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Oral Complications of Chemotherapy and Head/Neck Radiation (PDQ®)

Patient Version
Last Modified: 09/16/2011

Overview

Oral complications are common in patients receiving chemotherapy or undergoing radiation therapy to the head and neck.

Oral complications are medical problems that involve the mouth during or after a disease, procedure, or treatment. The complications may be side effects of the disease or treatment, or they may have other causes.

The oral cavity is at high risk of side effects from chemotherapy and radiation therapy for a number of reasons.

  • Chemotherapy and radiation therapy stop the growth of rapidly dividing cells, such as cancer cells. Since normal cells in the lining of the mouth also divide rapidly, anticancer treatment can prevent cells in the mouth from reproducing, making it difficult for oral tissue to repair itself.

  • The mouth contains hundreds of different bacteria, some helpful and some harmful. Chemotherapy and radiation therapy can cause changes in the lining of the mouth and production of saliva and upset the healthy balance of bacteria. These changes may lead to mouth sores, infections, and tooth decay.

  • Wear and tear occur from normal use of the mouth, teeth, and jaws, making healing more difficult.

Preventive measures may lessen the severity of oral complications.

Oral side effects may make it difficult for a patient to receive all of his or her cancer treatment. Sometimes treatment must be stopped. Preventing and controlling oral complications will enhance both the patient's quality of life and the effectiveness of cancer therapy.

Preventing and treating oral complications of cancer therapy involve identifying the patient at risk, starting preventive measures before cancer therapy begins, and treating complications as soon as they appear. Patients with poor mouth care before treatment begins may have more frequent and severe oral complications after treatment has started.

Patients receiving chemotherapy or undergoing radiation therapy to the head and neck should have their care planned by a team of doctors and specialists.

To manage oral complications, the oncologist will work closely with the patient's dentist and may refer the patient to other health professionals with special training. These may include the following specialists:



Glossary Terms

bacteria (bak-TEER-ee-uh)
A large group of single-cell microorganisms. Some cause infections and disease in animals and humans. The singular of bacteria is bacterium.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
cell (sel)
The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
chemotherapy (KEE-moh-THAYR-uh-pee)
Treatment with drugs that kill cancer cells.
complication (kom-plih-KAY-shun)
In medicine, a medical problem that occurs during a disease, or after a procedure or treatment. The complication may be caused by the disease, procedure, or treatment or may be unrelated to them.
dentist (DEN-tist)
A health professional who specializes in caring for the teeth, gums, and other tissues in the mouth.
dietitian (dy-eh-TIH-shun)
A health professional with special training in nutrition who can help with dietary choices. Also called nutritionist.
infection (in-FEK-shun)
Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.
oncologist (on-KAH-loh-jist)
A doctor who specializes in treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation.
oncology nurse (on-KAH-loh-jee...)
A nurse who specializes in treating and caring for people who have cancer.
oral (OR-ul)
By or having to do with the mouth.
oral cavity (OR-ul KA-vih-tee)
Refers to the mouth. It includes the lips, the lining inside the cheeks and lips, the front two thirds of the tongue, the upper and lower gums, the floor of the mouth under the tongue, the bony roof of the mouth, and the small area behind the wisdom teeth.
prevention (pree-VEN-shun)
In medicine, action taken to decrease the chance of getting a disease or condition. For example, cancer prevention includes avoiding risk factors (such as smoking, obesity, lack of exercise, and radiation exposure) and increasing protective factors (such as getting regular physical activity, staying at a healthy weight, and having a healthy diet).
preventive (pree-VEN-tiv)
Used to prevent disease.
quality of life (KWAH-lih-tee ... life)
The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.
radiation therapy (RAY-dee-AY-shun THAYR-uh-pee)
The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.
saliva (suh-LY-vuh)
The watery fluid in the mouth made by the salivary glands. Saliva moistens food to help digestion and it helps protect the mouth against infections.
side effect (side eh-FEKT)
A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.
social worker (SOH-shul WUR-ker)
A professional trained to talk with people and their families about emotional or physical needs, and to find them support services.
specialist (SPEH-shuh-list)
In medicine, a doctor or other health care professional who is trained and licensed in a special area of practice. Examples of medical specialists include oncologists (cancer specialists) and hematologists (blood specialists).
speech therapist (speech THAYR-uh-pist)
A specialist who evaluates and treats people with communication and swallowing problems. Also called speech pathologist.
tissue (TIH-shoo)
A group or layer of cells that work together to perform a specific function.