Abstract
BACKGROUND: There is limited published evidence in KwaZulu-Natal on access to oral health care for patients undergoing cancer therapy in the head and neck region. OBJECTIVES: This study aimed to assess patients' oral health-related perceptions, practices and needs during cancer therapy. METHODS: This was a descriptive case study. A semi-structured face-to-face interview was conducted with volunteers (n=12) undergoing cancer therapy in head and neck region. Purposive sampling was used to select study participants who were recruited from a public tertiary central referral hospital in KwaZulu-Natal. A semi-structured interview was also conducted with the eThekwini district coordinator for oral health services to gain better insight into oral health service delivery for patients with special needs. RESULTS: The results indicated that oral health care in the sample population was not prioritised. Some of the emergent themes included: participants' knowledge and oral health self-care practices, support for participants to cope with head and neck cancer, barriers in accessing facility-based oral health care (poor access to dental services, failure of the local clinic to provide appropriate care), lack of referral by oncology care practitioners for patients to access dental care, and existing gaps in oral health service delivery The reported non-existence of a specific oral health policy to address cancer and the absence of a risk factor intervention program highlighted some of the shortcomings for quality oral health service delivery in this population group. CONCLUSION: The results indicated that oral health care is important for patients undergoing cancer therapy. There is an urgent need for oral health planning in the province to take into account the specific oral health needs of this vulnerable population.
Highlights
The increasing rate of cancer in the developing world, including the incidence of cancers located in the head and neck region, remains a huge public health concern.Oral cancer ranks as the sixth most common cancer on a global level and third in developing nations, with a high age standardized mortality rate (ASMR) of 6.8.[1,2] oesophageal cancer is ranked as the eighth leading cancer by the global cancer statistics database (GLOBOCAN) and accounted for 3.2% of new cases in 2018.3It is further postulated that probably ‘two-thirds of oral and pharyngeal cancers’ occur in developing countries.[2]
Some of the emergent themes included: participants’ knowledge and oral health self-care practices, support for participants to cope with head and neck cancer, barriers in accessing facilitybased oral health care, lack of referral by oncology care practitioners for patients to access dental care, and existing gaps in oral health service delivery
The results indicated that oral health care is important for patients undergoing cancer therapy
Summary
The increasing rate of cancer in the developing world, including the incidence of cancers located in the head and neck region, remains a huge public health concern. It is further postulated that probably ‘two-thirds of oral and pharyngeal cancers (excluding nasopharynx)’ occur in developing countries.[2] Alarmingly these countries ‘account for 67% of cancer-related deaths’ yet only ‘5% of cancer-related spending’ is evident in response to this public health crisis.[4]. The high cancer mortality rates in developing countries could be attributed to patients’ late presentation for diagnosis and treatment, suboptimal access to health care services, or patients opting to seek traditional health care before attending a health care facility.[1]. There is limited published evidence in KwaZulu-Natal on access to oral health care for patients undergoing cancer therapy in the head and neck region
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