School of Dentistry, foundation collaborate to provide life-changing treatment for cancer patients
By KELLY EDWARDS
A recent phone call came to Dr. Mary P. Walker (Pros ’99, PhD ’01), associate dean for research and graduate programs at the UMKC School of Dentistry, with an urgent tone.
Just diagnosed with a form of head and neck cancer, the caller needed a dental examination and any required care before she could begin radiation treatments. Her regular dental clinic, however, couldn’t immediately work her into its schedule.
Now, the woman was reaching out to Dr. Walker for help. She came to the right place.
Two years ago, Dr. Walker applied for a grant from the HNC Living Foundation, a local non-profit organization that provides support for head and neck cancer patients. A $225,900 grant allows the School of Dentistry to serve Kansas City area head and neck cancer patients needing immediate dental care before starting their cancer therapy. The foundation recently renewed the grant for $325,000 for another two years.
So Dr. Walker, realizing the urgency of her caller’s need, made the necessary connections. Within a day, the woman was getting the necessary dental care.
“We know that until that happens, she’s not getting the medical care she needs to move forward with treating the cancer,” Dr. Walker said. “The timeliness, the urgency of the pre-radiation therapy dental care is what we truly understand here. That’s a unique situation.”
Her background includes NIDCR-funded research focused on understanding how radiotherapy can cause teeth to deteriorate, which led to updates in the U.S. Oncology Network’s treatment guidelines to limit the therapeutic radiation dose to teeth during cancer treatment.
Besides her research, she has an expert’s familiarity with oral and dental complications associated with head and neck cancer radiotherapy treatment. These complications are especially debilitating for patients’ quality of life, as traditional medical insurance does not cover pre- and post-cancer dental treatment. For that reason, Dr. Walker said, HNC Living Foundation’s financial assistance is life changing for patients who would normally not be able to afford dental treatment.
“Radiation oncologists and radiation physicists normally don’t want to start radiation therapy until the patient has had the dental care they need,” she said.
Thanks to her efforts and the grants from the foundation, the specialty care program at the School of Dentistry is now a major referral center for cancer patients in urgent need of dental care from more than 30 radiation oncology treatment centers from as far away as St. Louis.
Years ago, the standard protocol was to remove a patient’s teeth before radiation therapy, with the expectation that they would begin to decay anyway. Now, Dr. Eric Gottman (DDS ’01, Pros ’04), a prosthodontist and clinical associate professor, is a member of the team that works with cancer patients to preserve their teeth throughout the cancer treatment.
“A lot of times, the people we see need extractions, fillings, root canals, things like that, and they need to be done very quickly so that we can maintain the teeth throughout the cancer treatment,” Dr. Gottman said. “Our initial focus is to get those treatments completed as soon as possible.”
In the first two years of the HNC Living Foundation grant, clinicians at the School of Dentistry treated 167 cancer patients. The new grant is expected to provide for service to 200 to 225 patients.
A Kansas City couple, Tom and Teresa Walsh, established the foundation after Teresa battled cancer in her jaw in 2013. Now, as Teresa celebrates her five-year anniversary of being cancer free, the Walshes are working with the dental school to see that others facing the same experience get the support and treatment they need.
“Through Teresa’s personal experience, we understand how vital good care is to the recovery and quality of life of the patient going forward,” Tom Walsh said. “Through our work, we’ve learned that dental care has proven to be one of the largest, if not the largest, unmet need for head and neck cancer patients. Together, with Dr. Walker’s help, HNC Living Foundation and the UMKC School of Dentistry have created a unique model benefitting patients in the Kansas City region. We are thrilled with our association and the satisfaction it brings knowing we’ve contributed to a better life for hundreds of patients in our own backyard.”
Dr. Walker points out that the funding and dental care don’t end with the pre-cancer treatments.
“Once a patient has had radiation therapy, their mouth is different and it’s different forever,” she said. “These are our post-radiation therapy patients.”
Those patients typically return for extended care to help them through the healing process and to maintain their oral health. That sometimes includes being fitted for dentures, as was the case during one patient’s recent appointment.
Dr. Gottman showed the patient how he was using heated compound to get an impression of the man’s mouth. Dr. Gottman also explained how the finished dentures would fit. By the end of the appointment, the man was at ease and joked about how he would have to be careful when he sneezed.
Dr. Gottman said his work was richly rewarding. “We see them at their lowest of lows and then, the majority of the time, we get the benefit of seeing them after they’ve completed (cancer) therapy and have the opportunity to help them rehab their oral healing.
“The majority of these patients come back on three-month recalls, making sure they aren’t getting cavities, that everything is good and healthy, and making sure they don’t have any recurrence of the cancer.”
Dr. Walker said the greatest satisfaction for the team comes from the reaction of the patients.
One older patient who received aid from the foundation and care from the dental school wrote in a patient survey that she didn’t know what she would have done without them.
“At my age, coming up with the money would have been nearly impossible,” she said.
Another expressed gratitude for having received dentures that have improved her quality of life and self-esteem after cancer treatment.
“Now, I can smile,” the patient shared. “The dentures help me eat healthier foods to give me needed nutrients, and they have increased my ability to speak and be understood.”
A growing number of head and neck cancer patients are living far better lives than before, in part because of the dental school’s collaboration with the foundation. They also have been helped by Dr. Walker’s research that has led to a change in how teeth are being protected and cared for during radiation therapy.
“If I never do anything else in my research career,” Dr. Walker said, “we have impacted how patients are treated by now having a recommendation and a protocol for how teeth should be included and spared in radiation therapy. I think we’ve made a difference.”
Dr. Eric Gottman (DDS ’01, Pros ’04) works with a cancer
survivor to fit new dentures for the patient.
Dr. Gottman prepares to treat another cancer patient.
PATIENTS GRATEFUL FOR VITAL CARE
“I had no insurance at that time. My only insurance was through the VA from being a Vietnam veteran, but they do not offer dental assistance. I was in pretty much a hopeless situation.”
“Thank you so much for your help. I just lost my husband so I didn’t have a lot of money.”
“The grant helped me through my cancer in such a generous way. Without it I don’t know what I would have done for dental care. It took a lot off my mind. Thank you a thousand times over.”
“Dr. Gottman was excellent in his work and his patient empathy.”
“The costs associated with my cancer treatment were astronomical and exorbitant. Without the grant, my dental care would not have been possible. It was truly a godsend.”
“I felt a little bit taller, because I had my teeth and I had my smile.”