Oral mucositis

When starting cancer treatment you may think you know what to expect. Everyone knows it is possible to lose your hair and to feel sick but did you know it could also prevent you eating and talking?

The hallmark of oral mucositis (OM) is pain, as the surfaces that line the mouth and the tongue become red, swollen and covered in ulcers. The pain can be so severe that it is very hard to eat, drink and speak. It may even mean a feeding tube is necessary just to get enough nutrients to carry on with the cancer therapy.

Mucositis can actually occur anywhere along the digestive path but oral mucositis specifically happens in the mouth, and is sometimes called stomatitis. There are 4 stages of oral mucositis. Stages 1 and 2 are mild and characterized by soreness and the beginning of ulceration. During Stages 3 and 4, oral mucositis is more severe. At Stage 3, sufferers cannot tolerate solid food and so switch to a liquid-only diet. Eating is not possible at Stage 4 so people may need further help getting enough nutrients.
With both chemotherapy and radiation damage to the lining of mouth starts on day one of treatment. The first stages of oral mucositis happen below the mouth’s surface and are not always noticeable.

Typically people undergoing chemotherapy don’t start noticing symptoms until 5 to 8 days after starting treatment. The symptoms of oral mucositis can last between 7 to 14 days before healing begins. With each cycle of chemotherapy the risk of developing oral mucositis increases and the severity of the condition often worsens.1

Oral mucositis manifests later with radiation (at 2 weeks) and healing doesn’t begin until the end of therapy. Therefore with radiation for head and neck cancer, the symptoms of oral mucositis can continue for up to 8 weeks.

Speak to your doctor or nurse if you are worried about oral mucositis.

Download an oral mucositis patient factsheet for your own information and a nurse factsheet to give to your nurse.

1. Sonis ST. J Support Oncol 2004;2:3–8.

Oral Mucositis
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