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Cancer therapy: prevention of oral mucositis

The prevention of oral mucositis, a frequent adverse effect caused by some cancer treatments, relies on oral care and, in particular, the sucking of ice cubes before and during chemotherapy sessions.

Oral mucositis is the inflammation of the mucous membranes in the mouth (stomatitis) and the pharynx. It appears between 1 and 2 weeks after the start of some chemotherapy and radiation cancer treatments and, unless there are complications, generally heals in 2 to 4 weeks.

Oral mucositis can be severe and intensely painful, preventing the patient from drinking and eating, exposing to the risk of undernourishment, dehydration, haemorrhage and often deep infections, increasing the length of stay in hospital and leading to changes in the treatment.

Relief from the intense pain requires painkillers. There is no proven effective treatment to speed up healing, hence the importance of preventive measures. These include regularly brushing teeth and rinsing out the mouth, and adequate hydration and oral hygiene before chemotherapy so that the patient starts cancer treatment with mucous membranes that are as healthy as possible.

The only preventive measure whose effectiveness has been established is sucking ice cubes for several hours, starting before the chemotherapy session. This reduces the number of severe oral mucositis cases by 2 to 5 times, at the cost of minimal adverse effects.

©Prescrire April 2007

Source: "Mucites orales dues aux traitements anticancéreux : hygiène buccodentaire et glaçons à sucer" Rev Prescrire 2007 ; 27 (282) : 286-289.

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