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What is mucositis?
What causes mucositis?
What are the symptoms of mucositis?
What can be done to manage the symptoms of mucositis?
How does Mucotrol Work ?
Mouth, Gum, and Throat Problems
Mucositis is the swelling, irritation, and ulceration of the mucosal cells that line the mouth and digestive tract. It can be a very troublesome and painful side effect of chemotherapy or radiation. Mucositis is an inflammation of mucous membranes in the mouth. The terms "oral mucositis" and "stomatitis" are often used in place of each other, but their meanings are different.
- Mucositis is an inflammation of mucous membranes in the mouth. It usually appears as red, burn-like sores or as ulcer-like sores throughout the mouth.
- Stomatitis is an inflammation of tissues in the mouth, such as the gums, tongue, roof and floor of the mouth, and tissues inside the lips and cheeks. It includes infections of mucous membranes.
Mucositis may be caused by either radiation therapy or chemotherapy. In patients receiving chemotherapy, mucositis will heal by itself, usually in 2 to 4 weeks when there is no infection. Mucositis caused by radiation therapy usually lasts 6 to 8 weeks, depending on the duration of treatment.
The following problems may occur:
- Pain.
- Infection.
- Bleeding, in patients receiving chemotherapy. Patients undergoing radiation therapy usually do not have a bleeding risk.
- Inability to breathe and eat normally.
Swishing ice chips in the mouth for 30 minutes may help prevent mucositis from developing in patients who are given fluorouracil. Medication may be given to help prevent mucositis or keep it from lasting as long in patients who undergo high-dose chemotherapy and bone marrow transplant.
Care of mucositis during chemotherapy and radiation therapy focuses on cleaning the mouth and relieving the symptoms. Good oral care is important during cancer treatment. Some anticancer drugs can cause sores in the mouth and throat, a condition called stomatitis or mucositis. Anticancer drugs also can make these tissues dry and irritated or cause them to bleed. Patients who have not been eating well since beginning chemotherapy are more likely to get mouth sores.
In addition to being painful, mouth sores can become infected by the many germs that live in the mouth. Every step should be taken to prevent infections, because they can be hard to fight during chemotherapy and can lead to serious problems.
The cells that line the digestive tract are special; their lifespan is very short compared to other cells. Due to this reason, they reproduce rapidly. Chemotherapy agents do not differentiate between healthy cells and cancer cells. Because the digestive tract cells reproduce rapidly, the chemotherapy agents can destroy them quickly, breaking down the protective lining, leaving them prone to inflammation, irritation, and swelling. Mucositis can be further complicated by nausea and vomiting that often occurs with treatment.
Symptoms may include redness and swelling of the gums, ulcerations in the mouth, throat diarrhea, abdominal cramping, tenderness and rectal ulcerations or redness.
Mucositis may occur for a week or longer after completion of therapy. Unfortunately, there are no medications and no methods to control mucositis. Symptoms may not be preventable. However, you can manage pain and obtain relief by using Mucotrol™.
How does Mucotrol Work ?
Mucotrol™ is a concentrated oral gel wafer formulation. When slowly dissolved in the mouth, Mucotrol™ forms a coating on the oral mucosal surface, resulting soothing oral lesions, including oral mucositis that may be caused by chemotherapy or radiotherapy. Mucotrol is formulated as a slow-dissolving wafer for the convenience of the user. Unlike other products, no water is required for the usage of this product.
This patient summary on oral complications of cancer and cancer therapy is adapted from the summary written for health professionals by cancer experts. This and other accurate, credible information about cancer treatment, screening, prevention, supportive care, and ongoing clinical trials is available from the National Cancer Institute. Oral complications are common in cancer patients, especially those with head and neck cancer. This summary describes oral complications caused by chemotherapy and radiation therapy and various methods of prevention and treatment. Oral complications are common in patients receiving chemotherapy or undergoing radiation therapy to the head and neck.
The oral cavity is at high risk of side effects from chemotherapy and radiation therapy for a number of reasons.
- Chemotherapy and radiation therapy stop the growth of rapidly dividing cells, such as cancer cells. Since normal cells in the lining of the mouth also divide rapidly, anticancer treatment can prevent cells in the mouth from reproducing, making it difficult for oral tissue to repair itself.
- The mouth contains hundreds of different bacteria, some helpful and some harmful. Chemotherapy and radiation therapy can cause changes in the lining of the mouth and production of saliva and upset the healthy balance of bacteria. These changes may lead to mouth sores, infections, and tooth decay.
- Wear and tear occurs from normal use of the mouth, teeth, and jaws, making healing more difficult.
Preventive measures may lessen the severity of oral complications. Oral side effects may make it difficult for a patient to receive all of his or her cancer treatment. Sometimes treatment must be stopped. Preventing and controlling oral complications will enhance both the patient's quality of life and the effectiveness of cancer therapy. Preventing and treating oral complications of cancer therapy involve identifying the patient at risk, starting preventive measures before cancer therapy begins, and treating complications as soon as they appear.
Description and Causes
Radiation therapy and chemotherapy may cause some of the same oral side effects, including the following:
- Mucositis (an inflammation of the mucous membranes in the mouth).
- Infections in the mouth or that travel through the bloodstream, reaching and affecting cells all over the body.
- Taste changes.
- Dry mouth.
- Pain.
- Changes in dental growth and development in children.
- Malnutrition (lack of nutrients needed by the body for health, often caused by the inability to eat).
- Dehydration (lack of water needed by the body for health, often caused by the inability to drink).
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Tooth decay and gum disease.
Complications may be caused directly or indirectly by anticancer therapy. Oral complications associated with chemotherapy and radiation therapy may be caused directly by the treatment or may result indirectly from side effects of the treatment. Radiation therapy may directly damage oral tissue, salivary glands, and bone. Areas treated may scar or waste away.
Slow healing and infection are indirect complications of cancer treatment. Both chemotherapy and radiation therapy can affect the ability of cells to reproduce, which slows the healing process in the mouth. Chemotherapy may reduce the number of white blood cells and weaken the immune system (the organs and cells that defend the body against infection and disease), making it easier for the patient to develop an infection.
Complications can be acute or chronic. Acute complications are those that occur during therapy. Chemotherapy usually causes acute complications that heal after treatment ends. Chronic complications are those that continue or develop months to years after therapy ends. Radiation can cause acute complications but may also cause permanent tissue damage that puts the patient at a lifelong risk of oral complications. The following chronic complications commonly continue after radiation therapy to the head and/or neck has ended:
- Dry mouth.
- Tooth decay.
- Infections.
- Taste changes.
- Problems using the mouth and jaw due to tissue and bone loss and/or the growth of benign tumors in the skin and muscle.
Invasive dental procedures can cause additional problems. The dental care of patients who have undergone radiation therapy will therefore need to be adapted to the patient's ongoing complications
How can I keep my mouth, gums, and throat healthy?
- Talk to your doctor about seeing your dentist at least several weeks before you start chemotherapy. You may need to have your teeth cleaned and to take care of any problems such as cavities, gum abscesses, gum disease, or poorly fitting dentures. Ask your dentist to show you the best ways to brush and floss your teeth during chemotherapy. Chemotherapy can make you more likely to get cavities, so your dentist may suggest using a fluoride rinse or gel each day to help prevent decay.
- Brush your teeth and gums after every meal. Use a soft toothbrush and a gentle touch. Brushing too hard can damage soft mouth tissues. Ask your doctor, nurse, or dentist to suggest a special toothbrush and/or toothpaste if your gums are very sensitive. Rinse with warm salt water after meals and before bedtime.
- Rinse your toothbrush well after each use and store it in a dry place.
- Avoid mouthwashes that contain any amount of alcohol. Ask your doctor or nurse to suggest a mild or medicated mouthwash that you might use. For example, mouthwash with sodium bicarbonate (baking soda) is non-irritating.
If you develop sores in your mouth, tell your doctor or nurse. You may need medicine to treat the sores. If the sores are painful or keep you from eating, you can try these ideas:
How can I cope with mouth sores?
- Ask your doctor if there is anything you can apply directly to the sores or to prescribe a medicine you can use to ease the pain.
- Eat foods cold or at room temperature. Hot and warm foods can irritate a tender mouth and throat.
- Eat soft, soothing foods, such as ice cream, milkshakes, baby food, soft fruits (bananas and applesauce), mashed potatoes, cooked cereals, soft-boiled or scrambled eggs, yogurt, cottage cheese, macaroni and cheese, custards, puddings, and gelatin. You also can puree cooked foods in the blender to make them smoother and easier to eat.
- Avoid irritating, acidic foods and juices, such as tomato and citrus (orange, grapefruit, and lemon); spicy or salty foods; and rough or coarse foods such as raw vegetables, granola, popcorn, and toast.
How can I cope with mouth dryness?
- Ask your doctor if you should use an artificial saliva product to moisten your mouth.
- Drink plenty of liquids.
- Ask your doctor if you can suck on ice chips, popsicles, or sugarless hard candy. You can also chew sugarless gum. (Sorbitol, a sugar substitute that is in many sugar-free foods, can cause diarrhea in many people. If diarrhea is a problem for you, check the labels of sugar-free foods before you buy them and limit your use of them.)
- Moisten dry foods with butter, margarine, gravy, sauces, or broth.
- Dunk crisp, dry foods in mild liquids.
- Eat soft and pureed foods.
- Use lip balm or petroleum jelly if your lips become dry.
- Carry a water bottle with you to sip from often.
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