Managing alterations of the mucous membranes that line the oral, GI, and female reproductive cavities is really a major challenge for oncology nurses. This problem is usually called mucositis. Stomatitis refers specifically to inflammation of the oral lining of the mouth or throat.
Approximately 40% of cancer patients have this complication. It's a major concern since it can result in life-threatening events for example sepsis, infection, and malnutrition that might not be reversed without aggressive measures. Additionally, it affects quality-of-life issues since it can impact the patient's appearance and capability to communicate.
Factors that modify the level of stomatitis range from the kind of cancer, the patient's age and dental health, the kind of drug, and concomitant therapy. Patients with hematologic malignancies are more vulnerable to oral complications compared to those with solid tumors. These patients are functionally myelosup-pressed due to their cancer.
Because hematologic malignancies are more common in younger patients, the result is that stomatitis often occurs in patients younger than Two decades old. Patients receiving combination chemotherapy, radiation treatment, antimicrobials, and corticosteroids are in the best risk. Patients who consume alcohol and smoke tobacco will also be at high-risk.
Chemotherapy has indirect and direct effects on the oral mucosa. Direct stomatoxicity occurs because chemotherapy decreases the renewal rate of the basal layer of epithelial cells that line the mouth area.
The epithelium normally regenerates every 10-14 days. Using the cytotoxic attack on normal and malignant cells, these rapidly dividing epithelial cells are susceptible. It makes sense a thinning of the epithelium, resulting in localized or diffuse ulceration about 2 to 3 weeks after drug administration.
Drugs that cause stomatitis would be the antimetabolites and also the antitumor antibiotics. Indirect stomatitis may be the result of the myelosuppressive effect of chemotherapy on the bone marrow. The start of indirect stomatitis depends on the agent used. Most drugs exert their myelotoxic effect within 10-14 days after treatment.
It's believed that since the renewal rates of the oral mucosal cells and also the leukocytes offer a similar experience, stomatitis is observed close to the drug nadir, with resolution after marrow recovery. Other alterations in the oral mucosa include xerostomia, ageusia, dysgeusia, and hypogeusia.
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Note: This article was sent to us by: Kyle Jordan at 07262011
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