The August 3, 2009 edition of ONCOLOGY Nurse Edition features an article that recounts the difficult experiences of two cancer patients who developed oral mucositis.

Written by Marilyn L. Haas (PhD, CNS, ANP-BC), a nurse practitioner in Asheville, North Carolina, "Oral Mucositis in Radiation/Chemotherapy: Treatment Similarities" tells the case stories of "Mrs. S," a 64-year-old with

squamous cell carcinoma of the anal canal and "Mrs. J," a 48-year-old registered nurse with squamous cell carcinoma of the throat.

"When OM interfered with their eating, comfort, and overall quality of life, depression was evident to their family members"

Mrs. S. waited months and months, despite pain and periodic rectal bleeding, to see a doctor.  She was recently divorced and had financial concerns.  When she was finally examined, her physicians diagnosed the cancer and prescribed both chemotherapy and radiation treatments.  The side effects were unpleasant, including hair loss, neutropenia, a skin reaction in the perineal area and oral mucositis.

The combination of perineal pain and OM was so debilitating, that Mrs. S. wanted to stop her chemoradiation after having completed 22 of her scheduled 33 fractions of radiation, Dr. Hass reported.

Mrs. J., the registered nurse, worked in the hospital emergency room and found herself in the unpleasant position of becoming a patient.  "One day at work, she felt a lump on the side of her neck," writes Dr. Haas.  Eventually, a biopsy revealed the cancer and Mrs. J. was given concurrent chemotherapy and radiation.

At first, Mrs. J. experienced dry mouth and loss of taste.  Later, mid-treatment, she required a feeding tube and had to hold off on her last dose of chemotherapy because of unpleasant side effects. 

"When OM interfered with their eating, comfort, and overall quality of life, depression was evident to their family members," Dr. Haas wrote. 

Dr. Haas concludes that patient education is an important part of the management of patients who develop OM, as are visits with a qualified dentist before, during and after treatment.  She adds: "Oncology nurses need to continue to seek evidence-based interventions that can alleviate OM and its potential complications."

[Note:  The ONCOLOGY article discloses that Dr. Haas serves as a consultant for EUSA Pharma Inc..  Dr. Haas works for Mountain Radiation Oncology.]

Resources:

• ONCOLOGY (A Monthly Journal)
• Mountain Radiation Oncology
• American Association of Oral and Maxillofacial Surgeons (AAOMS)