Mouth sores can be a nuisance duringchemotherapy; not only due to the discomfort they cause but also from the limitations they can pose on eating and sometimes even talking. Symptoms can include redness, sometimes open sores, and burning in the mouth.
Some foods, as well as smoking, can exacerbate the symptoms and increase the risk of developing an infection (such as thrush) in your mouth.
Thankfully, an awareness of things that can either ease or worsen mouth sores can help to make decisions on how and when to seek medical attention.
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Symptoms
Inflammation of mucous membranes in the mouth sometimes referred to as stomatitis ormucositisoften begins a few days after starting chemotherapy and can last for several weeks.Radiation therapyand surgery can cause inflammation in the mouth as well, and symptoms may be worse if you are receiving a combination of chemotherapy and radiation treatments for your cancer.
Symptoms and signs include a burning type of pain and redness involving the floor or roof of the mouth, cheeks, gums, tongue, and lips. White patches can appear which turn red after the tissue sloughs. Mouth pain can make eating difficult and may make talking and swallowing uncomfortable.
Causes
Understanding why mouth sores occur can help to make decisions on how and when to seek medical attention. Since chemotherapy attacks rapidly dividing cells (like cancer cells), it can also affect the rapidly dividing cells lining the mouth. Chemotherapy may also affect the production of saliva, and alter the normal bacteria present in the mouth, making infections more likely.
Chemotherapy Drugs Most Likely to Cause Mouth Sores
Most chemotherapy drugs can cause mouth sores and 20 percent to 80 percent experience this side effect, but it’s more common with some drugs for lung cancer including:
These medications are used often, particularly with breast cancer chemotherapy, and therefore mouth sores are very common among people being treated for cancer.
Almost everyone who receives radiation to the head and/or neck region will experience mouth sores as well.
Coping
Good oral care is the first step in coping with, and decreasing the discomfort from mouths sores. It is a good idea to see a dentist familiar with the dental effects of chemotherapybeforebeginning treatment to make sure your teeth and gums are as healthy as possible. Ask your dentist about alternative toothbrushes if you should develop soreness.
Oral care
Good oral care is essential not only to manage mouth sores but as part of caring for yourself with cancer. We are learning that gum disease is linked with inflammation, and inflammation has been associated with an increased risk of developing cancer. It’s thought that inflammation may also play a role in the progression of cancer or recurrence.
Your Environment
The air you breathe and the company you keep can affect how your mouth sores feel.
Foods to Eat and Avoid
Taking some time to think about what you can and cannot eat will pay off in big dividends. It’s much easier to limit problem foods before they cause problems than to cope with a sore mouth as a reminder.
Treatment
Complications
Mouth sores can be an uncomfortable side effect of chemotherapy, but sometimes they can lead to more serious problems as well. Infections can develop (bacterial, fungal, or viral) especially if your white blood cell count is lowered from chemotherapy (chemotherapy-induced neutropenia). Bleeding may occur, especially if your platelet count is low (chemotherapy-induced thrombocytopenia). Pain can become quite severe for some people, requiring stronger pain management. Malnutrition and dehydration may occur if the pain and sores are interfering with your ability to take in adequate nutrition or fluids.
Considering the different side effects of chemotherapy, mouth sores may seem low on the list as far as seriousness, but that’s simply not true. Mouth sores can lead to weight loss, and weight loss in people with cancer can be very serious. In fact, cancercachexia, a syndrome which includes weight loss among other symptoms, is considered to be the direct cause of death for 20 percent of people with cancer.Don’t hesitate to call your healthcare provider if you are suffering from this common complication.
When to Call Your Healthcare Provider
Make sure to let your oncologist know of any symptoms you are having during your chemotherapy treatment, including mouth sores. Some reasons to alert your healthcare team between appointments include:
A Word From Verywell
Mouth sores can sometimes lead to complications in weight loss. But the primary reason to care for your mouth with mouth sores is to make sure your quality of life is as good as possible during yourcancer treatment. With treatments available that can now limit the impact of nausea and vomiting as well as low white blood cell counts, many people are living active lives throughout chemotherapy. Make sure to speak up and talk to your healthcare provider if your mouth sores are compromising your ability to live your best life while in treatment.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sroussi HY, Epstein JB, Bensadoun RJ, et al.Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis.Cancer Med. 2017;6(12):2918-2931. doi:10.1002/cam4.1221Idayu Mat Nawi R, Lei Chui P, Wan Ishak WZ, Hsien Chan CM. Oral Cryotherapy: Prevention of Oral Mucositis and Pain Among Patients With Colorectal Cancer Undergoing Chemotherapy.Clin J Oncol Nurs. 2018;22(5):555-560. doi:10.1188/18.CJON.555-560.Lalla RV, Bowen J, Barasch A, et al.MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy.Cancer. 2014;120(10):1453-61. doi:10.1002/cncr.28592Porporato PE.Understanding cachexia as a cancer metabolism syndrome.Oncogenesis. 2016;5:e200. doi:10.1038/oncsis.2016.3Additional ReadingChaveli-Lopez, B., and J. Bagan-Sebastian.Treatment of Oral Mucositis Due to Chemotherapy.Journal of Clinical and Experimental Dentistry. 2016. 8(2):e201-9.Daugelaite, G., Uzkuraityte, K., Jagelavicience, E., and A. Filipauskas.Prevention and Treatment of Chemotherapy and Radiotherapy Induced Oral Mucositis. Medicine. 2019. 55(2):pii:E25.Riley, P., Glenny, A., Worthington, H. et al.Interventions for Preventing Oral Mucositis in Patients with Cancer Receiving Treatment: Oral Cryotherapy.Cochrane Database of Systematic Reviews. 12:CD011552.
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sroussi HY, Epstein JB, Bensadoun RJ, et al.Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis.Cancer Med. 2017;6(12):2918-2931. doi:10.1002/cam4.1221Idayu Mat Nawi R, Lei Chui P, Wan Ishak WZ, Hsien Chan CM. Oral Cryotherapy: Prevention of Oral Mucositis and Pain Among Patients With Colorectal Cancer Undergoing Chemotherapy.Clin J Oncol Nurs. 2018;22(5):555-560. doi:10.1188/18.CJON.555-560.Lalla RV, Bowen J, Barasch A, et al.MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy.Cancer. 2014;120(10):1453-61. doi:10.1002/cncr.28592Porporato PE.Understanding cachexia as a cancer metabolism syndrome.Oncogenesis. 2016;5:e200. doi:10.1038/oncsis.2016.3Additional ReadingChaveli-Lopez, B., and J. Bagan-Sebastian.Treatment of Oral Mucositis Due to Chemotherapy.Journal of Clinical and Experimental Dentistry. 2016. 8(2):e201-9.Daugelaite, G., Uzkuraityte, K., Jagelavicience, E., and A. Filipauskas.Prevention and Treatment of Chemotherapy and Radiotherapy Induced Oral Mucositis. Medicine. 2019. 55(2):pii:E25.Riley, P., Glenny, A., Worthington, H. et al.Interventions for Preventing Oral Mucositis in Patients with Cancer Receiving Treatment: Oral Cryotherapy.Cochrane Database of Systematic Reviews. 12:CD011552.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sroussi HY, Epstein JB, Bensadoun RJ, et al.Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis.Cancer Med. 2017;6(12):2918-2931. doi:10.1002/cam4.1221Idayu Mat Nawi R, Lei Chui P, Wan Ishak WZ, Hsien Chan CM. Oral Cryotherapy: Prevention of Oral Mucositis and Pain Among Patients With Colorectal Cancer Undergoing Chemotherapy.Clin J Oncol Nurs. 2018;22(5):555-560. doi:10.1188/18.CJON.555-560.Lalla RV, Bowen J, Barasch A, et al.MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy.Cancer. 2014;120(10):1453-61. doi:10.1002/cncr.28592Porporato PE.Understanding cachexia as a cancer metabolism syndrome.Oncogenesis. 2016;5:e200. doi:10.1038/oncsis.2016.3
Sroussi HY, Epstein JB, Bensadoun RJ, et al.Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis.Cancer Med. 2017;6(12):2918-2931. doi:10.1002/cam4.1221
Idayu Mat Nawi R, Lei Chui P, Wan Ishak WZ, Hsien Chan CM. Oral Cryotherapy: Prevention of Oral Mucositis and Pain Among Patients With Colorectal Cancer Undergoing Chemotherapy.Clin J Oncol Nurs. 2018;22(5):555-560. doi:10.1188/18.CJON.555-560.
Lalla RV, Bowen J, Barasch A, et al.MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy.Cancer. 2014;120(10):1453-61. doi:10.1002/cncr.28592
Porporato PE.Understanding cachexia as a cancer metabolism syndrome.Oncogenesis. 2016;5:e200. doi:10.1038/oncsis.2016.3
Chaveli-Lopez, B., and J. Bagan-Sebastian.Treatment of Oral Mucositis Due to Chemotherapy.Journal of Clinical and Experimental Dentistry. 2016. 8(2):e201-9.Daugelaite, G., Uzkuraityte, K., Jagelavicience, E., and A. Filipauskas.Prevention and Treatment of Chemotherapy and Radiotherapy Induced Oral Mucositis. Medicine. 2019. 55(2):pii:E25.Riley, P., Glenny, A., Worthington, H. et al.Interventions for Preventing Oral Mucositis in Patients with Cancer Receiving Treatment: Oral Cryotherapy.Cochrane Database of Systematic Reviews. 12:CD011552.
Chaveli-Lopez, B., and J. Bagan-Sebastian.Treatment of Oral Mucositis Due to Chemotherapy.Journal of Clinical and Experimental Dentistry. 2016. 8(2):e201-9.
Daugelaite, G., Uzkuraityte, K., Jagelavicience, E., and A. Filipauskas.Prevention and Treatment of Chemotherapy and Radiotherapy Induced Oral Mucositis. Medicine. 2019. 55(2):pii:E25.
Riley, P., Glenny, A., Worthington, H. et al.Interventions for Preventing Oral Mucositis in Patients with Cancer Receiving Treatment: Oral Cryotherapy.Cochrane Database of Systematic Reviews. 12:CD011552.
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