attention should be given possibility of creating to both. Treatment with a food aversion oral pilocarpine could be during treatment. considered (63—66). This knowledge may Since candidiasis decrease the often follows possibility of such a chemotherapy and conditioning. contributes to poor oral Patients should be hygiene, it should be encouraged to eat many adequately treated. small meals throughout Poor oral hygiene the day rather than only before treatment three per day. increases the risk of tissue It is of utmost damage and eventual importance that the tooth decay. Consultation with a dentist before physician pro- treatment is most viding the primary care is beneficial. in close communication Acute radiation with others involved enteritis after small or (dentist, oncologist, large bowel irradiation as radiologist, etc.) and well as the use of communicates all chemotherapy often leads objectives. In particular, to taste aversion. the radiologist must be However, the probability aware of the need for of taste aversion can be adequate taste and decreased: salivary function. A recent National The patient should Cancer Institute avoid eating 4 hr monograph (67) on oral before and after complications of cancer chemotherapy or therapies should be bowel irradiation. examined for current The patient should approaches. intentionally ingest a novel tasting but nutritionally ACKNOWLEDGMENTS unimportant food (scapegoat tastant) This work was supported by shortly before National Institutes of Health irradiation or Grants Ag 04932, Ag 06841 , chemotherapy. and NS 20320. The patient should be informed of the REFERENCES Meyer J, Squier C, Gerson S. Structure and function of oral mucosa. New York: Pergamon Press. 1984. Wright N, Alison M . Biology oj epithelial cell populations. vols. Oxford: Clarendon Press. 1984 Beidler L. Smallman R. Renewal of cells within taste buds. J Cell Biol Mistretta CM. Permeability of tongue epithelium and its re- From Thiel et al., ref. 70. lation to taste. Am J Phvsiol 1971 762 / 48 Kalmus H, Farnsworth D. Impairment and recovery of taste following irradiation of the oropharynx. J Larvngol 0101 MacCarthv-Leventhal EM. Pos!-radiation mouth blindness. Lancet 138-9.
attention should be given to both. Treatment with oral pilocarpine could be considered (63—66). Since candidiasis often follows chemotherapy and contributes to poor oral hygiene, it should be adequately treated. Poor oral hygiene before treatment increases the risk of tissue damage and eventual tooth decay. Consultation with a dentist before treatment is most beneficial. Acute radiation enteritis after small or large bowel irradiation as well as the use of chemotherapy often leads to taste aversion. However, the probability of taste aversion can be decreased: The patient should avoid eating 4 hr before and after chemotherapy or bowel irradiation. The patient should intentionally ingest a novel tasting but nutritionally unimportant food (scapegoat tastant) shortly before irradiation or chemotherapy. The patient should be informed of the possibility of creating a food aversion during treatment. This knowledge may decrease the possibility of such a conditioning. Patients should be encouraged to eat many small meals throughout the day rather than only three per day. It is of utmost importance that the physician pro- viding the primary care is in close communication with others involved (dentist, oncologist, radiologist, etc.) and communicates all objectives. In particular, the radiologist must be aware of the need for adequate taste and salivary function. A recent National Cancer Institute monograph (67) on oral complications of cancer therapies should be examined for current approaches. ACKNOWLEDGMENTS This work was supported by National Institutes of Health Grants Ag 04932, Ag 06841 , and NS 20320. REFERENCES Meyer J, Squier C, Gerson S. Structure and function of oral mucosa. New York: Pergamon Press. 1984. Wright N, Alison M . Biology oj epithelial cell populations. vols. Oxford: Clarendon Press. 1984 Beidler L. Smallman R. Renewal of cells within taste buds. J Cell Biol Mistretta CM. Permeability of tongue epithelium and its re- From Thiel et al., ref. 70. lation to taste. Am J Phvsiol 1971 762 / 48 MacCarthv-Leventhal EM. Pos!-radiation mouth blindness. Lancet 138-9. Kalmus H, Farnsworth D. Impairment and recovery of taste following irradiation of the oropharynx. J Larvngol 0101