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Letter to the Editor
Editor, – I found the article on xerostomia (Aust Prescr 2006;29:97-8) to be both timely and informative. As a dentist I have experience in the UK, South Africa and the USA helping patients deal with the problems they experience post-radiotherapy for head and neck cancers.
When I attempt to discuss these issues with my Australian medical colleagues, they commonly reply that no patients experience any problems. This is in contrast to my own records which agree with the figure that 90% of patients suffer problems after radiotherapy.
There are as Professor Olver suggested a number of options being investigated to treat xerostomia. Amifostine is of benefit, but there are problems with the high incidence of nausea associated with its use (50%). The use of antioxidants is currently being investigated by the National Cancer Institute in the USA. Two forms of nitroxide are currently being examined. These are not approved by the US Food and Drug Administration for clinical use, other than for topical use to prevent hair loss and for a number of ophthalmic conditions.
I have had some success in prevention of xerostomia by employing intra-oral screens and other available antioxidants which are currently approved as dietary supplements. This is of course anecdotal and not scientifically proven but better to accept that a problem exists than to be in denial.
- Cotrim AP, Sowers AL, Lodde BM, Vitolo JM, Kingman A, Russo A, et al. Kinetics of tempol for prevention of xerostomia following head and neck irradiation in a mouse model. Clin Cancer Res 2005;11:7564-8.