Cancer Supportive Care

Oral mucositis is a painful inflammatory disease that develops in more than 80% of cancer patients receiving chemoradiation therapy.¹ Patients may manifest oral mucositis as early as the first week of cancer treatment, which begins as mild inflammation and quickly leads to ulcerative lesions. As a result, eating and swallowing become difficult, and patients often require feeding tube installation and narcotic drug use to relieve the pain. Unfortunately, these complications commonly lead to reductions in cancer therapy dosing and treatment interruptions.

 

Oral mucositis progresses through four stages.² In the initiation stage, cells damaged by radiation and chemotherapy release molecules that initiate toxic immune responses through the activation of innate immune receptors. Activation leads to increased production and accumulation of inflammatory components at the injured tissue site, triggering the invasion of inflammatory immune cells and the primary damage response stage. More inflammatory molecules and cells then become activated, resulting in the death of cells damaged in the initiation phase and the destruction of neighboring healthy tissues (amplification stage). These inflammatory events ultimately lead to the development of painful and debilitating lesions in the mouth (ulceration stage) that are susceptible to bacterial infection.