What is mucositis?
Mucositis is defined as an inflammation or ulceration of mucous membranes along the digestive tract, from the mouth to the anus. A frequent adverse effect of chemotherapy and radiation treatments that target the head and neck, stomatitis, or oral mucositis, is characterized by inflammation of the mouth that can develop into painful ulcers and mouth sores. Basic tasks such as eating and swallowing can become a challenge, leading to nutritional consequences, an increased risk of oral infections and difficulty speaking.
Gastrointestinal mucositis impacts the digestive system, and is more likely to affect cancer patients who take chemotherapy drugs. It may also be caused by radiation treatments to the abdominal or pelvic region. Telltale signs typically appear two weeks after the start of treatment and can include diarrhea, abdominal pain, bloating, rectal bleeding and anal or rectal ulcers.
How likely are cancer patients to experience mucositis?
Mucositis is one of the most common side effects for patients treated with chemotherapy or radiation for head or neck cancer, according to the Oral Cancer Foundation. Roughly 40 percent of cancer patients undergoing standard chemotherapy treatments experience oral mucositis, the Oral Cancer Foundation estimates, though gastrointestinal mucositis is also a known side effect of chemotherapy and radiation treatments.
How can integrative care help?
Integrative cancer care offers several remedies to reduce the pain, discomfort and progression of mucositis and its impact on nutrition.
Naturopathic medicine targets mucositis in its early “tingling” stage, when ulcers are just beginning to form. Targeted physical, exercise, massage and hydrotherapies may help, and naturopathic clinicians may recommend acupuncture and chiropractic care sessions, or dietary supplements, herbal and botanical preparations and amino acids such as L-glutamine. These providers work closely with nutrition therapists and pain management professionals to augment patients’ oral, nutritional and topical therapies, offering a comprehensive approach to symptom management.
Dietitians help patients meet their nutrition needs to achieve or maintain a well-nourished state with the goal of preventing delays in their cancer treatment regimen. Their advice can be essential in helping patients navigate painful mucositis, which affects patients’ ability to eat. Dietitians may recommend, for example, that patients suck on ice cubes to prevent mouth sores and numb the pain; increase fluid intake to prevent dehydration; eat soft, plain foods; or use supplements to maintain nutritional health. Since many nutrient deficiencies can be tied to mucositis, dietitians can assess which vitamins and minerals are lacking in the patient’s diet. In more extreme cases, patients may need feeding tubes if the pain and discomfort from oral food intake is too difficult.
Speech therapists who work on the oncology rehabilitation team may recommend an oral hygiene regimen to address mucositis. They can recommend oral rinses to reduce pain and improve oral care, reducing risk of infection and the severity of the mucositis. Additionally, speech pathologists may be instrumental in teaching patients techniques on how to swallow and speak, maximize salivary secretions, and to eat and drink without gagging or choking. They often work with other cancer care clinicians on the patient’s diet and pain management routine to craft a personalized plan.
The pain management team at Cancer Treatment Centers of America® (CTCA) is trained to manage cancer-related side effects such as mucositis. Mucositis symptoms may be alleviated with over-the-counter and prescription pain medications, prescribed by the licensed physicians on the pain management team.