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Chemotherapy-induced Mucositis
Mucositis Following Chemotherapy

Presentation

The present study was undertaken to evaluate the effect of low-power laser on the prevention of mucositis, xerostomia and pain as a result of chemotherapy. [ncbi.nlm.nih.gov]

Unfortunately, we can conclude that the interventions presented in this thesis did not lead to a decrease in the severity of mucositis in rats. [rug.nl]

In patients undergoing chemotherapy at standard doses, oral mucositis generally presents as grades 1 and 2 rather than grades 3 and 4. [touchoncology.com]

Entire Body System

  • Pain

    RESULTS: There was a significant (P = 0.007) 67% decrease in the daily average experience of pain felt before and after each treatment, confirming that LLLT can relieve pain among patients who have developed COM. [ncbi.nlm.nih.gov]

  • Sepsis

    Children suffering from mucositis have symptoms like nausea, vomiting, abdominal pain, and diarrhea, leading to a decreased nutritional intake and a higher susceptibility to develop a bacteremia or sepsis. [rug.nl]

    Children suffering from mucositis have symptoms such as nausea, vomiting, abdominal pain, and diarrhea, leading to a decreased nutritional intake and a higher susceptibility to develop bacteremia or sepsis. [umcg.nl]

    In granulocytopenic patients, these lesions are frequent portals of entry for indigenous oral bacteria, often leading to sepsis or bacteremia. Mucositis occurs to some degree in more than one third of patients receiving anti-neoplastic drug therapy. [biomodels.com]

    Mucositis affects 400,000 cancer patients annually, is associated with infection in 80% of patients, and has a mortality rate of 10% due to sepsis. 1 There is a significantly increased cost of care for patients who develop mucositis, including hospitalizations [practicalpainmanagement.com]

    También existe riesgo de muerte por sepsis si se introducen agentes patógenos en las úlceras de los pacientes inmunocomprometidos. [cochranelibrary.com]

  • Severe Pain

    For severe pain : oral or intravenous pain medication* may be required in addition to topical medication. (* prescribed by healthcare provider). Enhance healing: Apply Orabase ®, Ulcerase ®, etc. to irritated areas in mouth or on lips. [chemocare.com]

    Oral mucositis can be severely painful. The degree of pain is usually related to the extent of the tissue damage. Pain is often described as a burning sensation accompanied by reddening. [en.wikipedia.org]

    Treatment of Pain in Cancer Patients Pain management should be directed at the diagnoses of etiologic factors, pain mechanisms involved, and pain severity. (Refer to the PDQ summary on Cancer Pain for more information.) [cancer.gov]

Gastrointestinal

  • Dysphagia

    As a result, the child receiving chemotherapy may experience significant pain, dysphagia, alteration in nutritional status, and risk of infection. Severe mucositis can also delay therapy that may compromise the child's treatment and chance for cure. [ncbi.nlm.nih.gov]

    Oral mucositis in its early stages presents with erythema, mild pain, and mild dysphagia that is manageable with over-the-counter medications. [touchoncology.com]

    Dysphagia in head and neck cancer patients treated with chemoradiotherapy. Dysphagia 25 (2): 139-52, 2010. [cancer.gov]

    […] initiated by fibroblasts, and then subsequent healing occurs. 1 Initial symptoms include xerostomia with highly viscous saliva, followed by very painful oral mucosal ulcers with surrounding inflammation (erythema) of the mucosal membranes with odynophagia, dysphagia [practicalpainmanagement.com]

Jaw & Teeth

  • Periodontitis

    A recent study showed that hangeshashinto (TJ-14) might be useful for periodontal disease via downregulating pro-inflammatory prostaglandins in the cyclooxygenase pathway in human. [wjon.org]

    Poor oral care with concomitant dental and periodontal pathology such as dental caries, ill-fitting prostheses, defective restorations, orthodontic appliances, piercings, periodontitis, and third molar pathology leads to a greater risk for oral complications [ahcmedia.com]

    Myeloablated cancer patients with chronic periodontal disease may develop acute periodontal infections, with associated systemic sequelae.[ 3, 9 - 12 ] Extensive ulceration of sulcular epithelium associated with periodontal disease is not directly observable [cancer.gov]

    Patients with pulpal disease from dental caries or trauma, periodontal disease, and low-grade soft-tissue infections (especially those associated with partially erupted third molars) are at increased risk for bacteremia due to oral viridans streptococci [emedicine.medscape.com]

    Methotrexate and etoposide (Etopophos) are secreted into the saliva, with direct toxic effects on the mucosa (Table 2). 4 Prevention of Mucositis Risk factors for the development of mucositis include poor oral hygiene, dental caries, periodontal disease [practicalpainmanagement.com]

  • Oral Ulcers

    ABSTRACT Mucositis is an inflammatory response of the mucosal epithelium to the cytotoxic effects of chemotherapy and radiation therapy, causing pain and severe oral ulceration. [pesquisa.bvsalud.org]

    Previous studies exploring the use of propolis, a waxy substance produced by bees that is considered to be a complementary therapy to anticancer agents, for the treatment of esophagitis, stomatitis, oral ulcers, and other conditions achieved mixed results [oncologynurseadvisor.com]

    Oral ulcerative mucositis is a common, painful, dose-limiting toxicity of drug and radiation therapy for cancer. It is characterized by breakdown of the oral mucosa resulting in the formation of ulcerative lesions. [biomodels.com]

    Keywords: Oral mucosits, oral pain, mouth sores, oral ulcers, chemotherapy-induced side effects, reBalanceCa, xerostomia, oral mucosa, chemotherapy [touchoncology.com]

    Within the oral cavity, the loss of rapidly dividing mucosal cells results in atrophy, necrosis, and ulceration. [ahcmedia.com]

  • Sore Mouth

    Mucositis is when your mouth or gut is sore and inflamed. It's a common side effect of chemotherapy and radiotherapy for cancer. It can be very unpleasant, but usually stops in a few weeks. [nhs.uk]

    Clinical trials have demonstrated that Ethyol® can reduce dry mouth and may prevent mouth sores; however, more research is needed to prove the affect of this drug on mouth sores. [news.cancerconnect.com]

    More than a sore mouth: patients’ experience of oral mucositis. Oncol Nurs Forum. 2002;29:1051-1057. 5. Elting LS, Cooksley C, Chambers M, et al. The burdens of cancer therapy: clinical and economic outcomes of chemotherapy-induced mucositis. [theoncologypharmacist.com]

  • Aphthous Stomatitis

    stomatitis in otherwise healthy patients. [emedicine.medscape.com]

    […] radiotherapy‐induced mucositis, and the clinical presentation of the ulcers is more similar to aphthous stomatitis (Al‐Dasooqi 2013; Boers‐Doets 2013; Peterson 2015). [cochranelibrary.com]

  • Oral Bleeding

    Periodontal infection (gingivitis and periodontitis) increases risk for oral bleeding; healthy tissues should not bleed. Discontinuing dental brushing and flossing can increase risk for gingival bleeding, oral infection, and bacteremia. [cancer.gov]

Neurologic

  • Burning Sensation

    Take an antacid 1/2-1 ounce every 3-4 hours as needed to decrease burning sensation. [chemocare.com]

    No adverse effects have been reported in clinical trials, although postmarketing reports have included infrequent complaints of burning sensation in the mouth. If GELCLAIR is swallowed accidentally, no adverse effects are anticipated. [gelclair.com]

    You may experience a burning sensation followed by ulcers, and your mouth may appear red (inflammation) with sores (ulcerations). There may be associated discomfort and pain. [news.cancerconnect.com]

    Pain is often described as a burning sensation accompanied by reddening. [en.wikipedia.org]

    It may be accompanied by a burning sensation of the affected tissues. [cancer.gov]

Workup

[…] oral mucositis are the following: World Health Organization (WHO) Oral Toxicity Scale: Combines both objective and functional elements into a single score National Cancer Institute Common Toxicity Criteria (NCI CTC): Scores functional elements only See Workup [emedicine.medscape.com]

Accurate and early diagnostic workup. Effective preventative and therapeutic strategies. An individual approach geared to unique patient characteristics. [cancer.gov]

Treatment

Although treatment is available for a small subset of patients suffering from mucositis, the majority rely on pain relief as their only treatment option. [ncbi.nlm.nih.gov]

The compliance of TJ-14-treatment was good and side effects from TJ-14 were not observed. [wjon.org]

Utilización del láser para la prevención y el tratamiento de la mucositis oral inducida por quimioterapia y radioterapia de cabeza y cuello [Use of laser for the prevention and treatment of oral mucositis induced by radiotherapy and chemotherapy for head [crd.york.ac.uk]

Prognosis

Prognosis Chemotherapy-induced oral mucositis is a self-limiting condition. [emedicine.medscape.com]

Although breast cancer prognosis has improved dramatically in the last 20 years, a significant number of patients will present the evolution of the disease and most of them will die of this malignancy. [medichub.ro]

Dentition that exhibits poor prognosis and is within high-dose fields should be extracted before radiation therapy begins. [cancer.gov]

Incomplete outcome data Only two studies were at high risk of attrition bias (Askarifar 2015; Sorensen 2008), both due to differential attrition between groups, which may have been linked to prognosis. [cochranelibrary.com]

Etiology

Cranial Irradiation /adverse effects; Double-Blind Method; Head and Neck Neoplasms /complications /drug therapy /radiotherapy; Humans; Low-Level Light Therapy /methods /utilization; Prospective Studies; Randomized Controlled Trials as Topic; Stomatitis /etiology [crd.york.ac.uk]

GELCLAIR is a bioadherent oral gel that provides effective pain relief by adhering to the mucosal surface of the mouth, soothing oral lesions of various etiologies, including: Oral mucositis (OM)/stomatitis Irritation due to oral surgery Traumatic ulcers [gelclair.com]

Oral mucositis occurs independently of oral mucosal infections of viral and fungal etiology, but it may be exacerbated by such concomitant infections. [emedicine.medscape.com]

In 2011, the FDA cleared episil oral liquid for the management and relief of pain of oral lesions with various etiologies, including oral mucositis/stomatitis which may be caused by chemotherapy or radiation therapy. [en.wikipedia.org]

Epidemiology

Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer. 2004;100(suppl 9):1995-2025. Peterson DE, Bensadoun R-J, Roila F. [gelclair.com]

Epidemiology Frequency Some degree of oral mucositis occurs in approximately 40% of patients who receive cancer chemotherapy. [emedicine.medscape.com]

Sonis ST, Elting LS, Keefe D, et al.: Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 100 (9 Suppl): 1995-2025, 2004. [cancer.gov]

Pathophysiology

Therefore, the question arises if the currently used 5-phase pathophysiological model is correct for gastrointestinal mucositis. [rug.nl]

According to this five-phase model, the intestinal microbiota plays no role in the pathophysiology of mucositis. [ncbi.nlm.nih.gov]

Therefore, oral mucositis can be a dose-limiting condition, disrupting a patient’s optimal cancer treatment plan and consequentially decreasing their chances of survival. [4] Pathophysiology [ edit ] The pathophysiology of mucositis is complex and multifactorial [en.wikipedia.org]

Because this toxicity clusters with dermatologic toxicities, rather than GI (as is the case with conventional mucositis) toxicities, this suggests that the underlying pathophysiology is likely very different. [emedicine.medscape.com]

Prevention

Utilización del láser para la prevención y el tratamiento de la mucositis oral inducida por quimioterapia y radioterapia de cabeza y cuello [Use of laser for the prevention and treatment of oral mucositis induced by radiotherapy and chemotherapy for head [crd.york.ac.uk]

The pathobiology of mucositis is complex, and agents that target mechanisms to prevent mucositis or accelerate healing are in high demand. [ncbi.nlm.nih.gov]

Prevention and care of chemotherapy-induced gastrointestinal mucositis. [Groningen]: Rijksuniversiteit Groningen. Author Kuiken, Nicoline Sipke Sophia. / Prevention and care of chemotherapy-induced gastrointestinal mucositis. [rug.nl]

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