mucosite, fever, medical, cancer, bordet, brussels

Medical Informative Booklets

Chemotherapy / Radiotherapy

Mucosites Treatment by Athermic Laser

The Institute owns thanks to the support of the Friends of the Bordet Institute two laser equipment that allow to treat efficiently mouth and skin lesions, which have been caused by chemo-or radiotherapy.

The treatment by athermic laser :

- speeds up the cicatrisation, diminish the pain and has an anti-inflammatory effect,
- is painless,
- lasts 10 to 30 minutes and is performed by the dentist at the Institute, at the rate of 2 session a week according to the prescription doctor's demand.
- has no side effect,
- requires protection glasses to be worn.

How to make an appointment for the laser treatment ?

If your doctor considers that you have to follow a laser treatment, you will receive a letter from him, which you have to take with you to go to your appointment in the laser therapy consultation.
If you call the consultation (Tel : 02/541.38.19), the reception secretary will give you the date, the time and the place of the appointment with the dentist who treats you.
These information can change : you can have a look in the chapter "Consultations" for more information.
That goes for all patients that are able to move around whether they are hospitalised or not.
Hospitalized patients in the sterile service of the 3rd floor are treated according to their doctor in their room.

What is a mucosite ?

Mucite or mucosite ? French people say mucite, English people say mucosite.
It is an inflammation of buccal and digestive mucous membranes that appears very often one or two weeks after the beginning of the treatment (chemotherapy and radiotherapy), in the form of erythema, with desquamation of certain areas that turn into real ulcerations. These ulceration are really painful and sometimes patients have to interrupt the treatment.
mucite : grade I mucite : grade II mucite : grade III
A normal buccal mucosite is an excellent protection against :
- chemical aggressions
- the present micro-organisms in the oral cavity.
An interruption of this mucous protection causes secondary infections that increase the pain and slow down the cicatrisation.

The iatrogenic mucosite is the result of 2 mechanisms :
- the direct toxicity of the anticancer drugs on the mucous
- the myelosuppression
The pathogeny is certainly linked to the slow down of the epithelium basal cells renewal : the basal cells cannot renew and replace upper cellular layers under desquamation.

There are four stages of the mucosite development, these stages start 2 or 3 weeks after the beginning of the treatment :
- the1rst stage is inflammatory and vascular
- the 2nd is epithelial
- the 3rd is ulcerative and bacterial
- the 4th is the cicatrisation

The evaluation and classification by intensity degrees remain very difficult to define; several propositions have been mentioned.
We use the following gradation :
- grade 1 : erythema/minimal pain
- grade 2 : non confluent mucositis that can lead to a serofibrinous production. Moderated pain that need an antalgic treatment
- grade 3 : confluent mucositis with production of fibrinous fur. Severe pain.
- grade 4 : ulceration, haemorrhage and/or necrosis.

Recommandation = prevention.

A buccal and dental hyena is essential.
The patient has to be checked up by his or her dentist before the treatment or he has to go to a dentist at the hospital where he is treated.
A booklet with all important advice is available at the consultation (or click on "Advice before chemo-or radiotherapy ORL")

What are the effect of the laser ?

The athermic laser is characterized by the photonic energy conversion in tissues by a photoelectric effect on proteins. The energy is absorbed by the treated tissue that allows it to rebalance its own energy, which is disrupted by chemo- and radiotherapies or by another pathology.
Tissues function like accumulators : after having received the illumination, they restore part of it and it is beneficial for the surrounding pathologic tissue.

The athermic laser is painless and has no side effect. There is no risk of overdose.
The intensity and the application time of the athermic laser depend on the area and the importance of the lesions that have to be treated.
The laser sessions are efficient if they are repeated at least 3 times a week during the whole period of the lesions.
The athermic laser has a direct effect on the pain, namely on inflammation, with a diminution of edemas, and on the cicatrisation, since it has an effect on mitochondria from fibroblasts and collagenous synthesis.

The use of thermic laser requires a half-light room and protection glasses must be worn by the patients and the practician (the laser light is very dazzling).

Since mucous ulcerations are very sensitive, many precautions are taken when we treat them with optic fiber, namely in areas like the lip, the tongue edges, jugal mucous membrane, the velum palate and the frenulum of the tongue.
lasertherapy
The obtained results by the athermic laser at the Jules Bordet Institute are undeniable. They confirm the efficiency of the laser technique, announced by the French group of the Centre Lacassagne de Nice (Professeurs Ben Sadoun and Ciais) and the Centre of Marseille (Dr Franquin).