Radiation for breast cancer is a significant issue for the majority of patients – the diagnosis is devastating enough and treatment itself can be an exhausting process, never mind the long-term side effects of chemotherapy. Although most people are prepared for side effects like hair loss and sensitivity to bruising, mouth conditions like oral mucositis can also develop, having a similar impact on one's quality of life and sometimes on the course of the chemotherapy itself.
Oral mucositis, which starts with raw areas in the oral cavity, usually develops into frank ulcers that doctors originally believed came from cytotoxic agents killing off the healthy epithelial cells of your mouth. According to research by Dental Clinics of North America, however, these sores are also the result of an increase in the biochemical agents produced by the patient in response to the chemotherapy. Rest assured it's normal for this effect to create inflammation in the oral cavity, kill off the epithelial cells and create ulcerative lesions.
How These Conditions Occur
The onset of side effects like oral mucoscitis can happen within weeks of the start of chemotherapy. The lesion will first appear as a red sore, then the body's epithelial cells start to erode. Finally, a frank ulcer will develop. Keep in mind these ulcers can advance to the point that it takes weeks or longer for them to heal after the chemotherapy is finished. At this stage, the ulcer is now prone to several types of secondary infection, including a herpes simplex virus and a fungus called candida.
Often the worst side effect is pain, which can be severe enough to require management through narcotics. This, in turn, can lead to other complications. If you're unable to eat, for example, you may face a problem regarding adequate nutrition. This then makes you more prone to chemotherapy's most well-known secondary infections: gum disease, cavities and the like, according to Delta Dental. Also, these complications may require that the chemotherapy be interrupted until the patient can stabilize their nutrition intake. In severe cases, a feeding tube may be required so you can continue receiving the vitamins and minerals that are so crucial to your immune system.
Treatment of Oral Mucositis
The treatment is mainly aimed at soothing discomfort, and there isn't one approach that is considered the best. In especially uncomfortable situations, morphine may be prescribed for fast relief. But typically, topical anesthetics are used to supplement oral pain medications. Because the mouth produces its own saliva, many coatings and rinses have unfortunately not been effective, as they're diluted too quickly.
Consider sucking on ice chips during the delivery of the chemotherapy, as this does help to reduce the effects of the chemo in the oral soft tissues for long periods of time. Of course, a liquid or soft diet managed by a nutritionist may be necessary when the mouth is in a delicate state. For this reason, make sure your toothbrush has bristles that are as soft as Colgate® 360°® Enamel Health™ Sensitive. Low-level laser therapy has also started to undergo evaluation for its ability to limit inflammation and ultimately promote healing.
Remember, a dental exam prior to the start of chemotherapy is just as important as a physical. All infections in the mouth should be treated and good oral hygiene regimen started. From here, your oncologist, dental hygienist and dentist can work with you to ensure oral mucositis and other long-term side effects of chemotherapy aren't so long-term.