Trial to test if light can reduce side effects of cancer treatment

Researchers in the UK targeting oral pain

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A pioneering UK trial led by Newcastle upon Tyne Hospitals Trust is set to look at whether a new approach can reduce the pain of head and neck cancer treatment.

The Lite Therapy Effectiveness For Oral Mucositis (LiTEFORM) trial will discover if low level laser treatment can help in the management of painful irritation of the mouth lining – a common and very unpleasant side-effect of chemotherapy and radiotherapy.

4,000 people have radiotherapy for head and neck cancer every year in England and Wales. Most will develop painful mouth inflammation (oral mucositis).

Affected patients can’t talk, eat, drink or swallow as normal and some get painful swelling and mouth ulcers. 90 per cent of those with oral mucositis need the support of a feeding tube. Their normal family and social life is disrupted and weight loss and long term swallowing problems are common.

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Until now, most patients have had to rely on simple mouthwashes and coating gels. Like the few drug treatments tried out in the past, these often make little impact.

The four-year project is led by Newcastle Hospitals in partnership with Newcastle University, City Hospitals Sunderland NHS Foundation Trust and hospitals across England and Wales. LiTEFORM will tell cancer doctors whether low level laser therapy reduces the burden of painful mucositis for patients. If it does, the laser treatment may be taken up across the National Health Service.

'It’s so important that this type of research takes place in order to develop new, evidence based treatments for cancer sufferers.'

The treatment involves the application of low level light (laser) at the selected areas of affected tissue in the mouth and lips. The small laser probe will be aimed at up to six areas in the mouth and takes approximately 20 to 30 minutes to complete the treatment.

“I pioneered the LiTEFORM trial to spare my patients some of the traumatic side effects of radiotherapy," said Dr Michael Nugent, Chief Investigator for LiTEFORM at the Department of Oral and Maxillofacial Surgery at City Hospitals Sunderland NHS Foundation Trust.

“The long term goal of LiTEFORM is to improve the quality of life for radiotherapy patients, reduce pain levels, improve nutrition, and cut down the number of feeding tubes and hospital admissions.”

Valerie Bryant was diagnosed with throat cancer in 2009 and underwent intensive courses of both radiotherapy and chemotherapy. As a consequence of her treatment Valerie still suffers greatly with swallowing difficulties and soreness in her mouth and throat. She now sits on the management board for the LiTEFORM trial, using her experience as a cancer survivor to offer insights that will inform the development and conduct of the trial.

“The after effects of treatment can leave many cancer sufferers with both physical and psychological scars – such as anxiousness and isolation," Bryant said.

"I wish I could have signed up to take part in the LiTEFORM trial when I was undergoing my treatment eight years ago. It’s so important that this type of research takes place in order to develop new, evidence based treatments for cancer sufferers.

“If LiTEFORM proves the effectiveness of low level laser therapy then this treatment could be rolled out across the UK, having a huge impact on patients in the future.”

The LiTEFORM trial will run for four years and is funded by the NIHR Health Technology Assessment Programme.