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Prevent Oral Mucositis in Nasopharyngeal Cancer

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“For the first time, this study indicated that the probiotic combination had significantly enhanced the immunity of patients, reduced oral mucositis…

Oral mucositis (OM) is what I call a “Rodney Dangerfield” side effect. OM gets no respect. OM is a common, painful, potentially treatment altering side effect according to the first study linked and excerpted below. Patients can be hospitalized and rarely,  oral mucositis can cause death. OM causes the throat to be covered with plisters. Plisters that make swallowing painful and impossible in some cases.

 

Do you want to know the amazing aspect of OM? Most cases of OM can be prevented. According to the second study linked below, probiotics can enhance the patient’s immune system enough to prevent this painful side effect. Further, patients can use several different mouthwashes to either reduce OM once it has erupted or prevent OM if the patient has used the mouthwash prophylactically.

Have you been diagnosed with Nasopharyngeal Cancer? What stage? What is your treatment plan? Scroll down the page, post a question or a comment and I will reply to you ASAP.

Thank you,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:


Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review

Conclusions: Mucositis is a frequent, severe toxicity in patients treated with RT for head and neck cancer. While it appears that mucositis may lead to hospitalization and treatment interruptions, its overall impact on outcomes has not been adequately investigated.”

Probiotics May Prevent Oral Mucositis in Nasopharyngeal Carcinoma

A combination of probiotics significantly enhanced immune responses and reduced the severity of oral mucositis among patients with nasopharyngeal carcinoma who were undergoing concurrent chemoradiotherapy, according to results of a randomized, double-blind, placebo-controlled trial published in Cancer.

“For the first time, this study indicated that the probiotic combination had significantly enhanced the immunity of patients, reduced oral mucositis, and was beneficial for restoring microbial diversity after the end of concurrent chemoradiotherapy,” …

The mean incidence of oral mucositis in patients with head or neck cancer undergoing concurrent chemoradiotherapy or altered fractionation radiotherapy is about 80%, causing interruptions in therapy at a frequency of up to 19% and adding substantially to the costs of care.

To date, there are no effective ways to overcome oral mucositis.

Researchers randomly assigned 99 patients with locally advanced nasopharyngeal carcinoma who were undergoing concurrent chemoradiotherapy to a regimen of probiotics (n = 64) or a placebo (n = 35).

The probiotic combination contained Bifidobacterium longum, Lactobacillus lactis and Enterococcus faecium.

Researchers excluded six patients from the probiotic group for failing to undergo follow-up, at the patient’s request or because of poor drug compliance..

Participants took the probiotic combination or placebo twice a day for up to 7 weeks.

Grade 3 or higher oral mucositis served as the primary endpoint. Secondary endpoints included short-term curative effect, the immune index and fecal flora changes.

Results showed that patients taking probiotics had a significant reduction in the severity of oral mucositis.

The incidence rates of oral mucositis were:

  • Grade 0: 0 patients in probiotics group vs. 7 patients (12%) in placebo group;
  • Grade 1: 0 vs. 32 (55.1%);
  • Grade 2: 19 (54.2%) vs. 10 (17.2%); and
  • Grade 3: 16 (45.7%) vs. 9 (15.5%)

The probiotic combination increased the number of CD4-positive T cells (76.5% vs. 52.8%), CD8-positive T cells (62.9% vs. 29.7%) and CD3-positive T cells (69.7% vs. 45.4%), and it restored microbial diversity after chemoradiotherapy to that of healthy people.

The probiotic regimen did not affect tumor response to concurrent chemoradiotherapy. All patients reached parallel objective response rates…

“T cells play a central role in cell-mediated immunity,” Jiang and colleagues wrote. “The significance of enhanced numbers of CD3-positive T cells, CD8-positive T cells, and CD4-positive T cells in the [probiotic] group indicated that the probiotics confirmed their roles in modulating human immune responses to pathogens and tumor cells and were important in orchestrating overall immune responses.” – byJohn DeRosier

Chemotherapy, Radiation-induced Mucositis Prevention

“Mucositis (MU) is the painful inflammation and ulceration of the mucous membranes lining the digestive tract, usually as an adverse effect of chemotherapy and radiotherapy treatment for cancer.[1]

Oral mucositis frequently occurs in patients undergoing radiation and chemotherapy for several different types of cancer. The studies below talk about MU in head and neck cancer patients undergoing radiation. My experience is from patients who endured this painful side effect during an autologous stem cell transplant for my cancer, multiple myeloma.

Ulcerative oral mucositis lesion on the lateral an

My point is that MU can happen almost anytime a cancer patient undergoes radiation to the mouth and throat and a cancer patient can endure this painful side effect simply by undergoing a lot of chemotherapy.

If a person gets MU severely enough they can’t drink, they can’t swallow and they certainly can’t eat. Please believe me that if you have been diagnosed with head and neck cancer you want to work to prevent this difficult side effects.

I will cite prevention therapies both anecdotally and based on research. By anecdotally  I mean that I have read of many patients who have prevented MU by chewing on ice chips daily. To add to the study below citing topical vitamin E therapy as a preventative therapy, I have read of cancer patient who gargled with vitamin E. solution frequently during their autologous stem cell transplant. Yes, this therapy prevented mucositis.

I supplement with a brand and formula of vitamin E called Life Extension Gamma Vitamin E Mixed Tocopherols and Tocotrienols because this formula gives me all 8 forms of mixed Vitamin E.


Recommended Reading:


What is mucositis?

Mucosity  is the painful inflammation and ulceration of the mucous membranes lining the digestive tract, usually as an adverse effect of chemotherapy and radiotherapy treatment for cancer.[1] Mucositis can occur anywhere along the gastrointestinal (GI) tract, but oral mucositis refers to the particular inflammation and ulceration that occurs in the mouth. Oral mucositis is a common and often debilitating complication of cancer treatment.”

Infrared Imaging Eyes Mucositis After Head and Neck Radiation

“Thermal imaging was able to detect small and early changes in the temperature of mucosal surfaces – a possible predictor of the development of mucositis – among 34 patients who were treated with chemoradiotherapy for locally advanced squamous cell carcinoma of the head and neck.

“Detection of these early changes using sensitive thermal imaging technology would allow identification of patients who will require more intensive supportive care,” said Dr. Ezra Cohen, who presented the pilot study at the head and neck cancer symposium sponsored by the American Society for Radiation Oncology.

Radiotherapy-associated MU manifests initially as erythematous areas in the treatment field, which are accompanied by an intense inflammatory response histologically. Thus, Dr. Cohen and his associates had hypothesized that patients destined to display severe mucocutaneous toxicity would demonstrate greater alterations in thermal intensity early in therapy, compared with identically treated counterparts who do not subsequently develop the toxicity.”

Role of Vitamin E and Vitamin A in Oral Mucositis Induced by Cancer Chemo/Radiotherapy- A Meta-analysis

“Conclusion-Topical Vitamin E had performed better on oral MU than Vitamin E systemic administration. Though the efficacy of topical treatment with Vitamin A showed reduction in oral mucositis, it was evaluated in a very small sample which cannot be attributed to a larger sitting.

Dietary supplementation with omega-3 fatty acid attenuates 5-fluorouracil induced mucositis in mice

“Conclusion-Together, these results show that omega-3 fatty acid decreases the mucosal damage caused by 5-FU-induced MU…”

Adjunctive Treatments for the Prevention of Chemotherapy- and Radiotherapy-Induced Mucositis

Conclusion: There is plausible clinical evidence for the administration of several adjunctive treatments for the prevention and treatment of MU.

  • Probiotics were reported to reduce the burden of intestinal mucositis and treatment-induced diarrhea-
  • Activated charcoal and glutamine are beneficial for chemotherapy-induced diarrhea-
  • whereas the administration of honey, zinc, and glutamine reduce the risk of developing oral mucositis during chemotherapy or radiotherapy.

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