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#108689 12-12-2009 05:48 PM
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Hi folks

I have a very dry mouth (salivary glands radiated) but through regular dentist visits, daily fluoride treatments etc have been able to keep my teeth healthy.

They do discolour easily though and I wondered if other members have a magic cure for that. I clean with Biotene and treat with gel-kam after my coffee in the morning and they feel and look clean and white but after a couple of hours they become discoloured even though I drink water constantly.

Season's greetings and love from Helen



RHTonsil SCC Stage IV tx completed May 03
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As you know I had no radiation but hope someone here will come up with that magic cure. Having said that I do not think my teeth are looking as bright (would not call it white) as they should and will take it up with my dentist next visit wink
Love
Gabriele


History Leukoplakia bx 8/2006 SCC floor mouth T3N0M0- Verrucous Carcinoma.
14 hour 0p SCC-Right ND/excision/marginal mandibulectomy 9/2006, 4 teeth removed, flap from wrist, trach-ng 6 days- no chemo/rad.
6 ops and debulking (flap/tongue join) + bx's 2006-2012.
bx Jan 2012 Hyperkeratosis-Epithelial Dysplasia
24cm GIST tumour removed 8/2013. Indefinite Oral Chemo.

1/31/16 passed away peacefully surrounded by family

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Unfortunately, I can't help with the dry mouth, because I suffer from that myself and besides the biotene spray nothing else seems to work very well for me.

I use Gel-Kam regularly on all of my top remaining teeth. After continual use of Gel-kam a side effect of it is that it discolors teeth and the stains can only be removed by a clean from the dentist. I get my teeth professionally cleaned now every 2 months, and that removes any discoloration or stains from that treatment.

Karen


Last edited by Karen Rose; 12-12-2009 09:06 PM. Reason: typo

46 yrs:
Apr 07-SCC 80% entire tongue removed,T4N1M0
Neck/D,Jaw Split, Trache 2 ops,PEG 3.5yrs
30 x rad,6 x Cisplatin,
30 x HBO
Apr'08- flap Recon + ORN Mandibulectomy
(hip bone to reconstruct jaw)
Oct'08 1 Plate out-jaw
Mar'09 Debulk flap
Sep'09/Jan&Nov'10/Feb&Jun'11/Jan&Jul'12/Oct'13/April'14-More surgery
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That is interesting, Karen. I didn't know about the gel-kam side effect. I have been using is daily for nearly 7 years. At present I go to the hygenist 2 or 3 times a year. Maybe I should be going more often.

Best wishes for your recovery, Helen


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Same problem with discoloration here and I use gel-kam too. Mine look worse than they did when I was a 3 pack a day smoker. I hate it. I think it is the stannus fluoride vs the other kind whose name I forget at the moment. The stannus fluoride is suuposed to work better than the other one according to my fancy prosthodonitst. I get my teeth scaled and cleaned every two months by the hygenist and they stay somewhat white.

Take care,
Eileen


----------------------
Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
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My dentist mentioned to me about the staining but there is a message on the Gel-kam box that reads:


"Provides protection against dental decay. Helps reduce plaque and gingivitis after regular brushing and flossing. This is a preventative flouride treatment gel, not a toothpaste.

IMPORTANT: This product may produce temporary surface staining of teeth. Regular toothbrushing may prevent these stains, which are not harmful or permanent, and may be removed by your dental professional."

I have only been using Gel-kam for about 18 months.

Karen

Last edited by Karen Rose; 12-14-2009 04:04 PM.

46 yrs:
Apr 07-SCC 80% entire tongue removed,T4N1M0
Neck/D,Jaw Split, Trache 2 ops,PEG 3.5yrs
30 x rad,6 x Cisplatin,
30 x HBO
Apr'08- flap Recon + ORN Mandibulectomy
(hip bone to reconstruct jaw)
Oct'08 1 Plate out-jaw
Mar'09 Debulk flap
Sep'09/Jan&Nov'10/Feb&Jun'11/Jan&Jul'12/Oct'13/April'14-More surgery
Joined: Dec 2003
Posts: 528
aussieh Offline OP
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Whoops, it's the same old story!! READ the instructions!
Very helpful, thanx Karen.
love from Helen


RHTonsil SCC Stage IV tx completed May 03
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Hi all,

My brother who lives in Turkey got tongue cancer(SCC) almost 6 month ago. thats why I did register here. I thought I could find some answers I have been looking for.

He had a surgery, neck dissection. and then he had chemo and underwent radiation therapy for six weeks. chemo was one day per week. He has been having a problem with eating and speaking.
but the most problem for him is SALIVARY GLANDS. saliva production has been droped within 1-2 weeks after starting radiation therapy. I can not tell how much dose of radiation he was irradiated. His doctor's says his salivary glands may not recover again.

My question is that there is any thing else to protect or recover Salivary flow. mey be there is some medicene or something else, I do not know.



Iwill be really glad if you guys help me.

thank you in advance

BIRKAN

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Birkan,

There are many other factors that may figure into his side effects such as type of radiation (RT vs IMRT) and the path of radiation but GENERALLY a common side effect to his radiation is "dry mouth" and diminished taste especially right after radiation is completed. Again depending on those factors, most of us do recover a great deal of the saliva production and taste but it can take all of 2 years post Tx to recover as much as it will. For me it took a good 15 months before I was satisfied with my recovery. It's not 100% but if I had to guess I would say perhaps 90% back to normal.

Tell him to just be patient and see what happens. To my knowledge there is nothing that has proven to aid in the return of saliva or taste, otherwise we would all have used it.


David

Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
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My RO prescribed a drug Pilocarpine 3X per day. My saliva is returning pretty well. Don't know if the drug has helped or if it is just time.


DX 2/10/09; Stage 1 SCC side of tongue; Partial Gloss; PEG in 3/3/09; 3 Cisplatin; 35 IMRT; PEG out 7/17/09; Eating via mouth and walking 3 miles/day 4 wks after treatment end. 50 pound weight loss; Clear PET 09/09 and 09/10
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Colgate Gel-Kam uses Stannous Fluoride (0.4%) which stains the teeth.

There are other products that use Sodium Fluoride (1.1%) that don't stain the teeth.

I started with a Stannous Fluoride product, but due to heavy staining was switched to one based on Sodium Fluoride.

I was told that either product is fine. Currently I use Neutra Maxx 5000 Gel, but there are a number of other brands available.

You might want to discuss this with you Cancer Center's Dental Group or OC Dental professional.


Don
TXN2bM0 Stage IVa SCC-Occult Primary
FNA 6/6/08-SCC in node<2cm
PET/CT 6/19/08-SCC in 2nd node<1cm
HiRes CT 6/21/08
Exploratory,Tonsillectomy(benign),Right SND 6/23/08
PEG 7/3/08-11/6/08
35 TomoTherapy 7/16/08-9/04/08 No Chemo
Clear PET/CT 11/15/08, 5/15/09, 5/28/10, 7/8/11

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Acupuncture may be a viable option in some cases for some dry mouth.

There are a growing number of people in my local OC Support Group who think so and are receiving an Acupuncture protocol consistent with the one being used in the MDA trials.

At one of our recent local Support Group meetings Dr. Brummund from UCSD CCC told us that acupuncture is often recommended and used here at the US (Balboa) Naval and VA Medical Centers along with the (NIH) UCSD CCC (where he is a H&N Surgeon).

The link below contains info on acupuncture trials at MDA.

www2.mdanderson.org/depts/oncolog/articles/09/6-jun/6-09-brief.html

Researchers at M. D. Anderson have found that acupuncture made patients less likely to experience xerostomia�severe dry mouth�following repeated radiation therapy for head and neck cancers.


Don
TXN2bM0 Stage IVa SCC-Occult Primary
FNA 6/6/08-SCC in node<2cm
PET/CT 6/19/08-SCC in 2nd node<1cm
HiRes CT 6/21/08
Exploratory,Tonsillectomy(benign),Right SND 6/23/08
PEG 7/3/08-11/6/08
35 TomoTherapy 7/16/08-9/04/08 No Chemo
Clear PET/CT 11/15/08, 5/15/09, 5/28/10, 7/8/11

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I am acquainted with Dr. Chambers at MDACC. Please note how careful he was in his quote about acupuncture's ability to improve salivary flow.

In the study, 19 patients suffering from xerostomia due to radiation therapy underwent twice-weekly acupuncture sessions for 4 weeks. The patients were then tested for saliva flow and completed questionnaires designed to gauge the effects of the acupuncture sessions on their quality of life. �Patients in the study had improvements in their physical well-being and in subjective symptoms,� said Mark S. Chambers, D.M.D., a professor in the Department of Head and Neck Surgery and a study author. �Although the patient population was small, the positive results are encouraging and warrant a larger trial to assess patients over a longer period of time.�

There were only 19 people in the study, which is microscopic in its scope and ability to draw conclusions from it. Also notice the careful use of the word "subjective" in his quote. And while he comments on measurement of salivary flow pre puncture, he does not mention a measurable improvement in actual flow post accupunture.

The problem with all the acupuncture studies so far in the US, is very few of them took the time to actually, in a scientific method, measure salivary production/output pre acupuncture and post. They relied on the patients "perception" that something was better. None of the positive studies ever claim to have restored salivary function, and the impact of placebo effect is heavy in most of them.



Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.
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Agree with the treatment veterans above. Saliva glands may recover from radiation enough to produce sufficent fluid. Pilocarpine can stimulate remaining cells. Current research will soon provide a clearer picture of the effect of gene therapy on individuals who have not had a return of saliva nor been helped by pilocarpine. Dry mouth is still a big problem for many.


Hx of stage IV non-oral cancer tx with radiation, chemo & surgery in 2005. Currently a research nurse with National Institutes of Health working on a clinical trial using gene therapy for radiation-induced xerostomia. [email protected]
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David,
thank you so much.
as I understood there is nothing for that. but Carmen mentioned about drug which is called ' PILOCARPINE'. what is this? do you know?

Carmen, do you think my brother should use it.

thanks,

birkan

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I tried PILOCARPINE but I was not a good candidate for it. Every pore in my face and neck seemed to DRIP moisture - except of course for my saliva glands. I literally could have worn a towel around my neck. Not the desired result so we stopped use. Hope it works better for you.

Donna


Donna,69, SCC L Tongue T2N1MO Stg IV 4/04 w/partial gloss;32 radtx; T2N2M0 Stg IV; R tongue-2nd partial gloss w/graft 10/07; 30 radtx/2 cispl 2/08. 3rd Oral Cancer surgery 1/22 - Stage 1. 2022 surgery eliminated swallowing and bottom left jaw. Now a “Tubie for Life”.no food envy - Thank God! Surviving isn't easy!!!! .Proudly Canadian - YES, UNIVERSAL HEALTH CARE IS WONDERFUL! (Not perfect but definitely WONDERFUL)
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I took Salagen which is the generic for pilcarpine for two years and I believe it did help with my saliva production. I started taking it at the beginning of radiation to help prevent the destruction of my saliva glands. I was on 5mg 3-6 times a day. I would perspire heavily for about 5 minutes about 30 minutes after I took it. If it gets unbearable, cut back the dosage. I think I only took it 3 times a day after radiation but that was a long time ago so I don't remember whne I cut the dosage for certain. He might try it for a month or two and see if it helps.

Take care,
Eileen


----------------------
Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
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Very interesting posts here.

I will discuss with my dentist re Don's recommendation of using a sodium fluoride based product. Acupuncture is also something I will investigate - I guess it can't do any harm, even if it doesn't help with xerostomia.

Don, you are fortunate to have a local support group.

I wish my fellow members a healthy and peaceful new year.
Helen



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The Colgate Neutra Fluor Sodium Flouride toothpaste that Don is using is available over the counter at the pharmacy and also at the warehouse Discount Chemist Shops. (usually cheaper than buying it at the dentist)

Karen


46 yrs:
Apr 07-SCC 80% entire tongue removed,T4N1M0
Neck/D,Jaw Split, Trache 2 ops,PEG 3.5yrs
30 x rad,6 x Cisplatin,
30 x HBO
Apr'08- flap Recon + ORN Mandibulectomy
(hip bone to reconstruct jaw)
Oct'08 1 Plate out-jaw
Mar'09 Debulk flap
Sep'09/Jan&Nov'10/Feb&Jun'11/Jan&Jul'12/Oct'13/April'14-More surgery
Joined: Dec 2003
Posts: 528
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Thanks for that, Karen. Helen


RHTonsil SCC Stage IV tx completed May 03
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Birkan, I would definately have your brother talk to his RO or MO about trying the Pilocarpine. Worth a try. I did not suffer any of the potental side effects. I am taking a 5mg tablet 3 times per day. They are not time released so they can be crushed if they need to be put through a PEG.

Carmen


DX 2/10/09; Stage 1 SCC side of tongue; Partial Gloss; PEG in 3/3/09; 3 Cisplatin; 35 IMRT; PEG out 7/17/09; Eating via mouth and walking 3 miles/day 4 wks after treatment end. 50 pound weight loss; Clear PET 09/09 and 09/10
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Carmen,
thank you so much. we asked his RO and said he can use it. i was just wondering about side effects. but he will use it.
can i get this from any pharmacy? because in Turkey we do not have it. i live in Dallas so i can get it myself for my brother.

thanks
birkan

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Side effects listed on the pamphlet included with the RX included burred vision, Jitters, Excess sweating, excess tearing and runny nose. There were others, but this is all I remember. I have the runny nose = but that is just an annoyance.

I had no trouble getting it at a local pharmacy. Good Luck.


DX 2/10/09; Stage 1 SCC side of tongue; Partial Gloss; PEG in 3/3/09; 3 Cisplatin; 35 IMRT; PEG out 7/17/09; Eating via mouth and walking 3 miles/day 4 wks after treatment end. 50 pound weight loss; Clear PET 09/09 and 09/10
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I am searching it on internet and they require prescription.
Do I need a prescription to buy it from local pharmacy either?

thanks

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Yes you need a prescription for it. Ask your RO. The only side effect I had was excessive sweating for about 5 minutes after I took it. This problem can be much worse in a very humid environment.

Take care,
Eileen


----------------------
Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
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Sorry Birkan - I should have been more specific - I had no trouble getting it at a local pharmacy with a prescription.


DX 2/10/09; Stage 1 SCC side of tongue; Partial Gloss; PEG in 3/3/09; 3 Cisplatin; 35 IMRT; PEG out 7/17/09; Eating via mouth and walking 3 miles/day 4 wks after treatment end. 50 pound weight loss; Clear PET 09/09 and 09/10
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