Acupressure on Xerostomia in Head and Neck Cancer Patients

This is a randomized controlled trial aimed to1) examine the effect of a self-administered acupressure intervention on head and neck cancer patients with xerostomia (primary outcome) relative to oral health education control; 2) examine the effect of self-administered acupressure on secondary outcomes, including quality of life and severity of symptoms of head and neck cancer patients; 3) evaluate patients' expectancy of acupressure; 4) explore the acceptability of self-administered acupressure for head and neck cancer patients with xerostomia. Hypothesis: self-administered acupressure has better effect on xerostomia for head and neck cancer patients comparing to oral health education. Acupressure will also benefit head and neck cancer patients on quality of life and severity of symptoms. Head and neck cancer patients may have good acceptability of self-administered acupressure.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* age ≥18 years;
* able to give informed consent;
* diagnosed with head and neck cancer (cancers in the head and neck region, e.g. oral cancer, nasopharyngeal cancer, oropharyngeal cancer, hypopharyngeal cancer, laryngeal cancer, sinus cancer, salivary gland cancer);
* completed radiation therapy or chemoradiotherapy for at least 2 weeks;
* complains of xerostomia after the treatment;
* able to communicate in Cantonese or Mandarin.

Exclusion Criteria:

* history of xerostomia prior to head and neck cancer treatment (e.g., Sjögren Syndrome);
* practiced acupressure or received acupuncture in the last 3 months;
* having contraindications to acupressure, e.g. blood system disease (e.g., leukemia); pregnancy; lactating; upper or lower extremity deformities; infection or injuries at the acupoints.

Those who are taking medications/alternative substances to treat xerostomia on a fixed dosage regimen in the past one month will not be excluded.

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• BACKGROUNDDavies AN. A comparison of artificial saliva and chewing gum in the management of xerostomia in patients with advanced cancer. Palliat Med. 2000 May;14(3):197-203. doi: 10.1191/026921600672294077. PMID 10858827
• BACKGROUNDEisbruch A, Kim HM, Terrell JE, Marsh LH, Dawson LA, Ship JA. Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2001 Jul 1;50(3):695-704. doi: 10.1016/s0360-3016(01)01512-7. PMID 11395238
• BACKGROUNDJensen SB, Pedersen AM, Vissink A, Andersen E, Brown CG, Davies AN, Dutilh J, Fulton JS, Jankovic L, Lopes NN, Mello AL, Muniz LV, Murdoch-Kinch CA, Nair RG, Napenas JJ, Nogueira-Rodrigues A, Saunders D, Stirling B, von Bultzingslowen I, Weikel DS, Elting LS, Spijkervet FK, Brennan MT; Salivary Gland Hypofunction/Xerostomia Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO). A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life. Support Care Cancer. 2010 Aug;18(8):1039-60. doi: 10.1007/s00520-010-0827-8. Epub 2010 Mar 17. PMID 20237805
• BACKGROUNDMercadante S, Calderone L, Villari P, Serretta R, Sapio M, Casuccio A, Fulfaro F. The use of pilocarpine in opioid-induced xerostomia. Palliat Med. 2000 Nov;14(6):529-31. doi: 10.1191/026921600701536273. No abstract available. PMID 11219883
• BACKGROUNDGarcia-Chias B, Figuero E, Castelo-Fernandez B, Cebrian-Carretero JL, Cerero-Lapiedra R. Prevalence of oral side effects of chemotherapy and its relationship with periodontal risk: a cross sectional study. Support Care Cancer. 2019 Sep;27(9):3479-3490. doi: 10.1007/s00520-019-4650-6. Epub 2019 Jan 24. PMID 30675665
• BACKGROUNDSung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4.