A Correlational Study on Taste Alterations and Quality of Life Among Cancer Patients

Introduction One of the major problems faced by the world today is cancer. Cancer is an abnormal growth of cells. Chemotherapy, surgery, and radiation therapy are the treatment regimen for cancer. Prolonged use of chemotherapy drugs can cause different side effects such as alopecia, weight loss, sexual dysfunction, mood swings, and the most important one is taste alterations. The aim of the study is to determine the taste alterations (TAs) and quality of life (QOL) among cancer patients who have undergone three cycles of chemotherapy. Methods The approach used is descriptive survey design. The sample comprised 62 cancer patients selected by convenient sampling. The tool used was baseline proforma, University of Washington Quality of Life (UW-QOL) questionnaire version 4.1, chemotherapy-induced taste alteration scale (CiTAS). Results The majority of the patients belonged to the age group of 41 to 50 years (37.09%) among whom 40% were females. The majority of the patients were not diagnosed with any other disease (91.9%). Around 80.6% of patients reported to have sore mouth, out of whom 45.2% maintained oral care by brushing teeth. The most commonly seen type of tumor was head and neck (37.1%) whereas the tumor type genitourinary was the least seen (3.2%). The majority of the patients had stage II cancer (53.2%) and about 62% of them did not have metastasis. There is significant association with selected demographic variables and QOL (sore mouth, oral care, and tumor type). There is also a significant association with selected demographic variable and TAs, (oral care and tumor type) and there is a negative correlation between TAs and QOL. Conclusion Identification of the severity of TA helps in providing alternative measures to improve the taste buds which may help in improving the QOL.

Full Mouth Oral Rehabilitation by Maxillary Implant Supported Hybrid Denture Employing a Fiber Reinforced Material Instead of Conventional PMMA

Many people have life-long problems with their dentures, such as difficulties with speaking and eating, loose denture, and sore mouth syndrome. The evolution of dental implant supported prosthesis gives these patients normal healthy life for their functional and esthetic advantages. This case report presents the fabrication of maxillary implant supported hybrid prosthesis by using Nanofilled Composite (NFC) material in teeth construction to rehabilitate a complete denture wearer patient.

Ulkus Aftosa Kompleks Manifestasi Penyakit Crohn

Latar Belakang: Ulkus aftosa kompleks mengacu pada ulkus mulut kronis berkaitan dengan gangguan sistemik. Kondisi tersebut, selain menimbulkan rasa sakit dan gangguan fungsi, dapat memperburuk kualitas hidup penderitanya. Tujuan: penulisan ini bertujuan untuk melaporkan keterkaitan antara ulkus aftosa kompleks dengan gangguan gastrointestinal, yaitu penyakit crohn. Kasus dan penanganannya: laki-laki 73 tahun mengeluhkan nyeri mulut sejak 3 bulan lalu, yang disertai dengan perut sebah, kembung dan terkadang nyeri ringan disertai dengan sakit kepala. Saat pemeriksaan, tampak adanya ulkus dengan dasar bergranuler, tepi sedikit meninggi dan tertutup lapisan putih pada mukosa lipatan mukobukal, pipi, dasar mulut dan palatum. Permukaan mukosa bibir dan pipi memberikan gambaran seperti batu bata (cobblestoning). Mengacu pada gejala dan temuan klinis, ditegakkan diagnosis kerja ulkus aftosa kompleks manifestasi gangguan gastrointestinal, susprk penyakit crohn. Terapi awal berupa kombinasi spiramycin-metronidazole, methyl-prednisolone, parasetamol dan larutan kumur perhidrol. Satu minggu kemudian, tampak adanya perbaikan lesi dan aktifitas fungsional. Berdasarkan pemerikasaan dari poli penyakit dalam Rumah Sakit Umum Sardjito (RSS), pasien mendapatkan medikasi lanzoprazole, ulsidex dan enzyplex. Terapi lanjutan berupa methyl-prednisolone dengan dosis tapering, anti jamur topical nistatin untuk mencegah infeksi ikutan dan larutan kumur yeng mengandung Benzydamine HCI untuk mengurangi nyeri. Kesimpulan: Ulkus mulut manifestasi penyakit Chohn mempunyai karakteristik unik dan dapat dibedakan dari ulkus mulut kronis lainnya. Dalam penegakan diagnosis ulkus aftosa kompleks, identifikasi etiologi gangguan sistemik yang tepat akan sangat membantu dalam menetapkan perawatan lesi mulut yang sesuai. Background: complex aphthous refers to chronic oral ulceration, which is related to systemic diseases. This condition can cause oral discomfort, alter the normal oral function anf eventually can decrease the quality of life. Purpose: this paper is intended to report the relationship between complex aphthous with gastrointestinal disorder, in particular crohn’s disease. Case and management: A73 year old man complaint a chronic sore mouth since 3 months ago. Abdominal discomfort, mild indigestion and headache occur accompanied by oral symptoms. Clinically, there were multiple ulcers with granular base, slightindurate border covered with white thick layers at mucobuccal fold, buccal, floor of the mouth and palate mucosa. Labial and buccal mucosa demonstrates a cobblestoning appearance. According to systemic symptoms and oral findings, complex aphthous as manifestation of gastrointestinal diseases, specifically suspected to Crohn’s diseases, is accepted as working diagnosis. Spiramycin combined with Metronidazole, Methyl-prednisolone, Paracetamol and perhidrol mouthwash were given as initial therapy. One week later, it seems some improvement on oral lesion and oral functional activity. From internal Medicine Clinic, Sardjito General Hospital, patient received Lanzoprazole, Ulsidex and Enzyplex. Tapering doses of methyl-prednisolone and oral fungal topical Nystatin for prevention from secondary infection were given as subsequent therapy. Benzydamine mouthwash was given for alleviate sore mouth. Conclusion: Complexs apthous ulcers as manifestation of crohn’s disease have a unique characteristic and quite discriminate to other chronic oral ulceration. In establishing the diagnosis of complex aphthous., the identification of proper etiology would help in determining the appropriate management of the oral lesion.

Longitudinal relationship between inflammatory markers and patient-reported symptom severity during induction therapy for multiple myeloma.

9083 Background: Multiple myeloma (MM) patients undergoing induction therapy experience both disease- and therapy-related symptoms. We investigated the association between the trajectory of symptom severity and changes in levels of inflammatory markers. Methods: MM patients (N=62) rated symptoms via the M. D. Anderson Symptom Inventory (MDASI) twice a week during induction therapy. Patients contributed serum samples before the start of every chemotherapy cycle. A panel of pro- and anti-inflammatory cytokines and markers was evaluated by Luminex. Ordinal regression analyses were used to describe the relationship between cytokines and symptom outcomes across time. These analyses were adjusted for patient and clinical factors (age, sex, diabetes diagnosis, anemia, BMI, comorbidity, staging, ECOG PS, prior treatment status, tumor response, opioid use, and chemo regimen). Results: Bortezomib-based induction therapy was received by 89% of the sample. Fatigue was persistently the most severe symptom during induction therapy, followed by disturbed sleep, muscle weakness, pain, drowsiness, and bone aches. Numbness, which is representative of chemotherapy-induced peripheral neuropathy, significantly worsened from baseline (p=0.01). We observed significant longitudinal associations between sIL-1R1 and distress and sadness (both p=0.02); between sIL-6R and disturbed sleep (p=0.001), poor appetite (p=0.04), and sore mouth (p=0.006). IL-6 was significantly associated with pain, fatigue, nausea, and sore mouth (all p<.05). A negative association between sTNF-RII and pain, sleep, distress, remembering, poor appetite, and nausea (all p<0.05) was also observed. MCP-1 was positively associated with numbness (p=0.04); while MIP-1α was negatively associated with sleep, numbness, constipation, poor attention (all p<0.01), and bone aches (p=0.0006). IL-10 was negatively associated with mood interference (p=0.04). Conclusions: Frequent assessment can document the longitudinal course of multiple symptoms during induction and provides opportunity to evaluate systemic inflammation as a potential source of symptom burden during induction therapy for MM.

The Longitudinal Relationship Between Inflammatory Markers and Patient-Reported Symptom Severity During Induction Therapy for Multiple Myeloma

Abstract 4920 Background: Patients with multiple myeloma (MM) undergoing induction therapy experience both disease- and therapy-related symptoms. This longitudinal study investigated the association between the trajectory of symptom severity and changes in levels of inflammatory markers. Methods: Patients with MM repeatedly rated symptoms via the M. D. Anderson Symptom Inventory (MDASI) during induction therapy. Patients contributed serum samples before start of every cycle of chemotherapy. A panel of cytokines, including interleukin (IL)-6, soluble IL-6 receptor (sIL-6R), soluble IL-1 receptor type 1 (sIL-1R1), soluble tumor necrosis factor receptor type 2 (sTNF-R2), monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1 alpha (MIP-1A), and IL-10, was examined by Luminex method. Ordinal regression analyses were used to describe the interaction of cytokines and symptom outcomes across time, adjusted for patient and clinical factors of age, sex, diabetes diagnosis, anemia, body mass index, co-morbidities, tumor stage, Eastern Cooperative Oncology Group performance status (ECOG PS), prior treatment status, tumor response, opioid use, and chemotherapy regimen. Results: Sixty-two patients were enrolled on study; of these, 89% received bortezomib-based induction therapy. During induction, the most severe patient-reported symptoms were (in order of severity): fatigue, muscle weakness, disturbed sleep, pain, drowsiness, bone aches, and numbness. Fatigue was persistently the most severe symptom, while therapy-induced neuropathy (MDASI numbness item) increased significantly from baseline (P=.01). We observed significant longitudinal associations between sIL-1R1 and distress and sadness (both P=.02); between sIL-6R and disturbed sleep (P=.001), poor appetite (P=.04), and sore mouth (P=.006); between IL-6 and pain, fatigue, nausea, and sore mouth (all P<.05); and negative associations between sTNF-R2 and pain, sleep, distress, difficulty remembering, lack of appetite, and nausea (all P<.05). MCP-1 was positively associated with numbness (P=.04). MIP-1A was negatively associated with disturbed sleep, numbness, constipation, difficulty paying attention (all P<.01), and bone aches (P=.0006). IL-10 was negatively associated with mood interference (P=.04). Discussion: Frequent assessment documented the longitudinal course of multiple symptoms during the induction period, providing an opportunity to evaluate potential changes in inflammation as one source of symptom distress. Our preliminary study suggests a network of pro- and anti-inflammatory cytokines relevant to symptom expression during induction. The results warrant further basic and translational studies to confirm the role of inflammation in the development of symptoms during treatment. Such information may suggest methods of effective symptom management and identify potential biomarkers for patients at high risk of symptom burden during treatment for multiple myeloma. Disclosures: No relevant conflicts of interest to declare.