An NIHR funded ‘soft’ laser therapy pioneered in the UK by doctors in Southampton to help prevent side effects in patients receiving treatment for head and neck cancer could now be offered nationwide.
The National Institute for Health and Care Excellence (NICE) has now recommended low level laser therapy (LLLT) as a way of healing tissue in the mouth and throat while a patient undergoes chemotherapy and radiotherapy.
The technology was introduced by Dr Shanmugasundaram Ramkumar, a consultant clinical oncologist at Southampton General Hospital, who described it as a “potential breakthrough” ahead of an initial project in 2014.
LLLT, which is also known as cold laser therapy, is a drug-free treatment that reduces pain and inflammation by stimulating damaged cells using a laser/LED light beam. It is more commonly used to treat musculoskeletal problems such as tendon, bone and nerve damage.
Each therapy session takes around 15 to 20 minutes and is delivered three times a week for six weeks during radiotherapy and chemotherapy treatment.
Around 80 to 100% of people with head and neck cancer treated with chemotherapy and radiotherapy suffer from severe soreness in the mouth and throat, dry mouth and swallowing problems as a result of their treatment.
This complication, known as oral mucositis (OM), can also affect taste and speech and cause excessive secretions of saliva, which leads to nausea, vomiting and breathing difficulties.
Currently, most patients are treated with a combination of pain killers and anti-sickness drugs and many require frequent hospital appointments or admissions to control their symptoms or provide nutritional support via nasal or stomach feeding tubes.
“OM is a serious acute side effect for patients undergoing chemotherapy and radiotherapy for head and neck cancer and the standard treatment options on the NHS do not fully address the problems these patients suffer from,” explained Dr Ramkumar.
“It causes very unpleasant complications such as painful dry mouth, swallowing difficulties and sickness but, in the worst cases, it can interrupt radiotherapy treatment and potentially increase the risk of regrowth of tumour cells.”
He added: “I am delighted at NICE’s decision to recommend LLLT for patients with OM as it could now ensure better outcomes, improved quality of life and better treatment compliance for many more patients, as well as reduced medication and inpatient costs.
“It gives us all great satisfaction to have led the introduction of this treatment option for OM from early-stage studies through to a major multicentre national trial and NICE recommendation and we look forward to the technology being adopted more widely for patients across the UK.”
LLLT for OM is currently part of a wider £1.2 million study, led jointly by University Hospital Southampton NHS Foundation Trust (UHS) and the Newcastle Upon Tyne Hospitals NHS Foundation Trust, which involves 380 patients at 10 sites across the UK and will run until 2019. The study is funded by the National Institute for Health Research (NIHR).
In addition, UHS has established a treatment pathway and facilities to deliver LLLT as a routine treatment for radiotherapy and chemotherapy induced oral mucositis outside of clinical trials. The NICE guidance on LLLT for preventing or treating OM is available online.
Posted on Friday 13 July 2018