Managing Mouth Sores From Chemotherapy
Mouth sores are a common side effect of certain chemotherapy drugs as well as radiation to the head.1,2
Chemotherapy and radiation therapy kill rapidly dividing cells, such as cancer cells. However, the gastrointestinal (GI) tract, including the mouth and the throat, is made up of cells that divide rapidly.3
For this reason, the GI tract is particularly susceptible to damage from chemotherapy and radiation treatment. Chemotherapy- or radiation-induced damage to the cells lining the mouth, throat, and gastrointestinal tract is called mucositis3 This side effect of cancer treatment can significantly affect how you feel and may cause delays in treatment.4
While side effects can cause delays in treatment, it's important to manage them so you can receive your chemotherapy on time and at the right dose for you. Find out more about chemotherapy cycles and schedules.
Diagnosing Mouth Sores
Symptoms of mouth sores commonly occur 3 to 10 days following treatment with chemotherapy. You may experience a burning sensation followed by ulcers, and your mouth may appear red (inflammation) with sores (ulcerations). You may also experience discomfort and pain.1,3,5
- Mouth sores can make chewing and swallowing difficult, interfering with your food intake, resulting in weight loss.
- Your may have difficulty talking.
- Because the lining of your mouth also serves to protect you against infection, mouth sores make you more susceptible to bacterial, fungal, or viral infections in the mouth.
- Ultimately, mouth sores can become severe enough that it is necessary to reduce your chemotherapy dose or delay your treatment in order to allow your mouth to heal.
Treatment That Makes Mouth Sores Worse
While mouth sores can occur with any treatment for cancer, it is more severe if you receive the following:2,4
- High-dose chemotherapy or radiation with stem cell transplants
- Radiation for head and neck cancer
- Combined chemotherapy and radiation therapy
The technique used to administer radiation may also impact the severity and duration of mouth sores. The following radiation techniques tend to produce less severe mouth sores:5
Your doctor may suggest combining chemotherapy with radiation therapy. Find out more about how cancer is treated with radiation therapy.
Other Factors That Make Mouth Sores Worse
A number of other factors contribute to the severity of mouth sores, including:1,2,4
- Poor oral and dental health prior to treatment
- Kidney disease
- Age—younger children or older adults
- Smoking and the use of chewing tobacco during episodes of mucositis
- Harsh foods and alcohol
- Concomitant disease (disease occurring at the same time), such as diabetes or AIDS
Preventing and Treating Mouth Sores
Treatment for mouth sores generally consists of good oral care, mouthwashes, and cryotherapy (sucking on ice chips).
Oral Care
Good oral care helps prevent mouth sores:1,6
- Rinse your mouth with a saltwater solution 2 or 3 times per day.
- Brush your teeth 2 or 3 times per day with a soft toothbrush.
Mouthwashes
A mouthwash of salt and baking soda may relieve mouth sores as well as medicated mouthwashes and is less expensive.1,6
Cryotherapy (Ice Chips)
You can relieve mouth pain by sucking ice chips when the chemotherapy drug is most concentrated in the body.
This technique, called cryotherapy, works by decreasing blood flow to the cells in the mouth, reducing exposure to the drug and decreasing the risk of developing mouth sores.5,6
Talk to your doctor about other ways to manage mouth sores.
Learn more about how you can best manage other types of chemotherapy side effects.
1. Chemotherapy and you. National Cancer Institute. Updated May 2007. NIH Publication No. 07—7156. http://www.cancer.gov/cancertopics/chemotherapy—and—you.pdf. Accessed June 4, 2010.
2. Mouth sores. American Cancer Society website. Updated April 27, 2009. http://www.cancer.org/docroot/MBC/content/MBC_2_3x_Mouth_Sores.asp?sitearea=MBC. Accessed June 4, 2010.
3. What are the possible side effects of chemotherapy? American Cancer Society website. Updated June 17, 2009. http://www.cancer.org/docroot/ETO/content/ETO_1_4X_What
_Are_The_Side_Effects_of_Chemotherapy.asp?sitearea=ETO. Accessed June 4, 2010.
4. Niscola P, Romani C, Cupelli L, et al. Mucositis in patients with hematologic malignancies: an overview. Haematologica. 2007;92:222—231.
5. Mouth sores (mucositis). University of Florida Shands Cancer Center website. http://www.ufscc.ufl.edu/patient/content.aspx?section=ufscc&id=23131. Accessed June 4, 2010.
6. Bensinger W, Schubert M, Ang K—K, et al. NCCN task force report: prevention and management of mucositis in cancer care. J Natl Compr Cancer Netw. 2008;6(Suppl 1):S1—S21.
Understanding Cancer –
Chemotherapy Side Effects –
Treating Cancer in Other Ways
Tracking Your Test Results –
Understanding Insurance and Tax Issues
Chemotherapy Resources and Organizations –
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