Brushing up on Mouth Care for Cancer Patients With Mucositis

Caroll Tipian, BSN, RN, OCN


Am Nurs Journal. 2014;9(11) 

In This Article

Abstract and Introduction


Chemotherapy and radiation used to treat head and neck cancers, as well as high-dose chemotherapy given to stem-cell transplant patients, can damage the mucosa of the oral cavity and GI tract. This article discusses mucositis in the oral cavity, which can cause symptoms ranging from a slight sensation change to pain and inflammation to ulcerative bleeding lesions.

Multiple mouth lesions can lead to colonization by microbial flora, resulting in a potentially life-threatening septic infection and prolonged hospital stays. In some cases, mucositis necessitates a treatment delay or termination, which can make cancer therapy less effective and increase the risk of residual tumor-cell proliferation. Many patients discontinue cancer treatments due to mucositis; about 60% require hospitalization for the condition, and 70% require tube feedings.

Mucositis can occur at any age. Younger patients have a higher mitotic rate and more epidermal growth factor receptors, which can increase severity of mucositis. Older patients typically have decreased renal function, which slows clearance of chemotherapy drugs and raises the risk of toxicity from high-dose cancer chemotherapy. Other risk factors for mucositis include poor nutritional status at the start of chemotherapy, a history of smoking (which can delay healing), and previous cancer treatments that caused mucositis. (See Biological phases of mucositis.)

When caring for a patient undergoing cancer treatment, your role is to ensure proper oral care; assess for mucositis signs and symptoms, such as pain, infection, dry mouth, taste changes, and poor nutrition; and use appropriate interventions.