Managing Oral Mucositis in Patients With Cancer

James Radke
Published: Sunday, Sep 07, 2008



One of the most uncomfortable consequences of anticancer therapy is the development of 

oral mucositis. This painful condition develops in approximately 40% of patients treated with 

standard chemotherapy, 30%–60% of patients receiving radiation therapy for cancer of the head 

and neck, 70% of patients who undergo bone marrow transplantation and receive high-dose chemo- 

therapy, and over 90% of patients receiving concomitant chemotherapy and localized radiation. (1)


Oral mucositis is characterized by erythema, swelling, and ulceration of the mucous membranes. 

The consequences of this inflammation can greatly affect a patient’s health, quality of life, and antican- 

cer therapy outcome. The disruption of the natural mucosal barrier can increase the risk of systemic 

infections. Furthermore, the intense pain associated with oral  mucositis may impede the patient’s 

eating and oral hygiene activities which in turn can disrupt the efficacy of cancer therapy. 


The economic consequences of oral mucositis are substantial. In patients receiving high-dose chemotherapy for

stem-cell transplant, Sonis and 
colleagues (2) observed that the increased infections, disruption of therapy, and

increased need for hospi
talization caused by oral mucositis added $43,000 per patient. Costs were also dependent

on the level 
of oral mucositis. The authors estimated that for each 1 point rise in the oral mucositis assessment 

scale (OMAS), there was an additional $25,000 in costs. Similarly, in patients treated with standard-dose chemotherapy,

a large portion of the extra 
costs of mucositis arise from the increased need for hospitalization. (3) 


Management of Oral Mucositis 

The best management option for oral mucositis however, is preventive therapy—a key component 

of which is recognizing which patients are at risk. 


Once it is established that the patient will likely develop oral mucositis, it is imperative that preventive/educational

measures be given to reduce the 
risk of developing mucositis or to reduce the severity of mucositis. Key educational

material should in
clude the importance of oral hygiene to reduce the risk of inflammation and nutritional advice to

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