Blood malignancy (Tumour)
Management and treatment of haematological malignancies are taken care of by haematological oncology. However, oral and maxillofacial surgery has a supporting role by dealing with / managing of some of the adverse effects of these oncological treatments, by providing diagnostic support in the form of biopsies, or by resection (and, where necessary, reconstruction) of deposits of these malignancies in hard or soft tissues in the head and neck region.
The term haematological malignancy covers a spectrum of different conditions affecting the blood and/or lymphatic systems, including different forms of lymphoma, myeloma and different forms of acute and chronic leukaemia. Despite differences between these conditions, most of them are treated by some variation of chemo- and/or radiotherapy and thus have similar adverse effects that will be seen in maxillofacial surgery. A subgroup of leukaemia patients will have, or will have had, a bone marrow transplant from a genetically non-identical donor (allotransplant), with subsequent need of ongoing immunosuppressant medication. Another subgroup of mostly leukaemia patients (acute lymphoblastic leukaemia (ALL) most commonly) are children. Both of these groups typically have special and often long-term needs for consideration in a maxillofacial clinic.
Common tasks for oral and maxillofacial surgery in supporting the treatment of haematological malignancies include
- assessment and management of various oral conditions, although these are more normally carried out by paediatric dental specialists or restorative dentists (for example, periodontal disease, before and after cancer treatment);
- supporting diagnosis by different biopsies;
- some other surgical interventions;
- assessment and treatment of mucositis (severe inflammation of the mucosa);
- assessment and treatment of oral infections, mostly fungal and bacterial infections;
- various aspects, depending on the underlying condition, of long-term monitoring and interventions after completion of oncological treatment.
The following page discusses these oral and maxillofacial surgery treatment modalities in more detail in the context of supporting oncological treatment of haematological conditions. Many of the treatment modalities are similar or identical to those used more widely for a range of oral and maxillofacial conditions and are discussed in detail in various other sections of the website.