Table of Contents
Affordable Prosthetics for
Economically
Disadvantaged
Patients
Sudarat Kiat-amnuay, D.D.S., assistant professor of
restorative dentistry and biomaterials,
Dental Branch
Sudarat Kiat-amnuay,
D.D.S.
Imagine losing a part of your face due to cancer. If this isn’t bad enough, now the prosthetic itches, makes your face look bizarre, smells funny, and costs more than your mortgage.
Sudarat Kiat-amnuay, D.D.S., studies prostheses for patients who have lost parts of their face due to cancer, trauma or birth defects. She is particularly interested in providing affordable alternatives to patients in underserved areas and developing countries.
Apart from the aesthetic benefits of improved prosthetics, her research also hopes to improve cancer patients’ emotional well-being. “Cancer of the head and neck region can profoundly affect patients’ quality of life as they are constantly reminded of their affliction. The emotions involved go far beyond just aesthetic considerations,” she said.
Kiat-amnuay is conducting a randomized, controlled, multicenter phase III clinical trial funded by the National Institutes of Health (NIH) comparing traditional silicone rubber facial prostheses to those made from a newer, more cost-effective material, chlorinated polyethylene (CPE). CPE was originally developed by Kiat-amnuay’s research mentor, Lawrence Gettleman, D.M.D., and his colleagues in the 1970s and ‘80s. This material costs less than one-tenth as much per pound as silicone rubber.
Kiat-amnuay’s interest in providing economical facial prostheses for low-income patients logically led her to consider CPE as a candidate material. Together with Gettleman, Kiat-amnuay co-wrote the proposal, and they were awarded $2.9 million to perform a clinical trial evaluating the two prosthetic materials.
“I was inspired to develop this clinical trial by one of my head and neck surgeon friends from Thailand and his work with cancer patients. For his patients, the silicone materials were simply too expensive,” she said. “As a consequence, many of his patients decided to forgo treatment of their cancer because they did not want the disfigurement and could not afford the reconstruction.”
Her research will benefit patients of all economic ranges looking for alternatives to traditional silicone extraoral facial prosthetics. According to Kiat-amnuay, silicone rubber facial prosthetics leave much to be desired.
“Many of the patients who receive ear, nose, eye and cheek prostheses have had problems with silicone rubber and its urethane liner, which tears, attracts fungus or discolors over time. There are numerous reports of dissatisfaction with the aesthetics, color stability, function or longevity of prostheses,” Kiat-amnuay said. “The silicone rubber materials have been used for more than 40 years with few improvements.”
This trial, which includes patients at the UT M. D. Anderson Cancer Center, is scheduled for completion in 2009. Patients still are being actively recruited for the study.