Patients with oral and oropharyngeal cancer face significant challenges whilst undergoing treatment for cancer. Some of the common difficulties faced by patients due to cancer treatment include coping with the treatment of cancer, emotional and mental aspects of cancer treatment, the financial burden of cancer treatment, and changes in eating habits.
The side effects of treatment increase sufferings in people with oral cancer. Among the various physical complaints of patients, the most common are pain, dry mouth, sticky saliva, and problems with eating and speech. In addition to physical pain, deformities caused by major surgeries performed to control diseases cause psychological stress to patients1.
Coping with oral and oropharyngeal cancer treatment
Each oral cancer treatment option has a number of common physical side effects. People with oral cancer have often described the burden of cancer as a cumulative effect on emotional well-being and health.
They often report oral pain that makes them disabled. Many of them regularly use morphine for pain relief. In addition to pain in the mouth and jaw, there is difficulty swallowing and pain in the mouth. Also, many patients complain of loss of smell after surgery. Facial deformities have been a serious problem for patients of all ages and genders undergoing surgery. Many of them always keep their face concealed, even at home. In addition to facial deformities, hair loss due to chemotherapy and scars on the face and neck were also common. Radiation darkened the patient’s skin, which is also a problem for women with buccal mucosal cancer1.
The side effects of chemotherapy can cause a number of psychological and physical problems, such as pain from newly diagnosed cancer, a decline in the patient’s physical and role functions, and increased depression. Many participants who had difficulty adhering to cancer treatment reported increased pain and treatment fatigue over time, including taking part in daily treatment, maintaining treatment adherence, and side effects of treatment. The side effects of cancer treatment are the most common cause of suffering and a significant contributor to non-compliance with cancer treatment. All cancer survivors live with the fear that cancer may recur or spread (metastasis). Some may also develop secondary cancer. Regular monitoring, screening and reporting of symptoms to the doctor can help detect new or metastatic cancer at an early stage. Chemotherapeutic drugs and radiation therapy may increase the risk for long-term dental problems, hypothyroidism, infertility, organ damage, neuropathy, osteoporosis and diabetes. Cancer treatment may lead to comorbidities associated with endocrine changes such as Decreased sex drive, Memory loss, Anemia, Decreased muscle mass, Depression, Weight gain, Loss of body hair2.
Coping with Mental/Emotional side effects of oral and oropharyngeal cancer
People diagnosed with oral cancer can have social and emotional consequences after being diagnosed with cancer. This can include overcoming various emotions, such as anxiety, depression, anger, or managing stress levels. Sometimes it is difficult for patients to express their feelings toward a loved one. Some people have found that talking to an oncology counsellor, social worker, or member of the clergy can help them develop more effective coping with cancer. Many patients try to avoid disclosing information about their illness to loved ones in order to save them from emotional stress1.
The most common emotional problems that cancer patients may experience include fear of recurrence of cancer, depression and grief due to cancer and its treatment, social stigma due to deformities, amputations, or significant changes in body function.
Coping with the financial burden of oral and oropharyngeal cancer
“Financial toxicity” has become a well-known term in the discussion of cancer drugs and treatment. Basic medical insurance plans do not cover most cancer treatments in the USA, and therefore, patients have to suffer extremely high OOP payments. In recent decades, the rising medication prices, health insurance costs, and other disease management expenses of cancer treatment have been a rising problem for cancer patients and their family members.
Coping with changes in eating habits
Oral cancer patients are also worried that they might not be able to eat properly. In addition to increasing the cosmetic importance of the face, the mouth and oral cavity are also associated with many important functions such as chewing, eating, speaking, and swallowing. Oral cancer patients who have undergone surgery have a significant functional impairment. They become uncomfortable because they cannot eat normally. As a result, many people avoid community activities and live mostly indoors. Difficulty in eating can be caused by pain in the mouth or jaw or tightness in the mouth due to fibrosis after radiation or surgery1.
- 1.Goswami S, Gupta S. How Patients of Oral Cancer Cope Up with Impact of the Disease? A Qualitative Study in Central India. Indian J Palliat Care. 2019;25(1):103-109. doi:10.4103/IJPC.IJPC_118_18
- 2.Zizinia S. Life After Cancer. Social & Emotional Impacts of Cancer. Life After Cancer. Social & Emotional Impacts of Cancer. Published 2022. Accessed March 2022. https://www.mdanderson.org/patients-family/life-after-cancer/social-emotional-impacts.html