The purpose of this work was to determine whether the morphology of the oral mucosa epithelium (OME) of patients with xerostomia differ from patients without xerostomia. In total, 34 patients with dry eye disease (DED) with or without xerostomia were examined at The Norwegian Dry Eye Disease Clinic with in vivo confocal microscopy of the lower lip. In addition, age- and gender-matched healthy controls (HC) were included. DED patients with xerostomia had a higher superficial to deep backscatter ratio compared with DED patients without xerostomia (p=0.002) and HC (p=0.001). Regression analysis demonstrated that this ratio was related to xerostomia independently of gender and age (p<0.001). Sensitivity and specificity of detecting xerostomia were 0.78 and 0.85, respectively, when using a superficial to deep backscatter ratio cut-off value of 0.995 (p=0.004). The mean nucleus to cytosol backscatter ratio in the superficial OME was lower in patients with xerostomia than in those without xerostomia (p=0.034). In vivo confocal microscopy is a potential tool for evaluating the oral cavity and to assess changes in the OME associated with xerostomia, objectively and quantitatively. The cause of the increased backscatter in the superficial OME in xerostomia, however, remains to be elucidated.

Background and aims: Current evidence suggests that acupuncture may provide some palliation of the symptoms and side effects of cancer and its treatments. Therefore, consideration of the potential benefit of the introduction of an acupuncture service in oncology at Cornwall was investigated. This study describes the experience of patients using the service.

Methods: Between April 2005 and October 2007, 107 oncology patients experiencing one or more of the following symptoms, such as nausea, vomiting, hot flushes, pain, breathlessness, dry mouth, anxiety, depression, fatigue, diarrhoea, constipation or difficulties in coping, were referred for up to 10 weekly acupuncture treatments. About 103 had acupuncture treatment. This observational study utilised responses to questionnaires and self assessment of symptoms at the start (baseline), on completion of treatment and at two months post-acupuncture treatment.

Results: Complete data were returned for 47 participants. Improvement in vasomotor symptoms was seen in 86% of patients presenting with hot flushes. There was a significant (p = < 0.001) reduction in anxiety following acupuncture. The mean difference between scores on the Fatigue Scale (18) across the study period showed improvement in patients experiencing fatigue (p = 0.039).

Conclusion: An acupuncture service for Oncology is practicable and is of benefit to patients. A future randomised controlled trial focusing on the use of acupuncture for hot flushes associated with hormonal treatments for cancer would be worthwhile as these patients form the bulk of referrals and many reported improvement in their hot flushes. A pilot study to compare acupuncture and Venlafaxine for hot flushes in breast cancer patients taking anti-oestrogen treatment is currently being planned. The results of this study demonstrate that acupuncture may benefit patients experiencing anxiety and/or fatigue associated with cancer. A larger randomised controlled trial would more adequately investigate this hypothesis.