Head and Neck Cancer Patients: New Relief for Chronic Dry Mouth

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Dr. Singh is testing the use of ALTENS treatment for patients with cancers of the head and neck.

An unusual treatment with a very long name is helping cancer patients who are experiencing xerostomia, one of the side effects of radiation to the head and neck. This dry mouth condition can damage salivary glands, causing chronic oral dryness and slowed salivation. 

Roswell Park offers these patients Acupuncture-Like Transcutaneous Electrical Nerve Stimulation (ALTENS), a noninvasive, acupuncture-like treatment that delivers low-voltage electrical pulses through electrodes placed on the skin. It offers effective relief for xerostomia without the side effects of drug treatments.

Anurag Singh, MD, Director of Radiation Research, Department of Radiation Medicine, began studying ALTENS as part of phase 2-3 randomized trials led by Raimond K. Wong, MD, of McMaster University in Hamilton, Ontario. The trials compared ALTENS with pilocarpine, another treatment used to relieve xerostomia caused by radiation. In the phase 3 randomized trial, 81% of head and neck cancer patients responded positively to ALTENS.

“We felt ALTENS was a promising way to improve saliva production without the associated side effects of pilocarpine,” Dr. Singh says.

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When the trials were over, the researchers set up a system that enabled patients to take ALTENS units home so they could self-administer treatments for a period of time, eliminating the need for them to travel back and forth to Roswell Park.

Dr. Singh says his team also conducted a randomized trial to study the optimal number of ALTENS treatments per week and the total length of treatment. They found that giving treatments four times per week over a total of six weeks was just as effective as twice-weekly treatments given over 12 weeks. The team will continue exploring how to maximize the effectiveness of ALTENS treatments, including for patients who have had head and neck cancer for years.

“We found that several long-term survivors who had been limited by xerostomia for years following completion of their treatment reported improvement in their salivary function from ALTENS therapy,” Dr. Singh says.

Roswell Park hopes to expand its ALTENS program both within and beyond its own hospital.

Dr. Singh’s group recently published the findings of their randomized trial in the Journal of Alternative and Complementary Medicine.