Cancer Treatment Related Mucositis – Inflammation of Mucous Membranes
The lining of the mouth, throat, and esophagus are very sensitive to radiation and chemotherapy. These treatments cause these areas to become red, sore, and swollen. This is called mucositis. Your saliva may become thick due to these changes. Your mouth may become dry as less saliva is being made. Taste buds are often affected causing changes in the taste of foods and liquids. You may also notice a change in the texture of foods.
Symptoms of mucositis depend on treatment.
|Radiation||Chemotherapy||Bone Marrow Transplant|
|Symptoms begin about the third week of treatment.||Symptoms often appear about 1-2 weeks into therapy.||Symptoms often occur in the first week after chemo.|
|Symptoms last for about 4-6 weeks.||Symptoms improve as you recover from chemo.||Symptoms last until the white blood cell count returns.|
With proper care, these symptoms will heal. The healing process may vary for each patient. Please discuss your symptoms with your nurse or doctor.
Tips to help reduce mucositis pain and promote healing
Frequent and thorough mouth care is crucial.
- Replace your toothbrush every 1-2 weeks.
- Do not use mouthwash (Listerine®, Scope® etc) as these can contain alcohol and make mucositis worse. You may use Biotene®.
- Do not use mouth rinses that contain peroxide.
- Ice chips and popsicles can be soothing.
- A soft diet may help to lessen discomfort. You will want to avoid hot, spicy, or rough foods (potato chips, toast, etc.).
For patients coming to the clinic for radiation or chemo treatments
1. Brush your teeth often with a soft brush or toothette and a gentle fluoride toothpaste such as Biotene® or Sensodyne®. You may floss gently, if this has been a routine part of your dental hygiene and your white blood cell and platelet counts are not too low. (Ask your doctor or nurse what your blood cell counts are). Check your tongue and mouth each day for sores or white patches. If you find sores or patches, report them when you come for treatment.
2. Rinse your mouth often to keep it moist. Mix ¼ teaspoon of salt and ¼ teaspoon of baking soda in an 8-ounce glass of warm water. If your mouth burns when you use this rinse, decrease the amount of salt in it. Many brands of artificial salvia can be purchased at your drug store. You will not need a prescription to buy it.
3. For thick saliva, gargle with the salt and baking soda mixture.
4. Numbing gels, sprays, and lozenges may be used. Pain medicines such as Tylenol® or ibuprofen may help make it easier to swallow. Sometimes, stronger pain medicines may be needed.
5. Avoid smoking and drinking alcohol (hard liquor, beer, or wine). Both can dry and irritate the mouth.
6. Some foods will bother your mouth. Avoid spices (pepper, chili powder, nutmeg, horseradish, and Tabasco®), and hot, rough, or course foods. High calorie, high protein, soft, bland foods are good to eat. Moisten food with sauces and gravy.
7. Dilute citrus juice. Orange, grapefruit, lemon, and lime juices are slightly acidic which can make your mouth worse. You may need to stop drinking citrus juices until your treatment is over, and your mouth is healed.
8. Mucositis can make your teeth more prone to decay. Special fluoride rinses can help prevent the decay. Your doctor will suggest you see your dentist.
9. Visit your dentist at regular times after you finish your cancer treatment. You should tell your dentist about the treatment to your mouth. Before having any oral surgery, teeth pulled, or any other dental work, please contact your oncologist at (608)-265-1700.
For patients who are in the hospital
1. Your nurses will encourage you to do your own oral care. Your family can be as involved in your care as they wish.
2. Rinse your mouth with normal saline (salt water) at least every two hours.
3. Brush your teeth with a soft-bristle toothbrush after each meal and before bed. If you are not eating meals, brush your teeth at least twice daily. Toothettes® (small soft sponges on sticks) may be used in place of a soft-bristle toothbrush.
4. A suction device is sometimes helpful for clearing secretions.
5. Your doctor may order pain pills, numbing medicines, or pain medicine given through an IV.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 04/20/2012
Copyright © 04/20/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4494
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