The Connection between Radiation Therapy, Chemo, and Mouth Sores

Cancer patients often develop unpleasant side effects as a result of treatment, particularly those going through chemotherapy (chemo) or radiation therapy. If you or a loved one is going through one or a combination of these treatments, you may have heard about the connection between radiation therapy, chemo, and mouth sores - a condition known as oral mucositis.

What Is Oral Mucositis?

Oral mucositis is common and debilitating side effect of chemotherapy and radiation treatment. The condition refers to mouth sores or ulcerative lesions of the tissues of the mouth including the lips, cheeks, gums, tongue, and the floor and roof of the mouth. However, it can affect other areas of the gastrointestinal (GI) tract including the esophagus, the tube leading to your stomach. The lesions of oral mucositis are frequently very painful. They can limit the nutrition of patients and may increase the risk of infection, reducing the quality of life of patients going through cancer treatment.

What Patients Are More Likely to Develop Oral Mucositis?

Oral mucositis usually affects patients going through chemotherapy and/or radiation treatment in areas involving the oral cavity. The condition can particularly affect those receiving radiation treatment to the neck, chest, or abdomen. Studies indicate that approximately fifty-one percent (51%) of patients receiving chemotherapy for solid tumors or lymphoma develop mucositis, while almost all patients treated with radiation for neck and head cancer develop some degree of oral mucositis. Furthermore, the same study reports that twenty-nine to sixty-six percent (29-66%) of patients receiving neck and head radiation treatment develop severe oral mucositis.

Symptoms of Oral Mucositis

Mouth sores and ulcerations are the main symptoms of oral mucositis. You may experience some redness to the lining of the mouth or develop ulcerations that are covered by a yellowish or white clot. The mouth sores can be very painful depending on the ulceration size and tissue damage. The pain can lead to difficulty speaking, opening the mouth, or even eating and drinking.

Because of the pain associated with oral mucositis, patients are at risk of developing anorexia, as well as cancer associated malnutrition (CAM), a type of malnutrition that affects the muscles and the metabolic processes of the body.

In addition to pain, cancer patients with oral mucositis may develop dysgeusia, an altered sense of taste or “taste blindness”. Dysgeusia is usually temporary symptom caused by damage to the taste buds that causes patients to perceive food as too sweet, bitter, or of a metallic taste. Furthermore, patients can develop a more severe form of mucositis referred to as GI mucositis. GI mucositis affects organs beyond the mouth that can lead to internal bleeding and diarrhea.

Diagnosis of Oral Mucositis

Mucositis is diagnosed based on the symptoms of the patient. The signs of discomfort and the appearance of the tissues of the mouth are used to evaluate the patient’s condition. The severity of the condition is evaluated by examining the phases of oral mucositis and using assessment tools such as The Oral Toxicity Score, The National Cancer Institute Common Toxicity Criteria for Oral Mucositis, and The Oral Mucositis Assessment Scale.

How Long Can Oral Mucositis Last?

Oral mucositis can start within days of initial treatment for patients going through chemotherapy. It is reported that the condition peaks at around day ten (10) of treatment, improving slowly over several weeks. On the other hand, mucositis associated with radiotherapy tends to appear after the second week of treatment with symptoms lasting from six to eight weeks. However, it is important to acknowledge that the duration of oral mucositis can vary depending on the severity of the condition and your treatment plan.

Can Oral Mucositis Interfere with Treatment?

Patients with oral mucositis can develop complications that interfere with treatment. The sores and ulcerations can become severely infected and may be life threatening during times of immunosuppression. Patients with severe mucositis may become too weak to withstand treatment as a result of low nutrition from painful swallowing. Furthermore, the condition can lead to unplanned hospitalizations that can interfere and disrupt the optimal treatment plan of cancer patients potentially reducing their chances of survival.

It is important to become familiar with the physical and financial burdens of oral mucositis. Talk to your doctor about oral mucositis treatments and the measures you can take before treatment to reduce the severity of mucositis.


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