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Mouth and throat sores are a common side effect of cancer treatment in children. The clinical name for this condition is oral mucositis.
Oral refers to the mouth and throat. Mucositis is a swelling of the mucous membrane, the moist, inner lining of some body organs. Mucositis can occur anywhere along the digestive tract including the mouth, stomach, intestines, and anus. It often results in painful sores.
More than 50% of childhood cancer patients may develop mucositis. More than 75% of patients who have a hematopoietic cell transplant (also known as bone marrow transplant or stem cell transplant) will likely have this side effect. Many patients say mucositis is one of the most unpleasant side effects of cancer treatment.
Mouth and throat sores are a cause for concern because they can:
This side effect can be managed, but it may not be totally prevented. Dealing with mouth and throat sores may include:
The factors that make patients more likely to develop mouth and throat sores include:
Chemotherapy and radiation treatment attack rapidly dividing cancer cells. However, some healthy cells also divide rapidly, including the cells that make up the lining of the mouth, throat, and digestive tract. Chemotherapy drugs and radiation may also attack these healthy cells.
Chemotherapy drugs cause death of cells. The cells’ energy center (mitochondria) sets off a chain of events that triggers inflammation of mucous membranes of the mouth and throat.
When the cells die, the skin of the mouth breaks down.
Patients and families should tell the care team when signs and symptoms appear:
Mouth and throat sores are diagnosed by:
The care team will grade the mucositis from 1-4 based on the severity of the condition. The grade will help determine treatment methods. Grades 3-4 are considered severe -- the more severe the grade, the more likely complications will develop.
Mouth and throat sores cannot be prevented in some cases. But there are steps patients can take to possibly lessen the severity of the symptoms.
Photo modulation (low-level laser) therapy is under study as a prevention and treatment method. It uses light to promote tissue regrowth, reduce inflammation, swelling, and relieve pain.
Treatment focuses on lessening pain, treating infections, and making sure the patient gets necessary nutrition.
Pain treatments may be local or systemic and will depend on the patient’s symptoms.
Local treatments may include:
Systemic treatments may include different types of pain medications. The care team may encourage other forms of pain treatment that don’t include medication.
When patients have problems eating and drinking, this situation may lead to dehydration and/or malnutrition.
Mouth and throat sores provide a place for germs (bacteria, virus, fungus) to enter the body and may lead to infection.
Treatment of infection may include antibiotics, antiviral and/or antifungal agents. The care team may consult an infectious disease specialist to develop the best infection treatment plan.
Reviewed: January 2019