Nothing in this article advocates self medication. It is understood that you will print off this page and bring it to your medical doctor for consultation and approval.
Mouth-sores are a common side effect of some chemotherapy drugs. It is such a drag for a patient to experience these sores on top of feeling bad from chemotherapy. These sores are painful and when my daughter got them during treatment she would not eat or drink. Apparently, your digestive track is lined with fast growing cells. Chemotherapy is designed to attack fast growing cells. When the cells die they fall off and creat a painful sore. The medical name for mouth sores is mucositis. Mucositis is an inflammation of the digestive tract and is outwardly manifested by sores in the mouth, nose, anus and anywhere inside the digestive track.
The suggested medical remedy is a prescription mouthwash that contains numbing medication along with an anti-fungal. Kayla hated the taste of this mouthwash and refused to use it saying that the painkiller only lasted five minutes. Her response forced me to look for other answers.
After reading four cancer books, I hit a gold-mine in the last book which said “L-glutamine may prevent mouth sores.” When I researched L-glutamine I found a wealth of information. Here is a brief synopsis: L-Glutamine (or just glutamine) is one of the 20 amino acids that make up proteins in the human body. Along with being used to make proteins, it is one of the body’s ways to safely carry excess ammonia out of the body, (chemo can cause excess ammonia.) [1] One of glutamine’s most important tasks in the body is to nourish cells that line the intestine and stomach. Glutamine passes freely across the blood-brain barrier. Once in the brain, it’s converted to glutamic acid and increases the concentration of GABA (gamma-amniobutyric Acid). Both glutamic acid and GABA are essential for proper mental function.
During exercise or other times of metabolic stress (e.g. fasting, severe injury, illness), the demand for plasma glutamine markedly increases. For instance, various cells of the immune system depend on glutamine as a primary fuel source, and thus the demand for glutamine increases when an immunological response is mounted, such as chemotherapy. This creates immune response as it causes stress to the body and the body tries to fight back. That is what is meant by immune response, fighting something that is foreign to the body. [2]
Glutamine is considered “brain food”. It helps build and maintain muscle, it is a useful tool in weight loss, and is used to treat many diseases such as arthritis, autoimmune disease, irritable bowel disease, lupus, etc. Glutamine is considered essential to maintaining a healthy gut.
When I questioned our Oncologist regarding the use of Glutamine she said that “it is a known nutrient, which is good for the prevention of mouth sores.”
“No toxicity of glutamine was observed. We conclude that oral glutamine can decrease the severity and duration of oropharyngeal mucositis in autologous BMT (Bone Marrow Transplant) patients.” [3]
See, this supplement has been used on patients and proven to be effective!
Glutamine can be purchased in a powdered form, is not expensive and it mixes well in any liquids.
During Kayla’s heavy cancer treatment this supplement proved to be a life saver. Even when her chemo dosages were increased she did not get the weekly mouth sores that her doctors practically guaranteed she would get. I can say to you that using this $12.00 supplement during her cancer treatment was a life saver!
Prevention Tips
Oral Hygiene is particularly important when on chemo, as chemo changes the chemistry of the mouth. Brushing and using mouth wash after every meal is vital. The best toothpaste and mouth wash for sensitive mouths is BIOTENE becdause it was developed by dentists for their patients use after oral surgeries. Another age-old remedy is warm saltwater rinses because the salt is a mild disinfectant.[4] A cancer survivor sent in the following to me. “I experienced esophageal problems for a few days after chemo infusions. I took prilosec and also drank aloe-vera juice. That kept the discomfort to a minimum. For whatever reasons, I didn’t develop mouth sores, perhaps because I used a salt-water rinse after meals. I also took as many vitamin/mineral supplements as my doctor would allow.”
Acidophilus and Probiotics are beneficial bacteria that are essential for digestion. It is available in capsules, chewable and liquid forms through your local pharmacy, health food store and even grocery stores. A daily dose of Acidophilus should be considered part of a healthy regimen and imperative when medications disturb or wipe out these beneficial bacteria. Chemotherapy is known to be very tough on the digestive tract and anything that can help promote beneficial bacterial growth is very important.
Ice, chewing or sucking on ice, during and after infusions has been found to help prevent mouth sores.
Pickles. Once a sore appears in the mouth, a simple action to help the pain is pickles. This was a tip from another cancer patient that really does work. Do not eat large quantities of pickles as these can also upset the stomach. Small amounts through out the day is what worked for Kayla.
Zinc supplementation has been shown to delay the development and speed of recovery of mucositis in one small trial of 30 patients and one larger trial of 97 patients. The optimal dose has not been determined. [5] . My suggestion would be to buy the lowest possible dose on the market (25 mg) and cut it in half. This of course with your doctor approval. See also my Zinc article on this website.
Nose Sores
Kayla complained of nose pain several times. When I used a flashlight to look into her nose, I was shocked to see a large bloody sore. No one had told me that mucositis could affect any area of the digestive tract! Nose sores are related to mouth sores and can be prevented in the same way – daily intake of Glutamine along with acidophilus and probiotics. The only additional step I use with sores in the nose is to apply a saline gel by the name of AYR directly onto the sore. Any nasal sore needs to be kept moist, so that it does not dry out, crack and bleed. Most drug stores carry AYR saline gel. This gel also keeps the sore clean by preventing additional germs from entering the wound. Another discovered remedy is to break open a Co-Q10 gel cap, put it on your finger and apply to any sore. This vitamin speeds up the time it takes for a sore to heal. We have used both of these with success.
Anal Sores
This is something that is not spoken about. They are the same as mouth sores, except at the other end of the body. These are also very painful. Dr. Wheatgrass Skin Recovery Cream proved very helpful for Kayla. It helped relieve the pain and aid healing. Go to the wheatgrass page on this site for more information or here is the link to the site that sells it: www.drwheatgrass.com If you do not have Wheatgrass cream you can also use Vitamin E oil or just break open a vitamin E capsule.
Patient Feed Back
A parent told me this story. Her son, diagnosed with Neuroblastoma, would get mouth and anal sores. Once put on the L-glutamine all of these went away. They then had to transfer to another hospital for treatment. The new facility would not approve L-glutamine even though it had worked earlier. The doctor said he knew that it was good but due to insurance costs and lawsuits he was not willing to recommend anything that was not a part of the standard treatment. Instead he wanted to place a feeding tube into the patient because he had stopped eating. (Feeding tubes can cause problems due to infections at the site.) The mother refused and decided to giver her son the glutamine anyway. Within four days all sores disappeared.
Many people believe that chemo side effects are just something one has to live with. This statement does not have to be true for you!
It is my hope that this information helps you. I am not a medical doctor nor medically trained in any way. There are hundreds of different chemo therapy drugs and cancers, therefore making it impossible for me to know if these recommendations are safe for any situation. I consulted with our doctors on everything that we did and so should you!
Best Wishes!
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References
1. National Urea Cycle Disorders Foundation “…use of valproic acid (an anti-epileptic drug which causes excess ammonia), and chemotherapy.” http://www.nucdf.org/ucd_symptoms.htm Internet September 2009.
2. Journal of Nutrition. 2001;131:2515S-2522S. Why Is L-Glutamine Metabolism Important to Cells of the Immune System in Health, Postinjury, Surgery or Infection? Philip Newsholme Department of Biochemistry, Conway Institute for Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland
3. Effect of low-dose oral glutamine on painful stomatitis during bone marrow transplantation P M Anderson, N K C Ramsay,, X O Shu, N Rydholm, J Rogosheske, R Nicklow, D J Weisdorf, and K M Skubitz August 1998, Volume 22, Number 4, Pages 339-344 Internet September 2009 http://www.nature.com/bmt/journal/v22/n4/abs/1701317a.html
4. Colgate World of Care Article Chemotherapy and Your Mouth. http://www.colgate.com/app/Colgate/US/OC/Information/OralHealthBasics/MedCondOralHealth/CancerOralHealth/ChemotherapyAndYourMouth.cvspNIH Publication No. 02-4361
5. (Ertekin, Koc, Karslioglu, & Sezen, 2004; Lin, Que, Lin, & Lin, 2006)