Cancer treatment is a long journey and often takes a toll on your body. It is often associated with some unwanted changes or adverse effects in your body. One of the most common side effects associated with cancer treatment is oral mucositis or mouth sores.
Cancer related mouth sores or oral mucositis often develop 3-10 days after chemotherapy and tend to worsen after 7-14 days. It leads to inflammation and small cuts on the inside lining of your mouth or on your lips. It can be painful and distressing, significantly affecting a patient's quality of life.
It is difficult to stop mucositis from happening, but some steps can be really helpful. Knowing what to look out for and how to manage these oral side effects can reduce the discomfort and pain. So, let’s discuss the mucositis in detail and potential measures to relieve pain and further complications.
- What is oral mucositis or mouth sores?
- What causes mouth sores in cancer patients?
- What are the common signs and symptoms?
- 5 tips to reduce mouth sores caused due to cancer treatment
What is oral mucositis/mouth sores?
Oral Mucositis, or mouth sores refers to inflammation or ulcerations in the mucous membrane of the mouth. It further causes little cuts or ulcers in your mouth and soft tissues of your lips which makes it hard to eat, chew, swallow and talk.
If left untreated, these sores can spread to the throat and further down in the gastrointestinal tract, resulting in serious infections, poor eating, dehydration, malnutrition, microbial infections and extreme weight loss or cachexia in severe cases.
What causes mouth sores in cancer patients?
Cancer patients can develop mouth sores and other oral complications due to several causes such as:
- Chemotherapy and radiotherapy used for treating cancer, acts by slowing or inhibiting the growth of rapidly dividing cancer cells. These treatments can also stop the growth of rapid growing health cells such as cells lining the mouth and gastrointestinal tract leading to mouth sores
- Radiation therapy can directly damage the oral tissue and salivary glands causing mucositis and dry mouth, especially in head and neck and oral cancer patients
- Chemotherapy and radiotherapy also disrupts the normal microflora of mouth, thus increasing the risk of tooth decay, bacterial infections and mouth sores
What are the common signs and symptoms?
Cancer patient with oral mucositis or mouth sores may develop symptoms include:
- Soft white patches in the mouth, on the tongue, or on the gums
- Swelling in the gums, mouth, or throat
- Bleeding in the mouth
- Small painful ulcers, canker and cold sores
- Pain in the mouth or throat
- A white or yellow film, patches, or pus in the mouth or on the tongue
- Thick saliva and increased mucus
- Mouth dryness and mild burning while eating cold and hot foods
- Imprints of the teeth on the tongue
5 tips to reduce mouth sores caused due to cancer treatment
It is difficult to treat mouth sores or oral mucositis in cancer patients, but a few tips and measures can help to reduce pain and discomfort associated with mouth sores. Treatment options include:
- Maintain oral hygiene
- Brush your teeth regularly, with a soft toothbrush or a foam swab and mild toothpaste, preferably after every meal
- Rinse your mouth with mouthwash, saltwater or warm water mixed with 1 tsp of baking soda and avoid using mouthwashes with alcohol
- Keep your mouth and lip moist throughout the day to ease discomfort. Always choose a mild moisturizer without chemical irritants
- Always clean your dentures or bridges after eating, and try to remove them frequently, if you are experiencing any discomfort.
- Get a dental checkup and fix your dental problems before starting chemotherapy to reduce risk of infections
- Watch on what you eat and drink
- Eat a healthy diet rich in high protein and calories often in a soft and semi-liquid, if you are having trouble while eating and swallowing.
- Drink plenty of fluids to reduce dehydration and try to use a straw as it keeps liquid away from sores
- Adopt healthy food choices such as mashed potatoes, cooked cereals, pudding, yogurt, soups, puppies and smoothies
- Avoid spicy, salty, hard, dry sticky and acidic foods containing citric acid
- Do not eat and drink foods with extreme temperatures either too cold or too hot
- Limit intake of alcohol and avoid smoking
- Follow self-management tips to reduce discomfort
- Chew ice chips to ease out pain and swelling
- Try chewing sugarless gum for increased saliva flow
- Use a cool mist humidifier at night to keep your mouth moist while sleeping.
- Take small bites, chew slowly, and sip liquids with your meals
- Treat pain and discomfort using prescribed medications
- Pain relieving medications such as gabapentin used for discomfort but it won't help to heal mouth sores
- Non-steroid anti-inflammatory medications that may help both healing and discomfort
- Palifermin, a growth factor drug available in liquid form that helps stimulate oral tissue
- Over the counter topical mouthwash solutions containing anaesthetic agents such as lidocaine or benzocaine to soothe mouth sores
- Other techniques for reducing your risk of mouth sores
- Cryotherapy: It includes use of ice chips before, during and after chemotherapy as it minimizes discomfort by decreasing tissue blood flow and limits high chemical or radiation exposure from treatment
- Low-level laser therapy: It includes the use of low energy light beams before high-dose chemotherapy or radiotherapy to prevent mouth sores. Clinical trials suggested that it reduces severity of mouth sores, pain and inflammation while speeding up the healing process
Above discussed tips will be helpful, but be sure to talk to a physician specialized in cancer care before using any over the counter medications. He/She will advice diagnosis or treatment depending on your case history.
Mouth sores or oral mucositis is the most common adverse effect of cancer treatments. It may go away on their own after a period of time but it is essential to seek medical treatment because it can lead to severe complications, if left untreated.
To manage any oral complications of cancer treatment, you should keep an eye over any changes occurring in your mouth after the treatment. Always check the inside of your mouth including cheeks, gums, tongue, and lips for any red areas or white patches. Also maintain oral hygiene and visit your dentist regularly to keep your gums and teeth healthy.
If you develop sores or having trouble in eating and drinking or getting any infections, you should speak to your oncologist about pain relieving medications and measures to speed up the healing process.
For additional information, read complementary therapies for reducing pain in cancer patients.