All treatments have possible side effects. Researchers are looking at ways to relieve these side effects. And how they can best support people with mouth and oropharyngeal cancer. 

Dry mouth

Radiotherapy to the mouth and oropharynx can cause a dry mouth (xerostomia). This happens because radiotherapy affects the glands that make saliva and keep your mouth moist. You may make less saliva than usual, or none at all. 

Having a dry mouth can make chewing, swallowing and talking difficult. So doctors are looking into new ways to prevent a dry mouth.

These include:

• drugs
• medical devices to stimulate the gums to increase the amount of saliva
• acupuncture

Pain after surgery

Some people have surgery to remove their lymph nodes (neck dissection) and the surgeon may also remove the accessory nerve. This nerve controls shoulder movement. So surgery can leave your shoulder and neck stiff and painful. 

Researchers are looking into acupuncture to see if it can help with this pain. It uses fine needles which are put under the skin at particular points called acupuncture points.

Lymphoedema

Surgery to your neck can cause swelling because of a build up of lymph fluid in the body. This can happen when the lymph nodes that usually drain the fluid are removed or damaged. This swelling is called lymphoedema.

Some researchers are looking at acupuncture and moxibustion to help with lymphoedema. It uses a dried herb called mugwort rolled into a stick. The practitioner holds the lit stick over the acupuncture points to warm them. 

The researchers concluded that acupuncture and moxibustion is safe for people with lymphoedema, especially when needles are not put into the area affected by lymphoedema. They suggest more research is needed to see how much it could help to improve symptoms. 

Preventing bone damage

Rarely, radiotherapy to the head and neck area can damage the jaw bone. This damage is called osteoradionecrosis. The problem develops because the blood supply to the area is reduced.

Doctors think that a high pressure oxygen therapy called hyperbaric oxygen (HBO) may be able to prevent or treat this side effect. The idea is that HBO works by increasing the supply of blood to the jaw. 

Researchers are looking at HBO therapy to prevent jaw problems in people having dental or jaw surgery after radiotherapy. They are also looking at whether HBO can help the jaw bone heal after surgery to remove a damaged jaw bone. 

Sore mouth

Radiotherapy for head and neck cancers can cause painful sores and ulcers in the mouth. This is called oral mucositis. 

Doctors are looking at a new treatment for oral mucositis called low level laser therapy. They shine a weak laser light on the lining of the mouth to see if it:

• reduces pain during and after radiotherapy 
• helps heal the mouth after treatment 

Taste changes

Your sense of taste can change after treatment for head and neck cancer. Researchers think that hypnosis might be able to help you manage these changes in taste. 

Hypnosis puts you in a state where your body is deeply relaxed and your mind is active. It can change your thoughts, feeling and behaviour by making suggestions that focus on a particular image or idea. 

Head and neck cancer services

Services for people with head and neck cancers including mouth and oropharyngeal cancer are now offered at fewer larger centres. The head and neck 5000 study aims to ask 5000 people how well these services work for them. This study has now closed and we are waiting for results. 

Support

Doctors want to find out how they can improve support for people with head and neck cancers. To do this, researchers are asking patients to fill in a questionnaire to identify things that concern them. This is called a holistic needs assessment. 

You then discuss your concerns with a doctor who can provide appropriate guidance and information. Although you don't have any direct benefit from taking part in the study, doctors hope it will help them support patients and improve care in the future.