Radiation Induced Xerostomia (Dry Mouth)

Acupuncture Can Help

Radiation induced xerostomia is a common side effect 
experienced from radiation therapy to the head and neck region.   

Radiation treatments are often given as a therapy for cancers involving the oral cavity, pharynx, larynx, paranasal sinuses, nasal cavity and salivary glands. 

Patients who receive radiation to the head and neck may experience redness, irritation, and sores in the mouth; a dry mouth or thickened saliva; difficulty in swallowing; changes in taste; or nausea. (1)

Why is dry mouth a problem?
Besides causing the aggravating symptoms mentioned above, dry mouth also increases a person's risk of gingivitis, tooth  decay and mouth infections such as thrush. (2) Irritation to the mouth and thick saliva contribute to difficulty eating which often affects proper nutrition and dietary intake needed to maintain good quality health and healing.

Treatment
Acupuncture is a viable option for prevention and treatment of radiation induced xerostomia. There are several studies showing support for the use of acupuncture to help stimulate the salivary glands in the production of saliva (see below). Most recently however, MD Anderson Cancer Institute along with Fudan University in Shanghai Cancer Center completed a study using acupuncture as a preventative therapy for dry mouth finding there is benefit in using it before symptoms present themselves from radiation therapy.

86 patients with nasopharyngeal carcinoma were treated in the study. Forty patients were randomized to acupuncture and 46 to the standard of care. Those in the treatment arm received acupuncture therapy three times per week during the seven-week course of radiotherapy. Patients were evaluated before radiotherapy, weekly during radiotherapy, and then again one and six months later. The results were based on data derived from two self-report questionnaires and measuring actual saliva flow. Patients completed the Xerostomia Questionnaire (XQ), an eight-item survey which assessed symptoms consistent with the condition.  XQ scores under 30 corresponded to mild or no symptoms of xerostomia. (3) 

The largest group differences in XQ scores were seen by the end of radiotherapy, but the differences persisted over time.  By one month after the end of radiotherapy, 54.3 percent of the acupuncture group reported XQ scores greater than 30, compared to the control group at 86.1 percent. By six months after radiotherapy, the numbers dropped to 24.1 percent in the acupuncture group and 63.6 percent of the control group still reporting symptoms of xerostomia.  Saliva flow rates were also greater in the acupuncture group, starting at three weeks into radiotherapy and persisting through the one and six month follow-up. (3) 

The second measure, MD Anderson Symptom Inventory Head and Neck (MDASI-HN), ranked the severity of cancer-related symptoms, other than xerostomia, and their interference with quality of life. The team also measured saliva flow rates using standardized sialometry collection techniques. (3)

Watch this video discussing how acupuncture works in xerostomia.
http://www3.mdanderson.org/streams/CompactVideoPlayer2.cfm?xml=cfg/Acupuncture-Study-2011--cfg

Supporting research on acupuncture and xerostomia:
1. http://www.ncbi.nlm.nih.gov/pubmed/22072272
2. http://www.ncbi.nlm.nih.gov/pubmed/18532895
3. http://www.ncbi.nlm.nih.gov/pubmed/11920486
4. http://www.ncbi.nlm.nih.gov/pubmed/10673783

For additional tips to support dry mouth go to:
http://www.mayoclinic.com/health/dry-mouth/AN02112

References:
1. http://www.cancer.gov/cancertopics/factsheet/Sites-Types/head-and-neck
2. http://www.webmd.com/oral-health/guide/dental-health-dry-mouth
3. http://www.mdanderson.org/newsroom/news-releases/2011/ut-md-anderson-study-finds-acupuncture-can-prevent-radiation-induced-chronic-dry-mouth.html

Image courtesy of http://www.intelligentdental.com/wp-content/uploads/2011/10/dry-tongue.jpg