Mouth Sores

21.03.2024

MOUTH SORES (MUCOSITIS) IN CANCER TREATMENT

Mouth sores that occur during cancer treatment, especially those caused by chemotherapy and radiotherapy, are a side effect called mucositis. This condition occurs when the oral mucosa is damaged during the treatment process and causes ulcer-shaped wounds to form in the mouth, on the lips, on the inner surfaces of the cheeks and on the tongue. Mouth sores can cause pain and difficulty for patients when eating, drinking and speaking, which can lead to inadequate nutrition and hydration, thus worsening their overall health. Treatment is supported by maintaining good oral hygiene, using alcohol-free mouthwashes, and pain relieving and healing topical applications. It is also recommended that patients avoid bitter, sour and hard foods and consume soft and cold foods. Management of mucositis is critical to improve the quality of life of patients undergoing cancer treatment, and therefore, early recognition and effective treatment of such side effects is necessary.

Image 1: Many different diseases may occur in the mouth during the cancer treatment process.

Some drugs that cause mouth sores (oral mucositis) in cancer treatment include:

Methotrexate

5-Fluorouracil

Alkylating Agents (e.g. Cyclophosphamide)

Topoisomerase Inhibitors (e.g. Irinotecan)

Platinum-Based Drugs (eg: Cisplatin, Carboplatin)

These drugs can affect the mucous membrane and cause sores to form in the mouth. For the management of mouth sores, it is important to pay attention to oral hygiene and apply appropriate treatment methods.

Image 2: Wounds in the mouth during cancer treatment can seriously affect the patient's nutrition and quality of life.

Signs and Symptoms: Symptoms of mucositis usually appear within a few days of starting treatment and may include:

• Redness and tenderness in the mouth and sometimes in the throat.

• The formation of wounds and ulcers.

• Difficulty eating, drinking and speaking.

• Pain and burning sensation.

• Metallic taste in mouth.

Reasons: Mucositis develops as a result of cancer treatments such as chemotherapy and radiotherapy damaging normal, healthy cells. Because these treatments attack rapidly dividing cells, mucosal cells in the mouth and throat are also damaged.

Risk factors: Factors that increase the risk of developing mucositis include high doses or long-term radiation therapy, certain chemotherapy drugs, poor oral hygiene, and smoking or alcohol use.

Treatment and Management: Treatment and management of mucositis may include the following methods:

Good Oral Hygiene: Regular tooth brushing and use of alcohol-free mouthwash.

Pain Management: Pain-relieving mouthwash solutions, topical anesthetics and mouth sprays can be used.

Nutritional Regulations: Avoiding bitter, sour and hard foods; Soft, pureed and cold foods can be preferred.

Medical treatment:In severe cases, corticosteroids or topical antibiotics may be prescribed.

Usage of Palifermin: In some cases, growth factors such as palifermin can be used to reduce the severity of mucositis.

Prevention: To prevent mucositis, it is important to perform regular oral care and adopt healthy eating habits before and during cancer treatment.

Mucositis is one of the challenging side effects of cancer treatment and can significantly impact patients' quality of life. Therefore, early recognition of mucositis and implementation of appropriate treatment and management strategies are important in reducing the effects of this side effect. Constant communication and cooperation between cancer patients and their physicians contribute to the successful management of this process.