Monday, October 06, 2008

My father has squamous cell cancer of the throat, tongue and cheek. It has also been found on his rib. He has a feeding tube and a tracheotomy. Recently his mouth has become terribly swollen. The doctors aren’t giving us any answers. He can’t even brush his teeth. What can this be and what can be done?

If your father is currently getting chemotherapy and radiation, or has recently completed treatment, he may have mucositis. This is a known side effect of radiation to the oral cavity and is like getting a bad sunburn inside your mouth.

The cells that line the mouth turn over every three days or so and are replaced by new cells. Radiation and chemotherapy can accelerate that process so that large areas of the tongue, inner lining of the cheek, and roof of the mouth can all become raw and exposed. This can then lead to inflammation and infection as the protective lining of the mouth is compromised.

A gentle mouth rinse with salt water can help keep the mouth clean. There are also prescription and over-the-counter oral rinses that can help. Some radiation oncologists will prescribe Trental (pentoxifylline) and vitamin A to reduce post-radiation scar tissue. There is some evidence that this combination of drugs can also decrease the severity and duration of the mucositis. I would discuss these options with your doctors.
