlying cause of osteoradionecrosis (ORN) following radiotherapy?
Why are dental extractions a significant concern following DXT (deep X-ray therapy) to the jaws?
Why are dental extractions a significant concern following DXT (deep X-ray therapy) to the jaws?
What is the most important reason for removing poor prognosis teeth before commencing head and neck radiotherapy?
What is the most important reason for removing poor prognosis teeth before commencing head and neck radiotherapy?
Which of the following is the most likely reason for a patient experiencing a persistent loss of taste after radiotherapy involving the salivary glands?
Which of the following is the most likely reason for a patient experiencing a persistent loss of taste after radiotherapy involving the salivary glands?
Why is liaising with other clinicians emphasized in the dental care of a patient undergoing head and neck radiotherapy?
Why is liaising with other clinicians emphasized in the dental care of a patient undergoing head and neck radiotherapy?
Following head and neck radiotherapy, rampant caries is often observed at the cervical margins of teeth. What factor MOST contributes to this increased caries risk?
Following head and neck radiotherapy, rampant caries is often observed at the cervical margins of teeth. What factor MOST contributes to this increased caries risk?
Why are silver markers used within brachytherapy seeds, as illustrated in the image?
Why are silver markers used within brachytherapy seeds, as illustrated in the image?
Which mechanism primarily explains why children are more prone to craniofacial defects as a result of radiotherapy?
Which mechanism primarily explains why children are more prone to craniofacial defects as a result of radiotherapy?
What vascular change is considered a direct contributor to the development of osteoradionecrosis (ORN) after radiation therapy?
What vascular change is considered a direct contributor to the development of osteoradionecrosis (ORN) after radiation therapy?
A patient undergoing head and neck radiotherapy reports intense skin soreness (erythema). What is the primary mechanism behind this reaction?
A patient undergoing head and neck radiotherapy reports intense skin soreness (erythema). What is the primary mechanism behind this reaction?
Which measure is most appropriate for managing xerostomia following radiotherapy involving the major salivary glands?
Which measure is most appropriate for managing xerostomia following radiotherapy involving the major salivary glands?
What preventative dental measure is most important to minimize radiation caries in a patient undergoing radiotherapy?
What preventative dental measure is most important to minimize radiation caries in a patient undergoing radiotherapy?
Why is optimizing dental treatment prior to starting head and neck radiotherapy so critical?
Why is optimizing dental treatment prior to starting head and neck radiotherapy so critical?
Why is it important to be aware of potential blood count changes in patients undergoing chemotherapy?
Why is it important to be aware of potential blood count changes in patients undergoing chemotherapy?
Flashcards
MDT Approach
MDT Approach
A multi-disciplinary team approach in medicine involves surgeons, oncologists, radiologists, speech therapists, restorative dentistry, Macmillan nurses, and dieticians.
Oncology
Oncology
The study of cancer, focusing on its development and spread.
Metastasis
Metastasis
The process by which cancer cells move away from the primary tumor and invade other parts of the body.
Cancer Treatment Modalities
Cancer Treatment Modalities
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Evaluation of Oral Cancer
Evaluation of Oral Cancer
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Oral Cancer TNM System
Oral Cancer TNM System
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T Stages of Oral Cancer
T Stages of Oral Cancer
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N Stages of Oral Cancer
N Stages of Oral Cancer
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M Stages of Oral Cancer
M Stages of Oral Cancer
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Stages of Oral Cancer
Stages of Oral Cancer
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Curative vs. Palliative
Curative vs. Palliative
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Cancer Risk Factors
Cancer Risk Factors
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General Cancer Symptoms
General Cancer Symptoms
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Chemotherapy
Chemotherapy
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Adjuvant Chemotherapy
Adjuvant Chemotherapy
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Neo-adjuvant Chemotherapy
Neo-adjuvant Chemotherapy
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Induction Chemotherapy
Induction Chemotherapy
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Chemotherapy Principle
Chemotherapy Principle
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Cell Cycle
Cell Cycle
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Non-phase Dependent
Non-phase Dependent
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Phase-dependent
Phase-dependent
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Phase-dependent examples
Phase-dependent examples
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Non-phase dependent examples
Non-phase dependent examples
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Chemotherapy - Broad Groups
Chemotherapy - Broad Groups
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Routes of Administration
Routes of Administration
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Local Toxicity
Local Toxicity
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Bone Marrow Toxicity
Bone Marrow Toxicity
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GI Toxicity
GI Toxicity
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Methotrexate - Mucositis
Methotrexate - Mucositis
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Alopecia
Alopecia
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Chemotherapy - Carcinogenesis
Chemotherapy - Carcinogenesis
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Gonadal Damage
Gonadal Damage
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Oral Complications
Oral Complications
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Pre-Chemo Dental Fitness
Pre-Chemo Dental Fitness
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Bleeding/Infection Risks
Bleeding/Infection Risks
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Methotrexate Ulcer Treatment
Methotrexate Ulcer Treatment
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Methotrexate and Suxamethonium
Methotrexate and Suxamethonium
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Managing Stomatitis
Managing Stomatitis
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Established Mucositis
Established Mucositis
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Candidosis Treatment
Candidosis Treatment
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Herpetic Infection Treatment
Herpetic Infection Treatment
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Treating Systemic Infections
Treating Systemic Infections
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Post-Chemo Risks
Post-Chemo Risks
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Platelets >50x10^9/litre
Platelets >50x10^9/litre
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Platelets <50x10^9/litre
Platelets <50x10^9/litre
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Granulocytes <2x10^9/litre
Granulocytes <2x10^9/litre
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Types of Radiotherapy
Types of Radiotherapy
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Neoadjuvant Radiotherapy
Neoadjuvant Radiotherapy
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Adjuvant Radiotherapy
Adjuvant Radiotherapy
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Radiotherapy Target
Radiotherapy Target
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Carcinogenesis and Chemotherapy
Carcinogenesis and Chemotherapy
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Chemotherapy and Sterility
Chemotherapy and Sterility
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Oral complications of chemotherapy
Oral complications of chemotherapy
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Dental Check-up
Dental Check-up
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Treating Ulceration
Treating Ulceration
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Preventing Stomatitis
Preventing Stomatitis
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Established Mucositis Management
Established Mucositis Management
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Candidosis
Candidosis
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Herpetic infection
Herpetic infection
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Systemic Infections
Systemic Infections
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Radiotherapy Fractions
Radiotherapy Fractions
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High Radiosensitivity (Malignant)
High Radiosensitivity (Malignant)
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External Beam Irradiation
External Beam Irradiation
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Local Toxicity Definition
Local Toxicity Definition
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FBC Monitoring During Chemotherapy
FBC Monitoring During Chemotherapy
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Chemotherapy Induced GI Toxicity
Chemotherapy Induced GI Toxicity
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Methotrexate - Induced Mucositis
Methotrexate - Induced Mucositis
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Chemotherapy Induced Alopecia
Chemotherapy Induced Alopecia
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Chemotherapy - Long Term
Chemotherapy - Long Term
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Chemotherapy - Gonadal Damage
Chemotherapy - Gonadal Damage
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Chemotherapy infection
Chemotherapy infection
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Granulocytes
Granulocytes
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What is Radiotherapy
What is Radiotherapy
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Palliative Radiotherapy
Palliative Radiotherapy
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Radiosensitivity - Normal Tissue
Radiosensitivity - Normal Tissue
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External Radical Beam
External Radical Beam
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Brachytherapy
Brachytherapy
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Radiotherapy Induced Fatigue
Radiotherapy Induced Fatigue
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Mucositis
Mucositis
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Xerostomia
Xerostomia
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Radiation Caries
Radiation Caries
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Osteoradionecrosis
Osteoradionecrosis
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Trismus
Trismus
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Loss of Taste
Loss of Taste
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Skin pigmentation
Skin pigmentation
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Hair loss
Hair loss
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Radiation Induced Malignancy
Radiation Induced Malignancy
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Pre-treatment dental care
Pre-treatment dental care
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Manage early complications
Manage early complications
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Promote optimum oral hygiene
Promote optimum oral hygiene
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Fluoride supplementation
Fluoride supplementation
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What is Brachytherapy
What is Brachytherapy
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Mucositis (Radiotherapy)
Mucositis (Radiotherapy)
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Xerostomia (Radiotherapy)
Xerostomia (Radiotherapy)
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Trismus (Radiotherapy)
Trismus (Radiotherapy)
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Loss of Taste (Radiotherapy)
Loss of Taste (Radiotherapy)
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Hair Loss (Radiotherapy)
Hair Loss (Radiotherapy)
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Basic types of Chemotherapy
Basic types of Chemotherapy
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General Radiotherapy Side Effects
General Radiotherapy Side Effects
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Mucositis (Oral)
Mucositis (Oral)
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General Side Effects of Radiotherapy
General Side Effects of Radiotherapy
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What is External Radiation?
What is External Radiation?
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Study Notes
- A titanium capsule contains adsorbed I-125 with silver markers, measuring 0.8 mm in height, 4.5 mm in length, and 0.5 mm in width.
General Side Effects of Radiotherapy
- Potential side effects involve tiredness, nausea, and loss of appetite.
- Erythema (soreness of skin) may occur at the beam entry site.
- Skin pigmentation and hair loss can take place at the beam entry site.
- There is a risk of radiation-induced malignancy years after treatment.
Oral Complications of Radiotherapy Involving the Salivary Glands
- Oral complications include mucositis, ulceration, candidiasis, and xerostomia.
- Radiation caries, dental hypersensitivity, and periodontal disease may occur.
- Loss of taste, trismus, and osteoradionecrosis are possible.
- Craniofacial defects can arise during growth.
Osteoradionecrosis
- Osteoradionecrosis is due to endarteritis obliterans, leading to poor blood supply.
- Dental extractions can lead to osteoradionecrosis.
- Teeth with a poor prognosis should be removed before treatment.
- If extractions are needed after deep X-ray therapy (DXT) to the jaws, specialist attention, antibiotics, and potentially hyperbaric oxygen are required.
- Osteoradionecrosis can involve the mandible.
Dental Care of the Head and Neck Radiotherapy Patient
- Poor prognosis teeth should be removed prior to treatment.
- Early complications like dry mouth, mucositis, and candidiasis need management.
- Optimum oral hygiene should be promoted through fluoride supplementation.
- Recurrence should be considered during treatment, and dentists should liaise with other clinicians.
Complications – Acute Toxicity
- Local toxicity causes tissue destruction if a chemotherapy agent is injected outside of the vessel.
- Bone marrow toxicity is dose-limiting; regular Full Blood Count (FBC) and differential testing is required.
- GI toxicity can cause nausea and vomiting by stimulating the CT zone, gut, and cerebral cortex.
- Methotrexate use can lead to mucositis.
Acute Complications - Continued
- Alopecia can occur but can be reduced by scalp cooling; hair loss typically starts 18-21 days after the first injection, and not all agents cause it.
Long-term Toxicity
- Carcinogenesis can occur due to long-term use of alkylating agents, leading to acute leukaemia.
- Gonadal damage can cause sterility.
Chemotherapy – Dental Relevance
- Oral complications include infections, ulceration, mucositis, lip cracking, gingival bleeding, xerostomia, dehydration, and abnormal dental development.
Dental Management – Before Chemotherapy
- Aim to get dentally fit if possible.
- Awareness is required for possible bleeding problems and a predisposition to infection.
During Chemotherapy
- Ulceration caused by Methotrexate may respond to topical folinic acid; avoid prescribing aspirin, as it increases Methotrexate toxicity.
- Suxamethonium may have increased toxicity in patients taking Methotrexate.
- Patients prone to stomatitis can suck on ice cubes or drink cold water during the infusion, particularly with 5-FU.
- Optimize oral hygiene and consider benzydamine hydrochloride for established mucositis.
- Treat candidosis with fluconazole.
- Treat herpetic infections with aciclovir.
- Aggressive treatment of any infections is necessary, as they soon become systemic.
After Chemotherapy
- There is increased susceptibility to infection and bleeding tendencies.
The Full Blood Count
- A platelet count >50x10⁹/litre indicates routine management; some patients may require desmopressin/platelets for surgery coverage.
- Granulocytes >2x10⁹/litre indicates normal management.
Summary
- Basic types of chemotherapy and radiotherapy are used in dental treatment.
- Potential complications can be local or general.
- Dentistry plays a central role in managing head and neck cancer.
- The impact of chemotherapy on blood count should be considered.
- It is important to optimise dental treatment before chemotherapy/radiotherapy is started.
- Liaison with MDT is important to treatment success.
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