IRC Question of
the Month: Mouth
Sores
| 
Q: I
am starting chemotherapy
for leukemia and I know that painful
mouth sores can be a side effect. Is there
anything to prevent or treat this?
A: It's great that you're
seeking side effects information before starting
treatment. Most cancer therapies do affect
healthy cells, but side effects can be managed
and are usually temporary. Side effects vary,
depending on your treatment - discuss the side
effects you may experience with your doctor.
Together, you can weigh any unwanted effects
against the benefits of therapy. Once treatment
begins, don't delay to tell your doctor about
any side effects you experience and seek help to
manage them - don't "tough it
out."
Cells that line the mouth, throat, esophagus,
stomach and intestines are sensitive to the
effects of chemotherapy and/or radiation
therapy. Painful mouth and throat sores called
"oral mucositis" can develop as a result of
treatment with high-dose chemotherapy and or
radiation. Treatment for this side effect is
important - to relieve the discomfort or pain it
can cause; to ensure that it doesn't interfere
with nutrition or oral medication needs; and to
manage the risk of infection.
Drug, mouth care and nutrition approaches are
used to prevent or limit the severity of oral
mucositis. For some people, treatment includes
the drug palifermin (Kepivance®).
Palifermin is given intravenously and stimulates
the cells lining the mouth and other parts of
the digestive tract to grow and develop. Other
topical and intravenous agents, are being
evaluated for their ability to prevent or treat
mucositis.
Mouth care includes use of mouth rinses
recommend by the doctor. It's important to avoid
mouth washes that contain peroxide or alcohol.
Oral mucositis and other side effects of
treatment make it a challenge to take in enough
calories and protein. Nutrition management is
important because both cancer and its treatments
increase the body's need for calories and
protein.
Nutrition strategies include:
- Request pain medication if discomfort is
keeping you from eating; soothe your mouth and
throat with ice chips (suck, don't chew),
Popsicles, ice cream or frozen yogurt.
- Cook foods until soft or prepare foods in a
blender or food processor.
- Eat high-protein, high-calorie foods to
speed healing of the sores or supplement with
liquid protein drinks recommended by your
doctor; try creamed soups, mashed potatoes,
puddings, cooked cereals, served lukewarm or
cold.
- Serve drinks lukewarm or cold and use a
straw to bypass mouth sores. Ask you doctor for
a complete list of foods and drinks to
avoid.
Occasionally, oral mucositis is severe enough
to warrant a period of prescribed high-calorie
and high-protein supplements with tube or
intravenous (IV) feeding until eating and
drinking can resume. These forms of therapy may
be used to keep patients as healthy and strong
as possible during treatment.
For more information, see Understanding
Drug Therapy and Managing Side
Effects and Food
and Nutrition Facts. Also, see
Treatment at www.LLS.org/whattoask for
free printable question guides to help you talk
to your doctor about side effects and other
aspects of treatment.
Please call our
Information Resource Center (IRC) to speak with
a trained information specialist. IRC staff are
available Monday through Friday, 9 a.m. to 6
p.m. ET, toll free at (800) 955-4572. Contact
us online or click the "Live
Patient Help" button on the www.LLS.org
homepage.
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