Side
Effects or Treatment
Support Guidelines > Oral
Side Effects
Last updated: 04/01/2008
|
Oral |
Resources | Research News
Oral
Mucositis | Oral Thrush | Loss
of Taste | Dry Mouth
| Burning Mouth Syndrome
Oral
side effects that can result from cancer treatments include
oral mucositis, oral thrush
and loss of taste sensation or smell.
Oral health is
important!
In addition to being painful, a sore mouth can become easily
infected. Every step should be taken to prevent infections, because
they can be hard to fight during chemotherapy and can lead to
serious problems or the interruption of your treatment.
Prevention:
Talk you your doctor about seeing a dentist at least two weeks
before chemotherapy begins. If you've already started
chemotherapy and didn’t go to a dentist, see one as soon as
possible, and notify him
or her that you are receiving treatment.
Tip: If
brushing becomes too painful due to mouth sores, try a finger
toothbrush. Meant for babies, they are very gentle yet are
helpful in keeping the teeth and gums clean. They can be found in
most drugstores and grocery stores.
See Oral complications of cancer radiotherapy.
Postgrad Med. 1977 Feb;61(2):85-92.
PMID: 834698 PubMed
| Related
abstracts
Oral
Mucositis ( stomatitis)
Inflammation of the mucous
membranes in the mouth.
It can range from redness to severe ulceration.
This is a side effect associated with many cancer treatments.
TOPIC
SEARCH: Radiotherapy and: PubMed
Cancer Treatment and Mucositis: PubMed
| ASCO
| Medscape
| WEB
Mucositis is painful and can affect nutrition,
increase risk of infection, and can delay treatment. It can lead to
major complications after or during cancer treatment.
Research News
 | Preventing / managing oral mucositis
(resources) - common and serious side effect related to high dose
therapy and stem cell transplantation Abstract
|
|
A prospective, randomized study of cryotherapy ... [ice chips
and ice-cold water shortly before, during, and for additional 90
min after completion of treatment] ... during administration
of high-dose melphalan to decrease the severity and duration of
oral mucositis in patients with multiple myeloma undergoing
autologous peripheral blood stem cell transplantation. Bone
Marrow Transplant. 2006 Jun;37(11):1031-5. PMID: 16633359
Compared to the normal saline group, patients using cryotherapy
experienced less grade 3-4
mucositis, 14 vs 74%, P=0.0005. Patients receiving cryotherapy
also had statistically
lower uses of narcotics and TPN, although there were no
differences in length of
hospitalization or weight loss. Patient-reported pain was
significantly lower and
activities were significantly better in the cryotherapy group.
|
Resources
and Articles
|
|
|
|
|
|
|
|
|
Mucosal damage: a major risk factor for severe complications
after cytotoxic therapy.
Semin Oncol. 2004 Jun;31(3 Suppl 8):35-44. Review. PMID:
15181607
|
|
Preventing Mucositis - discussion of investigational use of
Dehydroascorbic acid
DHA Medscape
(free login req.)
|
|
Management of oral mucositis during local radiation and
systemic chemotherapy:
a study of 98 patients. J Prosthet Dent.
1991 Sep;66(3):361-9.
PMID: 1800734 PubMed
| Related
abstracts
|
|
Prospective evaluation of a chamomile mouthwash for prevention
of 5-FU-induced oral mucositis.
Cancer. 1996 Feb 1;77(3):522-5.
PMID: 8630960 PubMed
|
|
Chlorhexidine prophylaxis for chemotherapy- and
radiotherapy-induced stomatitis:
a randomized double-blind trial.
Oral Surg Oral Med Oral Pathol. 1990 Mar;69(3):331-8.
PMID: 2179802 PubMed
|
| News: FDA Approves Kepivance for Severe Oral
Mucositis in Cancer Patients
Undergoing Bone Marrow Transplant; Pivotal Phase 3 Study
Published in
This Week's New England Journal of Medicine cancerconsultants.com
Dec 2004
Questions and Answers on Palifermin (Keratinocyte Growth
Factor) FDA.gov
|
|
News (Medscape):
"Ascorbic acid has antioxidant properties and participates in wound healing.
Dehydroascorbic acid (DHA) is a prodrug form of ascorbic acid that readily crosses cell
membranes and is converted into ascorbic acid within mucosal cells.
The hamster model of acute radiation is useful for assessing treatment for mucositis.
There is little systemic toxicity in the model, in which hamsters receive radiation therapy
to the buccal mucosa. In a randomized study[4] comparing DHA given topically vs a
non-DHA-containing topical solution in terms of their ability to reduce the incidence of
mucosal damage, DHA therapy led to no change in the onset of acute mucositis.
Other studies are now under way to evaluate other doses of DHA in this model.
This compound is being formulated for use in human studies, which are expected
to begin within the next 6 to 12 months. Interestingly, ascorbic acid does not
seem to be effective in this model, perhaps because it does not enter into cells as efficiently.
|
|
The cancer patient with severe mucositis. Curr Rev Pain.
2000;4(3):197-202. Review.
PMID: 10998733 abstract
|
|
Complementary Medicine AND:
 |
Oral glutamine to alleviate radiation-induced oral mucositis:
a pilot randomized trial.
Int J Radiat Oncol Biol Phys. 2000 Feb 1;46(3):535-9. PMID:
10701731 abstract
| related
abstracts
|
|
Vitamin E [topical] in the treatment of
chemotherapy-induced mucositis. Am J Med 1992;92:481–4.
abstract
|
|
Oral thrush
presents as distinctive
lesions of the mouth, tongue, or cheeks -- caused
by infection of the mouth with the fungus (yeast) Candida albicans..
Lesions are easily brushed away revealing a reddened, tender area that
may bleed slightly." MedlinePlus
Loss of taste sensation is called
Ageusia.
Anosmia is
the technical name for loss of smell. These are expected side effect
of localized radiation treatment, which can improve with time. These
effects can have " devastating physical and psychological consequences for the patient. Oral complications include
xerostomia, dental decay, mucositis, taste loss,
osteoradionecrosis, infection, and trismus. In many instances, these
problems can be eradicated or controlled with appropriate
treatment."
"As the
effects of the treatment fade away things return to normal, but it
may take up to a year for your sense of taste to return."
source cancerbacup.org.uk
Consulting a nutritionally oriented
health professional is advised to determine nutritional deficiencies
that may contribute to the problem, as well as nutrients that might
help to rebuild the cells damaged by treatment, such as Zinc,
and vitamin B-12, glutamine.
| About oral thrush CDC
|
| Information from Merck
Manual
"Depending on the cause of the taste disorder, a doctor may
recommend changing or stopping
a suspected drug, keeping the mouth
wet by sucking on candy, or just waiting several weeks
to see if
the problem disappears. Zinc supplements, which can be purchased
without a
prescription, are claimed to speed recovery, especially
from taste disorders that follow
a bout of the flu. The effect,
however, has not been scientifically confirmed."
|
| Taste and smell impairment CancerSupportiveCare
"The cells comprising taste buds usually
will regenerate
within four months after treatment. However, the degree of
long-term
impairment of taste is quite variable from patient to
patient."
|
| Impaired taste info MedlinePlus
"Vitamin (Vitamin B-12) or mineral (Zinc in diet)
deficiency"
|
| Disorders of taste and smell eMedicine.com
|
Burning Mouth Syndrome
( BMS):
burning pain in the tongue or oral mucous membranes, usually without
accompanying clinical and laboratory findings. Candidal infections
are also purported to cause burning mouth syndrome. About
BMS aafp.org
|
Burning mouth syndrome
(BMS): double blind controlled study of alpha-lipoic acid (thioctic
acid) therapy.
J Oral Pathol Med. 2002 May;31(5):267-9. PMID:
12110042
|
Dry Mouth
(xerostomia),
is a reduction in the
production and quality of saliva in the salivary glands is a known
side effect of radiation therapy.
Try to follow these simple
guidelines:
|
Perform oral hygiene after
each meal and before bedtime
|
Rinse mouth immediately
after meals
|
Brush and rinse
dentures after meals
|
Use fluoride-based
toothpaste
|
Drink clean water to
keep mouth moist at all times
|
Ask your doctor about
use of prescription fluoride gel at bedtime
|
Rinse often with salt
and baking soda solution
|
Limit or avoid
sugar-based liquids and foods
|
Avoid alcohol-based
rinses
|
Use lip moisturizers
|
Ask your doctor about Oral
pilocarpine (Salagen) a drug that stimulates saliva secretion |
| | | | | | | | | |
Adapted from thecancerblog.com
Research
|
Acupuncture for pilocarpine-resistant xerostomia
following radiotherapy for head and neck malignancies.
Int J Radiat Oncol Biol Phys. 2001 Jun 1;50(2):353-7. PMID:
11380221
Acupuncture reduces xerostomia in some patients who are
otherwise refractory to best current management.
|
Related Resources
|
Complimentary Medicine: Chemo-protection
PAL | Radio-protection PAL
|
|
Low blood counts PAL
|
|
Chemotherapy side effects PAL
|
|
Quick Reference
Stomatitis or mucositis: inflammation of lining of
the digestive system.
Xerostomia (Dry Mouth)
|
Research News:
| New Drug for Mouth Sores after Bone Marrow Transplants ~ Palifermin Approved for Leukemia, Lymphoma Patients
cancer.org
|
| Palifermin (rHu-KGF) Improves Quality of Life in Patients Undergoing Stem Cell Transplantation
CancerConsultants
2003
|
|
Amifostine: A
Useful Radio/Chemoprotectant? jo
| Medscape
|
|
|
|
stomatitis
xerostomia
