Breast cancer therapy: oral health and some clinical side effects, ethical considerations and medico-legal implications

M. M. Petrescu, A. Kozma, I. Diac, H. Lazarescu, A. K. Lackner, C. S. Glavce, A. T. Ispas

Abstract: Treatments for neoplastic disease, such as chemotherapy and radiation, can affect the patient's oral health. Chemotherapy is currently considered effective in treating or ameliorating neoplastic disease. However, therapy can induce damage to the patient's genetic material. Drugs used, through cytotoxic and mutagenic effects may also affect normal cells, including cells in the oral cavity [21]. The article aims to provide a synthesis of clinical side effects commonly reported by breast cancer patients, as well as other cancer patients, during and after treatment, ethical considerations in such treatments and medico-legal implications in some particular cases. Symptoms which involve and affect oral health may be: dry mouth, thickened saliva, a burning sensation in the mouth or throat, difficulty in chewing, swallowing or speech, taste changes, problems with teeth and gums, mouth mucosa and salivary glands. Some of these side effects may fade soon after the treatment ceases. However some of them are long-lasting or even permanent, requiring interventions from the dentist. A breast cancer diagnosis requires a complex approach, the patient has to be looked upon as having an organic pathological condition and a psychological issue in the same time which raises several ethical issues in the doctor-patient relationship. Medico-legal implications may arise from several possible scenarios which are detailed
Keywords: chemotherapy, clinical side effects, breast cancer, oro-dental disorders, medical and professional ethics, medico-legal implications.