Radiation treatments have helped save the lives of many cancer patients, but they have side effects.
Depending on the type of cancer that a patient has and the doses of radiation from the linear accelerators, the side effects vary.
For patients with head and neck cancers (inside the mouth, the nose and throat), doctors radiate the whole neck and jaw area because the disease may spread to the lymph nodes.
Dr Vijayakumar Narayanan, a consultant oncologist at Cancer Care Kenya, says after radiotherapy - which may involve 35 sessions - these patients experience dryness of the mouth, impaired hearing, difficulty in swallowing, involuntary mucus discharge, swelling and inflammation of the throat.
This dark side of radiotherapy piles stigma and agony on patients already suffering psychologically. But not all get severe side effects.
Dr Vijay says, if a patient knows what to expect, it becomes easier to manage the pain and one does not have to run to hospital unnecessarily.
“Some patients with head and neck cancers may have severe side-effects, especially those who smoke,” he says, adding that tobacco and alcohol intake during treatment impairs healing.
Of all the new cancers diagnosed in Kenya, 11 per cent (about 3,300 cases) are those affecting the head and neck, according to Ministry of Health statistics. These cancers affect people of all ages and attack the nasal cavity, salivary glands, tongue, sinuses, oral cavity and pharynx.
Patients with nasopharyngeal cancer, a rare type of head and neck cancer, which affects the area behind the nose, may lose their salivary glands especially if treated with high doses of radiation.
“Some hospitals don’t focus on saving the salivary glands especially those treating patients with old technologies,’’ Dr Vijay said.
But if a patient stops producing saliva, he can use artificial saliva sprays bought in pharmacies. Others produce very thick saliva that chokes. The glands may heal after two to three years and start producing saliva.
Saliva is important because it acts as an antibacterial and antiseptic, protecting one from having bad breath. To stimulate saliva production, chew sugarless gum and to avoid bad breath keep sipping water.
After three to six months of radiation, the jaws may lock and become painful. Exercising them daily or chewing rubber helps them move without so much pain. Avoid using toothpicks as they injure the weak gums, instead use ice chips to ease the pain.
“Brush the teeth using a paediatric toothbrush which is soft and Sensodyne toothpaste, which is not harsh. If you cannot afford a mouthwash, mix salt and baking powder in water and gurgle it often,’’ Dr Vijay says, adding that a patient should never remove his or her teeth because the wound will not heal.
Also remove dentures and any tooth filings during treatment.
Eat a balanced diet, which can include meat and an occasional glass of red wine to boost appetite. Avoid carbonated drinks, crisps and sugary foods.
But the doctor advises patients diagnosed with colon cancer to get rid of meat and dairy products from their diet.
Some chemotherapy treatments impair hearing.
“Unfortunately, hearing loss after treatment is not reversible. As a care-giver, if you notice that a patient cannot hear properly, don’t shout. It irritates the patient. Go near them and talk,” Dr Vijay says.