Author: Tia Alphonse
Gary Rackers bit his tongue one night, and it began to bleed. Thinking it wasn’t serious, he waited a couple of weeks, but something still didn’t feel right.
So, he asked his wife to take a look. She was shocked, Rackers said. His tongue was black.
After seeing his family physician and a local ear, nose and throat doctor in Jefferson City, Rackers was referred to Ellis Fischel Cancer Center. There, he connected with a physician who specialized in surgical treatment for patients with head and neck cancers. He was diagnosed with squamous cell carcinoma — a common oral cancer. The doctor ended up surgically removing half of Rackers’s tongue and nearly all of his teeth, and he began radiation and chemotherapy treatments.
Since then, Rackers said he‘s had 33 radiation treatments and three rounds of chemotherapy. He is pleased and proud of the work his physician did, he said. Because of her, he’s in the recovery phase: “I’m doing good…and I’m feeling good.”
Many head and neck cancer patients like Rackers lose their ability to produce saliva after radiation treatment. He said it doesn’t affect him much during the day, but his mouth gets quite dry at night. Dry mouth frequently disturbs his sleep, he said, causing him to often fetch water or juice for relief.
“If I could get through the night,” he said, the days are easy.
MU researcher and former dentist Olga Baker hopes to help patients like Rackers by dedicating her efforts to something most of us take for granted — saliva. Through her research, she hopes to find better solutions to combat dry mouth, particularly among cancer patients whose glands have been destroyed by radiation therapy.
When she practiced dentistry, Baker said she encountered many patients who struggled with dry mouth. Although the condition is often viewed as insignificant, those who underproduce saliva often develop mouth sores, cavities and a host of other issues. Baker said she has even worked with patients who have trouble talking because their inner cheeks stick to their teeth without natural lubrication from saliva. She has also treated patients who feel as if they are choking at night without the fluid to keep their airways moist.
Multiple groups of people suffer from chronic dry mouth. Patients who undergo radiation treatment for neck and head cancer are among a common group that often loses the function of salivary glands. After treatment, many of these glands stop working and can no longer naturally produce saliva, Baker said. She has seen patients who suffer from Sjögren’s syndrome, an autoimmune disease that causes inflammation that destroys the salivary glands. Other patients are born without functioning salivary glands at all.
“For these patients, there is no cure,” Baker said. “So, we’re working on different options.”
In the past, she worked to produce artificial saliva from plant-based resources and researched resolvins, lipids derived from the Omega-3 fatty acids commonly found in fish oil. This can be a potential treatment for dry mouth in Sjögren’s syndrome patients. These kind of solutions provide temporary relief, working as a spray that can be applied throughout the day to mimic the effects of saliva lubrication.
Baker’s current research into saliva production is dedicated to finding a more long-term solution to dry mouth, specifically for patients whose glands have been destroyed by radiation therapy. The therapy Baker is researching uses a specialized hydrogel that targets the affected glands. She has zeroed in on a protein called laminin-111, which is important to the embryonic process and has long been associated with regenerative properties. Baker said her previous research found that the protein helped restore salivary gland function when only single molecules were used.
She looked at recent studies on the way trimers, a combination of three molecules of a given protein, could give greater results than single molecules. She became interested in testing trimers of laminin-111 on salivary glands to see whether the protein could further restore salivary function in mice.
The experiment tested mice that had undergone radiation treatment and lost salivary function. Proteins from the treatment are put into hydrogels to make a more efficient delivery system. The gel was applied to the mice, and their saliva secretion was monitored. The treatment has proved effective in mice that lose salivary gland function due to radiation. Baker said the next step is to expand her research into larger animals and ultimately do clinical trials on human patients.
Meanwhile, Rackers is adjusting to his recovery. He said he no longer eats spicy foods, and he can’t stand the tanginess of condiments like barbecue and mustard. He can, however, still enjoy most foods.
“Tonight, I’m making smoked sausage, fried potatoes and steamed vegetables,” he said. “And I can eat that.”