Mucositis - Preventing mucositis

Some treatments can be taken before you receive cancer therapy to try to reduce the severity and duration of mucositis.

However, it's rarely possible to completely prevent mucositis from developing after some cancer treatments.

Oral mucositis

Palifermin

Palifermin is often given to people undergoing high-dose chemotherapy or radiotherapy as a preventative measure against oral mucositis.

Read about treating mucositis for more information on palifermin.

Benzydamine

Benzydamine may be used if you're having low-dose radiotherapy to your head or neck. Benzydamine has been shown to be reasonably effective in reducing the symptoms of inflammation (swelling) and soreness.

Benzydamine is available in the form of a cream, spray and mouth rinse. Your treatment team will be able to advise you about which type of benzydamine is best for you.

You may experience some stinging and numbness of your mouth when you first start using benzydamine, but these side effects should pass in a few days.

Other treatments

There are other treatments which may be used to reduce the severity of oral mucositis and how long it lasts, although some of these have not yet been tested thoroughly. These include:

• sucking on ice cubes or chips, held in the mouth, before, during and after cancer treatment
• honey smeared inside the mouth and slowly swallowed to cover as much mucous membrane as possible
• aloe vera used as a gel or mouthwash
• allopurinol mouthwash

A recent study looking into the effectiveness of a medicine called rapamycin suggested it may be a useful treatment for oral mucositis in the future. However, more research is needed before it can be widely used.

Gastrointestinal mucositis

Sulfasalazine

Sulfasalazine is a medicine that can be used to help reduce inflammation of the digestive system in people having radiotherapy to their pelvis.

Sulfasalazine works by blocking some of the body's chemicals involved in the inflammation process.

Occasionally, some people experience an allergic reaction to sulfasalazine. If you experience any allergy-like symptoms, such as a rash, shortness of breath or swelling of your lips or face, you should stop taking sulfasalazine and contact your treatment team as soon as possible.

Amifostine

Amifostine is a medicine sometimes used to help reduce inflammation of the rectum and anus in people who are having radiotherapy for rectal cancer. It can also be used to reduce symptoms of a dry mouth in people undergoing radiotherapy for head and neck cancer.

Amifostine helps protect healthy tissue by lowering levels of acid in the body, while also providing additional protection against infection.

However, there is currently poor evidence for the effectiveness of amifostine when used to treat mucositis.

Side effects can include:

• nausea and vomiting
• hiccups 
• low blood pressure (hypotension)

Ranitidine or omeprazole

Ranitidine and omeprazole are medicines used to help relieve stomach and gullet pain in people having chemotherapy. They work by lowering the level of acid in your stomach.

Common side effects of ranitidine include:

• diarrhoea
• constipation
• headache