Patient's Perspective
Patients with cancer report oral mucositis (OM) to be the most debilitating
side effect of their cancer treatment.1 Clearly
from a patient’s perspective, OM is a significant problem. It can become
a major obstacle in their life-saving cancer treatment, and it can become life-threatening
on its own.2,3 These threats and the well-established
medical, psychological and financial consequences
of OM make its ill effects hard to overstate from a patient’s point
of view.2
Likewise, it is hard to overstate the importance of the mouth in daily life
and the destructive effects OM can have on one’s quality of life. The
mouth is a central means of communicating with our family, friends and health
care providers, and it is our primary means of nourishing our bodies. When
its function is hindered or jeopardized, the effects are profound. Patients
can feel isolated from important social relationships, and the OM can interfere
with their eating and drinking regimens. In some cases, OM may increase feelings
of anger, frustration and depression.4,5
Although OM has several symptoms, the pain that accompanies OM is the most
troubling to patients and adds to their existing fears of the pain of cancer.2,6 Unfortunately,
in recent years it has been shown that medical care providers have not always
been as sensitive as they should be in treating OM pain.7 New
treatment guidelines recognize this problem, however, and emphasize state-of-the-art
pain management according to the World Health Organization’s (WHO) Pain
Management Ladder.2
The ill effects of OM have made it the subject of intense scientific study
over the past 10 years. Despite this focus, today there are few medicines that
have been proven effective in consistently preventing or treating the disease.8 This
lack of medical options is especially troubling, given the rate at which OM
occurs. The overall incidence for all cancer patients is estimated at 30%-40%.8 Patients
receiving hematopoietic stem-cell transplantation (HSCT) are especially at
risk of OM.1 For more statistics, visit the Prevalence
of OM section.
The current OM treatment options are limited, but there is hope for the future.
In recent years scientists have made dramatic advances in understanding how
OM occurs, and these discoveries are fueling new research into preventive treatments.
Several such treatments are being tested, and it is hoped that they will be
proven able to provide relief and protection for cancer patients facing OM.8,1 For
more details about these emerging treatments, see Latest
Developments.
References
- Epstein JB, Schubert MM. Oropharyngeal mucositis in cancer therapy.
Review of pathogenesis, diagnosis, and management. Oncology (Huntingt) 2003;
17:1767-79.
- Rubenstein EB, Peterson DE, Schubert M, Keefe D, McGuire D, Epstein
J, et al. Clinical practice guidelines for the prevention and treatment
of cancer therapy-induced oral and gastrointestinal mucositis. Cancer 2004;
100:2026-46.
- Brown CG, Wingard J. Clinical consequences of oral mucositis. Semin
Oncol Nurs 2004; 20:16-21.
- Eilers J. When the mouth tells us more than it says-the impact of mucositis
on quality of life. Oncology Supportive Care Quarterly 2004; 1:31-43.
- Schubert M. Oral mucositis in cancer patients. Oncology Special Edition 2004;
7:51-5.
- Epstein JB, Schubert MM. Managing pain in mucositis. Semin Oncol
Nurs 2004; 20:30-7.
- Elting LS, Cooksley C, Chambers M, Cantor SB, Manzullo E, Rubenstein
EB. The burdens of cancer therapy. Clinical and economic outcomes of chemotherapy-induced
mucositis. Cancer 2003; 98:1531-9.
- Sonis ST. A biological approach to mucositis. J Support Oncol 2004;
2:21-32.
