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Pediatric Head & Neck Cancer- Mucositis

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The area’s sensitivity (pediatric head and neck cancer) also means the effects of treatment can lower patient quality of life due to symptoms including loss of appetite, difficulty swallowing, or mucositis

Pediatric head and neck cancer patients face a host of challenges. Collateral damage aka side effects shouldn’t be one of them.

Or I should say that side effects can be a problem that should be identified and treated and/or healed.

Mucositis is a common side effect of people going through treatment for my type of cancer. When I first read about it in chat rooms I considered this problem to be pretty much of a non-event. I mean, sores in your mouth? Big deal…

Suffice to say I was very wrong. Oral mucositis can be both a dramatic side effect and can be greatly reduced or even eliminated. Recommended therapies are:

I admit that the above therapies are pretty low-tech. But according to numerous studies they work.

Are you a caregiver for a pediatric cancer patient about to undergo chemotherapy and or radiation? I am both a cancer survivor and cancer coach. Please scroll down the page, post a question or comment and I will reply to you ASAP.

Thank you

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer


“…80% of patients with malignancies of the head and neck receiving radiotherapy, and a wide range of patients receiving chemotherapy. Alimentary tract mucositis increases mortality and morbidity and contributes to rising health care costs.[3]

Proton therapy lowers treatment side effects in pediatric head and neck cancer patients

Cancers of the head and neck account for about 12 percent of all pediatric cancers, and they are generally different tumor types than those that affect adults. For solid tumors like neuroblastoma, thyroid cancer, and soft tissue sarcomas, treatment usually involves a combination of therapies including chemotherapy, radiation, and surgery. Post-operative radiation can be critical, since surgeons may not be able to completely remove all cancer given the complexity of the head and neck region.

The area’s sensitivity also means the effects of treatment can lower patient quality of life due to symptoms including loss of appetite, difficulty swallowing, or mucositis — in which ulcers form in the digestive tract, usually in reaction to chemotherapy or radiation.

“These concerns are especially important to address in pediatric patients, since they’re still developing and may need to deal with any adverse effects for the rest of their lives. This study shows that protons may be an important tool in improving quality of life both during treatment and for years after for these young patients,”

Researchers looked at 69 pediatric head and neck cancer patients treated with PBT at Penn and CHOP between 2010 and 2016-

  • Thirty-five (50 percent) of those patients had rhabdomyosarcoma, a cancer of the cells that make up skeletal muscles.
  • Ten (7 percent) were treated for Ewing sarcoma, a cancer most commonly found in the bone or soft tissue.
  • The other 24 were treated for a variety of other cancers affecting the head and neck regions.

“Different disease sites required different dosage levels, and we specifically found the severity of muscositis was associated with higher doses of radiation,” Vogel said.

Those numbers are still well below what is typically associated with photon radiation. In rhabdomyosarcoma, for example, 46 percent of patients historically report grade 3 or 4 mucositis…”

The effectiveness of vitamin “E” in the treatment of oral mucositis in children receiving chemotherapy.

“The aim of this study was to study the effect of vitamin “E” in the treatment of oral mucositis. 80 patients with oral mucositis were randomly distributed into 2 groups:

  • group A, topically applied vitamin “E” and
  • group B, vitamin “E” was given systemically.

The 2 groups were evaluated for 5 days. Results showed that in group A grades of oral mucositis improved significantly, while in group B no significant improvement was noticed. It is concluded that topical application of 100 mg vitamin “E” twice daily is an effective measure for the treatment of chemotherapy-induced oral mucositis.”

Natural agents in the management of oral mucositis in cancer patients-systematic review

“Introduction- Oral mucositis is most severe complication of cancer therapy characterized by ulcerative lesions of oral mucosa causing negative impact on patient’s quality of life. Wide variety of therapeutic agents are available to reduce the lesions of mucositis. Currently, natural herbal remedies have become popular in treating this condition due to fewer side effects than synthetic drugs…

Materials and method- Computerized literature searches were performed to identify all published articles in the subject. The following databases were used: PUBMED [MEDLINE], SCOPUS, COCHRANE DATABASE, EMBASE and SCIENCE DIRECT using specific keywords. The search was for limited articles published in English which were read in full by two authors.

Results-Twenty six randomized controlled trials satisfied our inclusion criteria. Most studies showed statistically significant result demonstrating the efficacy of natural agents with minimal side effects except manuka honey which was not tolerated by few patients.

Conclusion- Natural agents proved to be promising in healing cancer induced oral mucositis but future demands further randomized controlled clinical trials on these agents which should also be focused on drug interactions of the natural remedies…”



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