Radiation and chemotherapy increase a patient’s risk of developing the side effect known as oral mucositis, but certain actions can be taken to improve quality of life.
Patients with cancer who receive radiation therapy or chemotherapy may be at risk of developing oral mucositis, which can be a side effect of these treatments.
Oral mucositis may cause mouth sores, mouth pain, swelling, infection and bleeding that can affect the patient’s quality of life. It typically begins 5-10 days following treatment and can last for up to six weeks or longer, according to the Oral Cancer Foundation.
“Usually, oral mucositis starts with tenderness or soreness, then it can progress into open lesions,” Caroll Tipian, a nurse practitioner at Memorial Sloan Kettering Cancer Center in New York City, said in an interview with CURE®. “So when there is tenderness, (patients should) mention it to their health care provider or nurse practitioner.”
Patients are typically graded on a scale of zero (no signs or symptoms) to four (life-threatening) — four meaning sores may be bleeding. “If that’s the case, (and patients are a four), then some patients may need inpatient hospitalization because they might need IV pain medication.”
To help alleviate the pain of the mouth sores, patients may also be given topical lidocaine treatment. These products can be applied to a specific ulcer. However, if the mucositis is widespread, patients may need special mouth rinses, according to Tipian. “Depending on the severity of mucositis and treatment being received, we can sometimes use steroids to help with the inflammatory cascade,” she said.
While these treatments all are provided by a health care professional, there are certain things patients can do at home, such as maintaining good oral hygiene, which includes brushing twice a day with a soft toothbrush; flossing, if they don’t have low platelet counts; and using a mouth rinse four times a day with saline solution. Patients want to avoid strong flavored mouthwashes and mouthwashes that contain alcohol.
They also should eliminate tobacco and alcohol, maintain hydration and consume bland foods that are moist and soft. Acidic, salty, dry, spicy or hot foods may aggravate the mucositis; therefore, patients should try to remove these from their diet.
And, if a patient wears dentures, the Oral Cancer Foundation advises to remove them whenever possible to expose the gums to air.
Most importantly, patients shouldn’t wait to ask for help from their health care team. “Try not to play a hero. Make sure you stay on top of pain control because once the pain gets too high, then we are chasing the pain. Be cognizant,” Tipian said.