When starting cancer treatment you may think you know what to expect. Everyone knows it is possible to lose your hair and to feel sick but did you know it could also prevent you eating and talking?
The hallmark of oral mucositis (OM) is pain, as the surfaces that line the mouth and tongue become red, swollen and covered in ulcers. The pain can be so severe that it is very hard to eat, drink and speak. It may even mean a feeding tube is necessary just to get enough nutrients to carry on with the cancer therapy.
Mucositis can actually occur anywhere along the digestive path but oral mucositis specifically happens in the mouth, and is sometimes called stomatitis. There are 4 stages of oral mucositis. Stage 1 and 2 are mild and characterised by soreness and the beginning of ulceration. During stage 3 and 4, oral mucositis is more severe. At stage 3, sufferers cannot tolerate solid food so switch to a liquid only diet. Eating is not possible at stage 4 so people my need further help getting enough nutrients. Many people develop mild oral mucositis as a result of cancer therapy, but stages 3 and 4 are less common. 1
In people undergoing chemotherapy, damage to the lining of their mouths may start from day one of treatment. The first stages of oral mucositis happen below the mouth’s surface and are not always noticeable. Typically people don’t start noticing symptoms until 5 to 8 days after starting treatment. The symptoms of oral mucositis can last between 7 to 14 days before healing begins. With each cycle of chemotherapy the risk of developing oral mucositis increases and the severity of the condition often worsens.
Oral mucositis develops later with radiotherapy (at 2 weeks) and healing doesn’t begin until the end of therapy. Therefore with radiotherapy, the symptoms of oral mucositis can continue for up to 8 weeks.
Always speak to your doctor or nurse if you are worried about oral mucositis.
World Health Organisation. Handbook for reporting results of cancer treatment. Geneva, Switzerland: World Health Organisation, 1979.
2. Sonis ST. J Support Oncol 2004;2:3–8.