Acupuncture to treat dry mouth in cancer patients

Cancer patients are subject to both the unpleasantness of the disease itself and the treatment administered to cure it. Cancer therapies like chemo- and radiotherapy are notorious for their severe side effects, and an important part of cancer care is managing these unwanted adverse effects and improving the quality of life of cancer patients.

In this article we look at a particular side effect that commonly affects cancer patients, and how it can be addressed using acupuncture.

Why do cancer patients suffer from dry mouth?

Because cancer cells are not, from a treatment point of view, vastly different from the healthy cells around them, cancer therapies are usually quite aggressive and can damage healthy tissues despite our best efforts not to do so. This is responsible for the severity of the side effects following cancer therapy.

Dryness in the mouth is a relatively common side effect of cancer treatment, and can be caused by a number of different approaches to cancer therapy. The most common cause is perhaps the use of radiotherapy to treat cancers in the head and neck region.

Radiotherapy is the use of radiation to kill off cancer cells, and this treatment, whilst effective (particularly in conjunction with pharmaceutical and surgical approaches), is associated with some severe side effects including a loss of cells in the bone marrow and severe nausea.

Radiotherapy can damage salivary glands, structures responsible for the release of saliva into the mouth which keeps it moist and healthy. Damage to these glands impairs the production of saliva, and will often cause chronic dry mouth that will take several months to improve.

Dry mouth is also caused on a more temporary basis by a range of different drugs and chemical agents. Morphine, a strong painkiller often used to help cancer patients, is a good example as dryness of mouth is one of its characteristic side effects. Certain anti-emetics (drugs that combat nausea and vomiting), anti-depressants, and blood pressure medications are also known for causing dry mouth.

People suffering from lung cancers are particularly vulnerable to breathing through their mouth, which can cause dryness over time. Lung cancers often lave sufferers with difficulty in getting enough oxygen to their lungs, and many will compensate for this by breathing heavily through the mouth. In many cases an oxygen mask is provided to provide sufferers with the necessary oxygen, however breathing oxygen through a facemask can dry out a mouth quite quickly.

Dehydration, the lack of enough fluid in your body, presents with dry mouth as one of its first symptoms. Cancer patients are susceptible to dehydration because many chemotherapies can cause severe vomiting and diarrhoea, both processes which result in the loss of a great deal of fluid. Moreover when we vomit stomach acid is drawn up into the mouth, which causes further dryness to exacerbate any existing dehydration. Dry mouth in this case is a sign of a more serious problem, as long term dehydration disrupts many of the body’s normal functions and can be detrimental to good health.

How is dry mouth usually dealt with?

There are a number of standard approaches that have been developed to remedy dry mouth. When these fail then complementary therapies like acupuncture are often sought.

Certain drugs can stimulate the production of saliva, which is useful if your salivary glands have been damaged through radiotherapy. These drugs (bethanechol and pilocarpine) have a number of side effects like blurred vision and nausea, which means that they aren’t the best option for treating dry mouth. Other methods of stimulating saliva production include chewing mints or gum, these are perhaps a better option because they do not cause any side effects.

Artificial saliva is available if you are unable to produce any of the substance at all. There are various types of saliva which are quite useful, however some make use of pork products which might not be suitable to people of certain religions.

There are a fairly limited number of strategies available for the management of dry mouth, and as such alternatives are often sought. In the following section we look at whether acupuncture can offer a viable method of managing dry mouth.

How can acupuncture help dry mouth in cancer patients?

A review of the research to date published in 2010 suggested that acupuncture can help reduce dry mouth. This review did suggest, as many other reviews concerning acupuncture often do, that much more research is needed before this can be stated with any degree of conclusiveness.

Thus far however, it would seem that acupuncture can help reduce dry mouth in cancer patients, particularly when conventional remedies like drug treatments have failed. People respond very differently to therapies, and having alternatives to standard treatment is an invaluable asset, particularly in the treatment of conditions as complex as cancer.

The acupuncture treatment will most likely be performed using the conventional acupunctural technique of stimulating recovery through the placement of needles into specific acupoints. At present there are two separate philosophies with regards to how acupuncture works. The first is the traditional Chinese philosophy that developed the practice, which believes in the presence of an energy called Qi which travels through the body by means of specialised vessels called meridians. Acupuncture was first devised as a method by which healthy Qi flow through meridians can be restored, and through that, good health.

The second is a modern medical interpretation of the effects of acupuncture that argues that needling stimulates nerves and muscles, particularly to release natural painkilling neurotransmitters. Some sources suggest that acupuncture can also stimulate blood flow, and through that, the healing process.

Thus far no clear mechanism of acupuncture’s actions has been determined, however research into its effectiveness, as in the case of dry mouth, has proven promising, if not conclusive.

Acupuncture shouldn’t be used as a replacement for the medical care offered by doctors and nurses. It is most effective as a complementary therapy applied in conjunction with other methods of care.

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