Oral symptoms in patients with advanced cancer: an observational study using a novel oral symptom assessment scale

Oral symptom assessment tools in patients with advanced cancer: a scoping review

“…The number of oral symptoms assessed in each study varied from two [ 22 , 23 ] to 20 [ 3 , 36 ]. Xerostomia (“dry mouth”) was universally assessed, which is unsurprising as studies in patients with advanced cancer demonstrate a very high prevalence (i.e.…”

“…Xerostomia (“dry mouth”) was universally assessed, which is unsurprising as studies in patients with advanced cancer demonstrate a very high prevalence (i.e. 82–83.5%) [ 3 , 36 , 37 ]. Other commonly assessed symptoms included oral discomfort (18/18 studies), taste disturbance (15/18 studies), and denture problems (8/18 studies) (see Table 1 ).…”

“…The OHIP is a validated assessment tool that measures “the social impact of oral disorders”. The protocol paper states that the OHIP-14 (14 questions) would be used [ 33 ] but the main paper suggests that the OHIP-49 (49 questions) was used [ 31 ] Hjermstad et al, 2016 [ 34 ] Observational 12 “Pain in your gums”; “problems with bleeding gums”; “lip sores”; “problems with your teeth”; “soreness in your mouth”; “sores in the corners of your mouth”; “dry mouth”; “sticky saliva”; “mouth been sensitive to food and drink”; “food and drink tasted different than usual”; “problems eating solid foods”; “problems with an ill-fitting denture” Presence/absence “Extent to which you have experienced these symptoms”—not at all, a little, quite a bit, very much Previous week Validation study—EORTC QLQ-OH17 (leading to EORTC QLQ-OH15) Magnani et al, 2019 [ 35 ] Interventional – oral care regimen 3 “Xerostomia/dry mouth”; “dysgeusia”; “orofacial pain” Presence/absence Intensity—numerical rating scale 0–10 (low–high) Not described (but assessments performed on day 1, and day 3) Non validated questionnaire Davies et al, 2021 [ 3 , 36 ] Observational 20 (with option to report additional oral symptoms) “Dry mouth”; “mouth discomfort/pain”; “lip discomfort”; “cracking of lips”; “cracking of corner of mouth”; “taste disturbance”; “difficulty chewing”; “difficulty swallow-ing”; “difficulty speaking”; “‘dirty’ mouth”; “coating of tongue”; “bad breath”; “toothache/pain in teeth”; “sensitivity of teeth”; “jagged teeth”; “denture fitting problems”; “bleeding from mouth”; “burning sensation in mouth”; “altered sensation in mouth”; “ulcers in mouth” Presence/absence Frequency—rarely, occasionally, frequently, almost constantly Intensity—slight, moderate, severe, very severe Amount of distress caused—not at all, a little bit, somewhat, quite a bit, very much Previous week Oral Symptom Assessment Scale/OSAS Initial validation of OSAS undertaken as part of this study …”

“…Patients with advanced cancer experience a range of different symptoms, including a variety of different oral symptoms [ 2 ]. Thus, Davies et al [ 3 ] reported that 97.5% of participants in their multicentre study experienced at least one oral symptom, and that the median number of oral symptoms experienced was five (range 1–18). Moreover, many of these oral symptoms had a high frequency and a high intensity, and were associated with significant distress/ “bothersomeness” (and negative impact on quality of life).…”

“…Moreover, many of these oral symptoms had a high frequency and a high intensity, and were associated with significant distress/ “bothersomeness” (and negative impact on quality of life). For example, 79.6% of participants experienced xerostomia/dry mouth, and this was the third most common symptom overall (after “lack of energy” and “feeling drowsy”) [ 3 ].…”