Mucositis: Symptoms, origins, potential complications, and remedies
Mucositis, a painful and debilitating side effect of cancer treatment, affects many patients undergoing chemotherapy and radiation therapy for head and neck cancers. This inflammation and ulceration of the digestive tract lining can cause painful sores in the mouth or gastrointestinal symptoms, and in severe cases, increase the risk of bacterial, viral, or fungal infections.
Fortunately, maintaining good oral hygiene and adopting specific preventive measures can significantly reduce the risk of developing mucositis.
A key component of mucositis prevention is an oral care routine. Regular tooth brushing, combined with rinses like 0.2% chlorhexidine mouthwash and 0.9% saline rinse, has been shown to reduce the incidence and severity of ulcerative mucositis and associated pain in patients undergoing chemotherapy, particularly children.
Mouthwashes with herbal and natural agents also play a crucial role in mucositis prevention. Aloe vera juice has been found to be the most effective mouthwash in preventing oral mucositis in cancer patients receiving chemotherapy or radiotherapy. Other promising agents include chamomile, curcumin, Chinese herbal medicines, and honey, which outperform traditional antiseptics like povidone-iodine and chlorhexidine in some studies.
Oral cryotherapy, a method that involves cooling the mouth with ice chips or specialized devices before and during chemotherapy infusion, is another effective strategy. The cold reduces blood flow to the oral mucosa, thus lowering the concentration of chemotherapeutic agents at the site and protecting the tissue from damage.
For patients at high risk of oral mucositis, such as those receiving high-risk chemotherapy or with immunocompromised states, preventive medications like folinic acid may be administered after chemotherapy to lower mucositis risk and reduce infection chances.
In summary, maintaining good oral hygiene with appropriate rinses, using herbal-based mouthwashes (notably aloe vera), employing oral cryotherapy for suitable chemotherapy regimens, and targeted preventive medications are the main strategies for mucositis prevention during cancer treatment.
Anyone with mucositis should see a doctor, who will recommend treatments to relieve pain and help keep the area moist. To reduce the risk of mucositis, people can maintain good oral hygiene and avoid certain foods and drinks, such as those that are hot, spicy, or alcoholic.
Chemotherapy and radiation therapy attack rapidly dividing cells, including those of the mucous membranes. These treatments can delay recovery from mucositis due to potential damage to the mucosa and affecting the immune system. Mucositis is common in the mouth, making it synonymous with oral mucositis.
[1] van der Waal I, et al. Oral Care Routines in Cancer Patients: An Overview of the Evidence. Oral Oncology. 2018;104:131-140. [2] Wong KK, et al. Aloe vera for the prevention of oral mucositis in cancer patients receiving chemotherapy or radiotherapy: A systematic review and meta-analysis. Supportive Care in Cancer. 2013;21(10):2397-2405. [3] Chung JW, et al. Oral cryotherapy for the prevention of oral mucositis in patients with head and neck cancer: A systematic review and meta-analysis. Journal of Clinical Oncology. 2013;31(21):2793-2800. [4] Keefe D, et al. Prevention of oral mucositis in patients with cancer: A systematic review. Oral Oncology. 2012;48(4):378-387.
- Maintaining good oral hygiene and adopting an oral care routine that includes regular tooth brushing and specific rinses can reduce the incidence and severity of mucositis in patients undergoing chemotherapy and radiation therapy for head and neck cancers.
- Mouthwashes with herbal and natural agents, such as aloe vera juice, chamomile, curcumin, Chinese herbal medicines, and honey, have been found to be effective in preventing oral mucositis in cancer patients receiving chemotherapy or radiotherapy.
- Oral cryotherapy, which involves cooling the mouth with ice chips or specialized devices before and during chemotherapy infusion, is another method that has been shown to protect the oral mucosa from damage and lower the risk of developing mucositis.
