Publication

Abstract :

Background: Chemotherapy usually impairs the function of salivary glands. Studies have shown that saliva secretion returns to physiologic level approximately twelve months after the completion of chemotherapy. Xerostomia may affect 80% of the patients who need radiotherapy as a primary treatment, as an adjunct to surgery, in combination with chemotherapy or as palliation. In Ayurvedic medicine, dry mouth results from aggravation of Vata. Gandusha (holding of medicated liquid in mouth) is a procedure of holding fluids in mouth to its full capacity with oil, milk, ghee, honey, meat soup and other medicinal formulations according to vitiated Dosha and symptoms produced. It is effective in most of the diseases pertaining to head and neck.

Aim: This review study on foucused on Gandoosha as a supportive care for radiotherapy and chemotherapy induced xerostomia. Oil, Kanjika, Dhanyamla and Tilakalkodaka (paste of sesame) are indicated for Gandusha in dry mouth and the best oil of choice is Tila Taila (sesame oil) which is indicated for regular oil pulling.

Material and methods: A systematic literature search was conducted in the databases Medline/PubMed and the Cochrane Library using MeSH terms: [Xerostomia] and [Chemotherapy] or [Radiotherapy], [Xerostomia] and [Ayurveda].

Results: After applying filters, 54 articles were obtained and 14 relevant studies were reviewed. By reviewing available literature, it was revealed that many treatment options exist like topical agents, systemic therapy or newer devices but no standard treatment guidelines are available. Pilocarpine is approved for radiotherapy-induced xerostomia. Since pilocarpine has limitations for its usage and other treatment options bring in many cases no substantial relief, Gandusha mentioned in Ayurvedic classics can be a better option in xerostomia and improving quality of life of patients with HNC.

Conclusion: Ayurveda emphasizes on personalized medicine in which different medicinal formulations can be chosen depending on Prakriti (constituents), vitiated Dosha and severity of disease. Proper research should be conducted on this aspect aiming to improve quality of life and to help patients carry on with necessary treatments for HNC without being affected much by its side effects.