JEFF YOUNG, D.V.M., learned of his lymphoma after getting shooting pain in his arm and jaw. - PHOTO COURTESY OF JEFF YOUNG, D.V.M.

HE’S KNOWN FOR HIS straight talk and passion for pets. But most people may not know that the man who helps improve the lives of animals every day was fighting his own health battle for some time while doing it.

Jeff Young, D.V.M., star of the Animal Planet show “Dr. Jeff: Rocky Mountain Vet,” had B-cell lymphoma. Diagnosed in 2014 with the blood cancer, he received the standard chemotherapy treatment of cyclophosphamide, doxorubicin, vincristine and prednisone, more commonly known as CHOP. In an interview with 

®, Young explains why he didn’t let this self-called “nuisance” keep him down and how he’s handling life as a cancer survivor.

Young: My cancer diagnosis was pretty simple. I was getting a massage — I do karate, and I go for a massage every now and then &mdash; and was on my chest. The (masseuse) was working on my back, and I kept getting this shooting pain down my arm. I thought it was just a pinched nerve. About two weeks later, the same thing happened, except I felt (the pain) in my jaw and down my left arm. At that point, I thought it was a heart thing. I went to the emergency room, and they thought it was a heart attack. They took an X-ray and found an 8-centimeter mass next to my heart. Two days later, they had a needle in my back that confirmed the B-cell lymphoma.

I feel great and have plenty of energy. I work out and go to work every day. I go for a CT scan every year and a half.

Your wife cut your famous long locks while the cameras were rolling. Why did you choose to do this in a public manner?

The joke has always been that my hair is my strength. I had undergone some treatment, and I knew my hair was going to come out. It was just a matter of when, so I figured I’d go on the offensive. Cutting your hair and being bald in this day and age … Well, Michael Jordan made it in vogue.

You have your down moments and the “Why me?” (feeling). But for the most part, it was a matter of “I just have to get through this.” It was one more thing I had to do.

What was your biggest challenge while fighting cancer?

Not working as much as I’m used to. It bothered me that (the cancer) slowed me down. For 26 years, I have been coaching inner-city kids in distance running, and I didn’t get to coach much because I didn’t have the energy to run. I tried to work, but there were a few days when (I just didn’t) feel good, like a day or so after chemotherapy, and (I felt) nauseous. I tried not to let it change my life a whole lot. A positive attitude really makes a difference when you have cancer.

What advice do you have for other survivors who may be struggling to get up?

I get up every day and move forward. I don’t think you have a choice in life. With cancer, if you sit around, it’s not good for your immune system, and it’s not good for you psychologically. Get up and move. Go for a walk. It doesn’t have to be long. Interact with people. If you’re given lemons, make lemonade.

What’s one message that you want to leave for anyone reading this?

I had a great doctor, but when I asked about nutrition, yoga, meditation and other things, he wasn’t interested. It put me off and bothered me. Depending on your doctor and the program you’re in, find some outside sources that can give you support because it’s the whole body you’re treating. Doctors are treating (the cancer), but I’m more than just that. That 8-centimeter lump is not me. I really do believe changing my diet made me feel better, and I continue that. Do your research. Drugs are part of the battle — not the whole battle.

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Jeff Young, D.V.M., refused to let cancer stop him from living.

No Road Is Too Rocky for This Survivor

MOST PEOPLE HAVE HEARD the adage “Timing is everything.” For Nicole McGuinness, those words have never been truer than they were when a friend told her a surgeon from nearly 500 miles away was looking for her.

Erich Voigt, M.D., director of otolaryngology, head and neck surgery at NYU Langone Health in New York City, was at home and watching the HGTV show “Beachfront Bargain Hunt.” The woman on the show (Nicole) had a lump on her neck that Voigt felt should be checked. Through the power of social media, he found Nicole, who was examined and told that she had thyroid cancer. Unknown to Voigt, she was already a brain cancer survivor.

®, Voigt shares how this all unfolded, what it was like to meet Nicole for the first time and how others can potentially help save a life.

®: When most people would have been staring at the homes and beach, you noticed a lump on the homebuyer’s throat. How did you spot it? And what made you feel that it needed urgent attention?

Voigt: I was at home relaxing, watching a show. I like to kind of fantasize about beach homes and oceanfront. Working in the big city, you don’t really see the ocean, so it’s a relaxing time for me. And as I was watching the show, I noticed that the woman had something that wasn’t normal. Because I’m a head and neck surgeon and I train medical students and residents on how to do physical exams and how to notice these things, it just caught my eye. It was a very obvious finding to me.

Then you turned to social media, correct?

I paused on the TV and reviewed it a couple of times. And I thought, “Wow, there is really something there.” I showed a couple of family members who were over, and I rewound the show and fast-forwarded it and was like, “That’s a thyroid mass most likely.” And then I wondered, “Does she even know?” It dawned on me that this was someone who might have a problem and be unaware of it. Then I said, “Gosh, should I try to do something about it?” I thought about the implications of doing so. I went through a little process of should I, shouldn’t I. I felt an obligation to help.

I knew that if I were to put it on social media, I wouldn’t really be revealing anything about her that she hadn’t already put out into the media. She was already on TV, and her name was on the screen, so her identity was already out there. I decided to go to my Facebook page. I took a screenshot of the TV, then wrote, “I think this woman might have a problem. There’s a lump, and she probably needs a sonogram and a biopsy. If anyone knows her, reach out to her and see if we can help her out.”

Within two weeks, a friend of hers, who’d Googled the show, saw my picture (that I posted) come up. I had hashtagged the show, and that’s how she found it. She contacted me through Facebook and said, “I know that person, and I’m going to let her know.” She contacted Nicole, who immediately acted. She didn’t know that she had the lump. By interesting circumstance, the show was filmed in November 2017, and I saw the episode in May 2018, so that lump had been there for six months. She had been going through regular medical checkups, but it was never identified. Once she was notified, she went to her doctor, and the result was thyroid cancer.

I was totally shocked. I mean, chills up and down my spine. Honestly, it was an overwhelming feeling.

When you learned it was thyroid cancer, what went through your head?

To put it into a perspective of what I do every day, I’m always thoroughly examining every patient that I see. I stress this to the medical students. I teach a physical diagnosis course and how to examine the head and neck. We bring the medical students in and teach them how to examine by examining each other. So this is always something that’s in my consciousness. Because I had done it outside the medical professional realm, it confirmed that as a physician, you are always trying to help and do the right thing. I feel really good that it worked out and that, hopefully, when you find something earlier than later, you have a better prognosis.

You recently met Nicole, already a brain cancer survivor, in person. What was that like? And what did she say to you?

Meeting her was very emotional for both of us because it is a unique human experience to help someone like her. I felt very happy to have helped her. She was very grateful and thankful. She is a remarkably strong person. I didn’t even know about the brain cancer diagnosis, so to hear about that and that she fought something and is a survivor and so strong — it’s all just so miraculous to me.

Do you know how Nicole is doing? And do you plan to stay in touch with each other?

She got her care where she lives, in North Carolina, at Duke. She has been in touch about the steps that have been happening and asking me for some advice at times. I’m not her treating doctor, so I am giving her advice like I would give my mom or dad if they were ill. She’s doing well.

How can this story motivate others to keep an eye out?

There is something called a good Samaritan, and there are good Samaritan laws to help protect someone who is in health care (who may) help someone on the street — if someone falls and they get injured or you’re on a flight and they ask for a doctor &mdash; and generally health care providers will reach out and help people.

I think everyone has the capacity to help others. If you see something dangerous, if you see something where someone might be in danger, reach out and help. There are great stories all the time about people being heroes and saving others, but sometimes it can be something as simple as being a positive influence.

Additionally, in health care and in my region, in the head and neck, if any individual has a lesion, an ulcer or a sore that’s not going away and lasting more than two to three weeks, they really should get that looked at by their doctor. That also includes any type of swelling or lump or bump that’s in the head and neck region. We all can get swollen lymph nodes from colds and viruses, but those should go down after a week or so. If something persists, then get it checked.

How can patients recognize the signs and symptoms of thyroid cancer?

In general, thyroid cancer (presents) as a painless lump. It’s often found by the individual who might just look in the mirror and see a bump, or for men, they may feel a fullness as they are shaving their neck. More worrisome signs include trouble swallowing, voice changes and hoarseness and pain. Those are more significant findings of something that might be more advanced.

Is there anything else that you would like to add?

People should be in tune with their bodies. Be thoughtful that if something is changing, don’t be afraid of it. I know sometimes people will feel a lump and feel anxious about it. They ignore it and then hope it will go away, but sometimes people are ignoring their health issues, and they should go to the doctor. That ranges from a lump or a bump to chest pain. You can save a life — your own or another’s &mdash; if you do something sooner rather than later.

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Survivor diagnosed with second cancer after surgeon spots a lump on her throat while watching TV.

Sweet Serendipity: Cancer Caught on Television

AT DAWN ON OCT. 6, a flotilla of 27 canoes launched into Manele Bay in Lahaina, Hawaii, leaving in their wake an unforgettable image of hope and unity.

This October marked the 10th anniversary of Paddle for Life, a two-day voyage in which over 300 people from around the world, ranging in age from 5 to 80-plus, paddle across the ‘Au‘au channel from Lahaina to Lanai in traditional outrigger canoes, camp under the Milky Way and return the following day for a cause — raising money for cancer.

However, Paddle for Life is much more than that. It brings together people who have survived cancer, those still fighting it and others who have lost, or may lose, a loved one to the disease. Much like fighting cancer, the voyage takes physical, mental and emotional strength. Each canoe carries 12 to 18 people who paddle the 34-mile round-trip journey, often alongside schools of spinner dolphins. The Paddle raises money for the Pacific Cancer Foundation, a nonprofit organization that provides research and support for those diagnosed with cancer on Maui.

Mihaela Ryer lost her husband, Tom, to gastric cancer in 2014. She flew to Maui in 2017 from the Big Island to symbolically release his name. She vividly recalls mile 12 on day one: “Our captain started calling the names of the loved ones for whom our crew paddled, ‘Next two sides for the grandmother, next for the cousin, the father, the mother, the husband, the brother-in-law...’ Their names were in our strokes. As I released my husband’s name in the ocean, in the swirl at the end of my paddle, it traveled with the waves, the wind, the currents and the tides. Letting go, I kept paddling.” She feels that participating in the event allowed her to support and connect with a community of people, most of whom she had never met.

Paddle for Life follows the principle that the secret to a happy life is having good relationships (family, friends, lovers, community).

Last year, Gary Zakreski lost his wife of 46 years, Patricia, to appendix cancer. “I thought we were singled out,” he says.

Zakreski traveled from New Jersey to paddle a canoe for the first time in honor of his wife. What he encountered was much greater than he’d expected. The voyage surrounded him with others who had experienced similar loss and were learning to live again. “Our team was really diverse in age, gender and ethnicity — like cancer. The disease has no bias.”

Zakreski’s 2017 canoe team included Lauri McCaulley and her 17-year-old daughter, Gina, who had a kidney removed due to cancer at the age of two. They traveled from Washington again this year but this time with Dale, Lauri’s father. They paddled in celebration of Gina’s remission and in honor of Dale’s current battle with cancer. Native Minnesotan Lori Auhll, 81 years old and all of 95 pounds, was the eldest person on board. She’d started paddling at 62 in Oahu. “I love the bumps,” Auhll said in between gently correcting her teammates’ form. Her paddle routine: elbow and knee pads on. Auhll, a melanoma survivor, participated in her fifth Paddle event this year.

Team captain Anela Gutierrez got involved with Paddle for Life in 2009 as a technique and skill coach for the Pink Paddlers — the original team &mdash; which was created in 2006 and made up of breast cancer survivors. She now also paddles in honor of her godmother and father, both of whom lost their lives to cancer. “In the canoe, we learn to work with one another and take care of each other during our voyages,” Gutierrez says. “When we are on land, the island becomes our canoe where we work together, and we support each other.”

One-year-old Sully Langeveld was the youngest person affected by cancer to be honored in 2017. His 5-year-old sister, Indy, celebrated her birthday during the Paddle alongside her father in honor of Sully. She was the youngest paddler. This year, they paddled to celebrate the now-2-year-old’s recent cancer-free diagnosis. He’d had retinoblastoma.

Nancy La Joy is the first source of support for many families, like the Langevelds, who are hit with a cancer diagnosis.

La Joy serves as the executive director of the Pacific Cancer Foundation and is a powerful, heart-driven force behind the Paddle for Life event. It’s not just a job — it’s personal. Nancy paddles every year in honor of her father who passed away from lung cancer.

The man credited with starting this voyage is a world-renowned traditional outrigger paddler. Affectionately called Uncle by all who know (or know of) him, native Hawaiian Kimokeo, now 71, is a bit legend, community leader and spiritual guru all wrapped into one. To Kimokeo, everything is a lesson or a blessing. “Find the poi (a traditional Hawaiian food from taro root),” Kimokeo told Nancy in the middle of the ceremony among a tired crowd of over 300 paddlers. “It will be a lesson of patience for them.” Kimokeo, who has been paddling since 1957, says it’s about connecting the natural elements given to all of us: heavens, ocean and land.

Florida and Hugh Town, national paddle coaches from Vancouver, were a part of this voyage at its inception. Florida recalls a symbolic moment when her husband taught the original Pink Paddler women to respond to a tipped canoe. “They had to learn to right the canoe, get back in and start paddling,” she says. “‘Huli,’ the Hawaiian word for tipping or turning, is what cancer does to lives.” The voyage is a reminder of how to get back in the boat and keep paddling, she says. Sadly, Hugh died of advanced colorectal cancer. “The surgery was a success,” says Florida, “but the daily radiation and chemotherapy weakened him, and shortly after, that big, beautiful heart simply stopped beating.”

Although the event is full of heart-rending stories, humor keeps many afloat. Cervical cancer survivor Pamela Kim Harris paddles in honor of her parents, who both died of the disease. “My dad used to say, ‘Pammy, don’t rock the boat.’ And my mother would agree but add in a whisper, ‘That’s right. Don’t rock it. Jump out naked and tip the damn thing over,’” she says. “I miss them both. I promise to follow my father’s directions and politely ignore my mother’s for the good of all!” Back on land, hundreds of paddlers join hand in hand during Hawaiian chants. A mile-long, 260-pound locally handmade ti leaf lei is carried from island to island as a symbol of peace. Island chiefs exchange gifts, and paddlers are serenaded by Hawaiian music and fire dance. Canoes are decorated with pictures of lives, taken by cancer, who are symbolically along for the voyage.

The canoes themselves are a metaphor for the voyage. For Polynesians, the wa‘a (canoe) is a living, spiritual entity, originating from a tree in their forest, explains Gutierrez. The canoe is like a bird, or manu, that goes out to sea but always finds its way back to land. Manu ihu is the front, or male part, of the canoe that leads. Manu hope is the back, or female part, of the canoe, which is considered sacred. Momoa is the ledge on the very back of the canoe where ancestors sit. This is one of the most important parts of the canoe because it is from these ancestors that guidance and safety is sought. The ‘iako and ama make up the parts of the outrigger, which bring balance. The phrase “He wa‘a he moku, he moku he wa‘a” means “a canoe is an island, an island is a canoe.”

This year, Jo Lozynsky, 68, participated in her third Paddle for Life as part of the Calgary Canoe Club Sistership team from Canada. When Lozynsky was undergoing treatment for breast cancer 14 years ago, paddling became medicine for both her body and soul. “This year, I paddle in honor of my own difficult but unfinished journey and in honor of two dear friends who completed their final journeys last summer,” she says. “I paddle with k&#363;lia i ka nu‘u (strive to reach the summit) and ho‘okahi ka ‘ilau like ana (wield the paddles together)!”

Survivors and caregivers reflect on the cancer experience as Paddle for Life marks its 10-year anniversary.

A Healing Journey

NEW ADVANCES IN CANCER treatment have brought the welcome challenge of living beyond cancer — survivorship. Although these advances in therapy have lengthened the life span of many individuals with cancer, the financial, physical and psychological burdens of a diagnosis can be daunting. But there are reputable, user-friendly and costeffective websites and mobile apps that can enhance a cancer survivor’s quality of life.

The financial costs of cancer treatment cannot be underestimated. Data from the National Cancer Institute in 2015 list the average cost of breast cancer in women 65 and older as $23,078 and $2,207 for continuing treatment. Regardless of insurance status, this price tag is daunting. Fortunately, the National Comprehensive Cancer Network (NCCN) has a free app, NCCN Reimbursement Resource App, for patients and caregivers dedicated exclusively to assisting with reimbursement. The app helps individuals search for resources and payment assistance programs to cover the cost of care. Users can search by cancer type, drug name and assistance program.

The many other facets of survivorship — medical appointments, side effect and symptom monitoring, drug schedules and dosages, record keeping and engaging with members of the treatment team &mdash; can now be managed with the touch of a button on a cell phone thanks to modern technology. Survivorship apps and sites such as My Care Plan by Journey Forward and Cancer.Net from the American Society of Clinical Oncology allow individuals to track symptoms, medications, and follow-up appointments and maintain contact information.

Resources like Cancer.Net as well as Breast360.org offer patients information written by reputable sources, including oncologists and breast surgeons. Both sites are updated regularly with news sections that digest the latest research and provide helpful videos and links to additional resources. Breast360.org also offers a list of active clinical trials that are researching new treatments for breast cancer and guidance specifically for survivorship.

The psychological impact of a cancer diagnosis, coming face-to-face with one’s own mortality, is one of the biggest effects of the disease. Apps can help survivors face this challenge through mind-body techniques such as mindfulness meditation, contemplative prayer and simple, coherent breathing exercises. Popular ones include Headspace and Insight Timer. Both offer guided and unguided meditation options, secular and religious (all types) practices and educational podcasts.

The last but perhaps most important aspect of survivorship is staying active and involved. Cancer treatment and the accompanying psychological burden can often leave individuals with debilitating fatigue, unwanted weight gain, new physical pain and limitations. Studies show that physical activity of nearly any type and at any point in the cancer care continuum benefits individuals in all these areas as well as many others. Once again, technology comes to the rescue. Apps offer modalities for every form of physical movement imaginable, with options to join social networks to stay inspired and set personal goals plus anonymity features for those unable or unwilling to venture into public exercise venues. Top apps such as MyFitnessPal offer everything from calorie and macronutrient targets to recipes, step trackers, reminders and links to other fitness apps. Others such as Strava can even map an individual’s course while he or she is walking or running.

Prevention of a recurrence or a new cancer is often at the forefront of survivors’ minds. While many cancers are sporadic, growing data support the role of environmental factors in the development of disease. Although individuals cannot change their genetic makeup, they can follow essential guides for making healthy choices going forward. The Environmental Working Group provides a user-friendly, unbiased one called Healthy Living. Available as a website and an app that can scan listed products at a store, this program guides consumers to better choices for everything from water filters to cosmetics to cleaning products and, of course, food.

A cancer diagnosis is undeniably a life-altering event. As with all such moments that cause paradigm shifts in an individual’s world, taking on the challenge with knowledge creates empowerment and resilience — keys to moving beyond the initial fear and shock. Taking advantage of technology and the tools available today is one way to move beyond just being a cancer survivor and truly thrive.

Lauri Medina, M.D., FACS, is a board-certified general surgeon at Southwest Medical Group in Cortez, Colorado. Medina also serves on the board of directors of The American Society of Breast Surgeons Foundation.

Apps and online resources can help the mind, body and soul.

Getting 'Smart' About Survivorship

Regina Parker always maintained her dental hygiene with regular cleanings and daily care. Until age 53, she had had only a filling or two, but that was before two bouts with cancer.

In 2010, Parker received a diagnosis of stage 2A breast cancer and began chemotherapy. Her oncologist then recommended a prophylactic oophorectomy, the removal of the ovaries to help lower the risk of ovarian cancer. “I had (the oophorectomy) in February 2011,” she says. “Surprise! Cancer in both ovaries.”

Parker’s disease was stage 3C. She had debulking surgery and another six rounds of chemotherapy with Taxol (paclitaxel) and carboplatin, which ended in August 2011. She was put on an aromatase inhibitor, a type of hormonal therapy with known side effects such as heart problems, bone loss and broken bones, from September 2011 through August 2016 to help prevent the cancer from returning. Since 2011, Parker has been cancer-free.

Her mouth, however, has not fared as well as the rest of her. From 2011 to 2018, Parker estimates, she has paid $10,000 out of pocket to cover nine crowns, numerous fillings and a root canal because of dry mouth and the resulting decay.

But Parker says neither her oncologist nor her dentist recommended any change in her routine of cleanings every six months, and the only side effect discussed was related to Prolia (denosumab). She received shots of the medication twice a year for three years to build back bone density. Parker had bone loss in her mouth and femur from the aromatase inhibitor.

“The jaw necrosis was the only dental issue I was ever warned of besides the increased risk of infection while I was on chemo,” Parker says.

Osteonecrosis, or the death of bone tissue, is one of the rare but serious side effects of Prolia. The condition can be triggered by a tooth removal, according to the American Cancer Society.

In one instance, Parker’s dentist refused to remove a tooth after learning she was on Prolia, forcing Parker to find an oral surgeon to do the job.

Although Parker’s dental troubles continue, she now has insurance that covers part of her oral work. Parker has tried to determine whether these problems are connected to her treatments but has received little confirmation. “I’ve told (my doctors) the chemo messed up my teeth and that I have had lots of dental problems,” Parker says. “They just kind of shake their heads and say, ‘Yeah, it could be treatment-related.’”

Stories like Parker’s frustrate Dennis Abbott, D.D.S., an oncologic dentist in Dallas, Texas, and a member of the International Society of Oral Oncology (ISOO), who says the mouth is consistently forgotten when it comes to cancer treatment. There is no doubt that Parker’s crowns and tooth decay came from her treatment, he says.

A third of all people treated for cancer will have oral complications that may interfere with treatment or affect quality of life, according to the National Comprehensive Cancer Network (NCCN).

But aside from a few fellowship programs, dental schools have yet to offer degrees in oncologic dentistry. Abbott’s designation as an oncologic dentist comes from his own study of the topic and continuing education classes.

Cancer treatments, such as radiation to the head and neck, chemotherapy, and blood and marrow transplantation can cause oral complications, according to the NCCN. Side effects specifically related to oral health may include dry mouth, infections, tooth decay, mucositis (painful inflammation), difficulty swallowing, loss of sense of taste and osteonecrosis. “Dry mouth is the big instigator of tooth decay, and it travels like wildfire,” Abbott says.

Similar to patients at risk of osteonecrosis with Prolia use, those who have received intravenous and oral forms of bisphosphonate therapy — used to prevent the loss of bone density &mdash; are also at risk, Abbott notes.

“There is an 80 to 100 percent chance patients with head and neck cancer and stem cell transplant recipients will develop a side effect before, during or after their treatments,” says Deborah Saunders, D.M.D., B.Sc., presidentelect of ISOO and medical director of the dental oncology program at Health Sciences North/Horizon Santé-Nord in Ontario, Canada — a position she has held for 17 years.

The program brings dedicated dental faculty to patients to help meet their oral needs. However, Saunders says she also sees patients on active therapy for breast cancer and rectal cancer who need an assessment because either their physician has seen deterioration in their mouth or they’re having acute complications, such as mouth sores.

Many reasons may explain why these side effects are often overlooked. Some members of the health care team may not understand the immediate and long-term importance of oral health in these individuals, Abbott says. “For some, it is one more hoop they have to jump through, and they may not know who to turn to,” he adds. A lack of clinical trials needed to support a change in diagnosis and treatment is another barrier.

Cost also plays a role. In his practice, Abbott says, he often sees patients come up against financial toxicity. “How are people going to pay for it? How are people going to get the treatment that they need after I identify it?” he asks.

In 2016, about 74 million Americans did not have dental insurance, according to the National Association of Dental Plans. And many patients do not have the thousands of dollars to put out of pocket to get their teeth fixed. Parker worked out a payment plan with her dentist and cut back in other places to pay for her care.

The NCCN, which sets standards for cancer treatment, acted in June 2018 when it updated its section on head and neck cancer, adding recommendations to include extensive pre- and post-dental exams and treatment for patients with this disease.

“The growing acceptance among oncologists that oral issues can be critical to their patients with head and neck cancer is a positive step,” Abbott says. “But oncologists need to look at all patients who are getting an immunosuppressant drug of any kind.”

He says there is still no “bridge of understanding and realization that we are dealing with some pretty bad bugs here, some of which can make bacteria that are normally found in the flora of our bodies become pathogens.”

Until oncologists make that connection, they are not going to understand the importance of the oral medicine side of it, Abbott says.

Prevention is key, according to Saunders, who adds that keeping the mouth clean and moist is critical not only as a person moves through their treatments but also afterward, since some of the side effects can appear later. Dry mouth causes the most side effects in the teeth, Saunders says. Saliva contains many components for overall health, such as digestive enzymes and immunoglobulins. However, it is the mineral that is found in saliva that keeps teeth hard and mineralized, Saunders says. When saliva flows and the quality of saliva is altered, teeth can become demineralized quickly, which can lead to decay. Supplemental fluoride and re-mineralizing agents, such as calcium and phosphate, are essential to maintaining the integrity of tooth enamel.

Using a bland mouth rinse of baking soda and salt, caring for the skin, swallowing exercises and understanding that oral care will be crucial for the rest of a patient’s life can also reduce oral side effects, according to recommendations from ISOO.

No patient loses their teeth from the side effects of head and neck radiation therapy if they are compliant with mouth care, Saunders says. “If the radiation beam is high enough that it destroys the ligament around the tooth that stays in the jawbone, yes, you can lose a tooth that way,” she says. “But most patients will lose their teeth after the radiation treatments are over simply because they’re not caring for them. They’re not applying fluoride. They’re not brushing them twice a day.”

In working with patients post treatment, Saunders talks with them about moving forward as a survivor and not a victim. She says that she often uses the quote “a lifelong commitment to oral care.”

Saunders lets patients know that the game has changed and that this care will be the new norm. “It reassures them that they are not alone, that the side effects that they’re experiencing are common to many and this is normal, even though it doesn’t feel comfortable,” Saunders says.

Certain cancer treatments can affect the mouth, so dental health should be a lifelong commitment.

Fall 2018 | Heal

No Road Is Too Rocky for This Survivor

Sweet Serendipity: Cancer Caught on Television

A Healing Journey

Getting 'Smart' About Survivorship

Giving Teeth to Oral Care

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