How do you manage the thickened secretions secondary to xerostomia during head and neck radiation?
Answer from: Radiation Oncologist at Academic Institution
I find that the management of acute effects of RT for H&N treatment is somewhat of a dark art. What works for one patient may not work for another. The thickened secretions are from acute irritation of the salivary glands and not so much from "xerostomia" during the acute phase of RT. For thicke...
Comments
Radiation Oncologist at University of Missouri at Columbia, Ellis Fischel Cancer Cener Agree that there is no one approach, and a trial o...
Radiation Oncologist at AV Strauss MD I have found that regular use of deeply breathed i...
Medical Oncologist at UNMH Does anyone have experience with Amifostine for ra...
Radiation Oncologist at Baylor Scott & White Health For pilocarpine, double check they don't have narr...
Radiation Oncologist at Rush University Medical Center @Michal J. Wolski, 100%!!
@Tripti Chopade, by the...
Answer from: Radiation Oncologist at Community Practice
Agree with @Daniel W. Golden that there is a paucity of evidence based interventions and a lot of "hit or miss" interventions. There are 2 related side effects for patients - one is xerostomia, and the other is that patients feel like they have "a lot of phlegm in the throat." I agree with salt and ...
Comments
Radiation Oncologist at Northeast Georgia Medical Center In addition to all mentioned, I will add using a b...
Radiation Oncologist at Rush University Medical Center Great point, @Jack T. Griffeth!
Radiation Oncologist at Vice Chair, Northside Hospital Cancer Institute Agree!
Answer from: Radiation Oncologist at Community Practice
Some additional options to those already mentioned that work nicely:
Tussionex
Drink club soda or papaya juice
Drink a solution made with a meat tenderizer (add ¼ teaspoon tenderizer to 1 cup of liquid)
Answer from: Radiation Oncologist at Academic Institution
I agree with all of the above. I will note that the "phlegm" is particularly bad for patients who have a significant 70 Gy volume in the posterior pharyngeal wall, especially large OPX and NPX tumors, as the fourth major salivary gland is actually embedded in the lower posterior NPX and makes a secr...
Answer from: Radiation Oncologist at Community Practice
Despite IMRT, with more but even without chemo (platinoid) most vexing, variable, and problematic issue in H&N. The dysfunctional gooey saliva needs expectoration, swallowed worsens n&v, appetite, and taste loss. I prefer H2O2 or anything that bubbles, but some like NaCl/H2O: whatever works&...
Answer from: Medical Oncologist at Community Practice
The take-home message is that a strategy that works for one may not work for the other. I provide them the resources that include all that has been mentioned here and also tell them to experiment strategies on their own (after discussing with the clinical team). I avoid prescribing medications since...
Agree that there is no one approach, and a trial o...
I have found that regular use of deeply breathed i...
Does anyone have experience with Amifostine for ra...
For pilocarpine, double check they don't have narr...
@Michal J. Wolski, 100%!! @Tripti Chopade, by the...