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Oral Surgery · single question

A patient with prostate cancer who received PELVIC radiation presents with xerostomia. What is the LEAST likely explanation for the xerostomia?

  1. Sjögren's syndrome
  2. Dehydration
  3. Medications (common side effect of many systemic drugs)
  4. Pelvic radiation (radiation to the pelvic area is FAR from the salivary glands — least likely to cause xerostomia)
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Correct answer: D. Pelvic radiation (radiation to the pelvic area is FAR from the salivary glands — least likely to cause xerostomia)

  • A. Sjögren's syndrome (autoimmune destruction of salivary and lacrimal glands) is a common cause of severe xerostomia.
  • B. Dehydration reduces overall fluid volume including salivary flow.
  • C. Medications are the most common cause of xerostomia (anticholinergics, antihistamines, antidepressants, antihypertensives, diuretics).
  • D. Correct. Radiation-induced xerostomia is caused by DIRECT IRRADIATION of the salivary glands. In a patient with prostate cancer receiving PELVIC RADIATION, the radiation field is in the pelvis — FAR FROM the major and minor salivary glands (parotid, submandibular, sublingual). Therefore, pelvic radiation is the LEAST LIKELY cause of xerostomia in this patient. If the patient has xerostomia, other causes should be investigated.

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