The Swallows Australian Edition Magazine

Oral and Maxillofacial
Surgeons outlook on
patients with tumours
of the Head and Neck
Oral and Maxillofacial Surgeons understand a
Head and Neck Cancer patient's journey very
well because we often see them from the very
first investigative procedure and onward from
there. We are likely to be part of the ongoing
care and can follow up for many years.
For example, many oral lesions are first spotted
by general dentists who will refer the patient to
an Oral and Maxillofacial Surgeon (OMFS), as
we are dentally trained. During our surgical
training, we are exposed to the management of
most head and neck tumours. This helps when
we have to inform the patient and their families
of what to expect.
A Maxillofacial Surgeon is usually part of a
multidisciplinary clinic and a timely referral to
one of these clinics is an efficient path to
expeditious treatment.
Whilst we have a very good understanding of
all of the different treatments that can be used
for Head and Neck Cancer we only undertake
the surgical one initially. This is because we are
experts in the mouth/oral region and have a
clear idea of how best to minimize patients’
longer term issues with function.
All of us are aware of the emotional impact of
an oral operation but we are specifically keen
on restoring functions such as chewing,
smiling and even pulling faces!
Radiotherapy and chemotherapy affect the
mouth as well as the surrounding muscles and
skin. Specifically, it affects the salivary glands,
jaw bone and teeth.
Reconstruction after surgery, has developed
enormously in the last decade as has
management of the side effects of
radiotherapy. With both medical and dental
training, OMFS are in the optimum position to
liaise with dental practitioners, oncologists and
others to maintain the best care of Head and
Neck Cancer patients, for life.
One of my roles is to educate patients about
supplemental treatments that may make life
easier following treatment of head and neck
cancer; for example hyperbaric oxygen, very
specific mouthwashes and tissue enhancing
medications.
Maxillofacial Surgeons can suggest
reconstructive options for the mouth, face and
jaws including titanium teeth implants if
required.
One of my greatest pleasures in caring for
patients is in long-term management.
Sometimes teeth need removal for any of the
usual reasons, but after chemo and
radiotherapy there can be issues of healing. It
is very satisfying to be able to reassure patients
that this is possible without dire consequences,
to undertake the surgery, to monitor the
supportive treatments which may include
special medications, hyperbaric oxygen
therapy and plenty of reassurance. There are
reconstructive options for replacing teeth even
in irradiated tissues which sometimes surprises
people.
Before Brisbane had hyperbaric oxygen
chambers (it now has two), I had to send
patients to Townsville.
Our special relationship with dentists, specialist
prosthodontists and prosthetists, gives many
patients options for quality of life improvement
after treatment.
Although the experience of a malignancy of the
head, neck mouth and jaws is inevitably a
daunting one at the outset, there are many
options available for reducing the difficulties,
and progress is being made all the time.
In my time as a specialist OMFS, not only has
the life expectancy of patients with this
diagnosis improved, but due to improving
treatments and reconstructive options, so has
the quality of life.
Dr Caroline Acton OStJ
Oral and Maxillofacial Surgeon
BDS, FDSRCS (Eng), MDSc (Oral Surg),
FRACDS(OMS) - Royal Brisbane and Women’s
Hospital and Caroline Acton Oral Surgery Pty
Ltd.:CAOS cheacton@powerup.com.au
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