Stomatitis describes an inflammation of the mucous membranes of the mouth. This condition, frequently referred to as mucositis, can result from cancer treatments such as chemotherapy and radiation therapy. It is characterized by mouth ulcers or sores, and pain in the mouth. The first symptoms may be sensitivity to spicy foods and reddened mucous membranes. The patient with stomatitis may also experience a dry or swollen tongue, difficulty swallowing, and an inability to eat or drink. It is usually a short-term condition, lasting from just a few days to a few weeks. Reddened areas in the mouth may appear as early as three days after receiving chemotherapy, but normally it is within five to seven days. As time goes on, ulceration occurs. The inflammation can range from mild to severe. If complications such as infection do not occur, stomatitis usually heals completely within two to four weeks.
Stomatitis is most often caused by cancer treatments such as chemotherapy and radiation therapy. Chemotherapy medications work because they are attracted to rapidly growing cells like cancer cells. However, many of the body's normal cells also grow rapidly, and chemo-therapy kills them as well. The mouth includes several structures that together are referred to as the oral cavity: the lips, teeth, gums, tongue, pharynx, and the salivary glands. Most of these structures are covered by mucous membranes, the shiny, pink moist lining of the mouth. The outer layer of mucous membranes grows very rapidly,
and because of this they can easily be damaged by chemotherapy and radiation therapy. When these cells are damaged, they slough off, and the lining of the mouth is left vulnerable and without protection. This exposed lining may become inflamed, swollen, and dry, and will often develop ulcers or sores.
Stomatitis caused by radiation therapy normally develops in the area where the radiation is given. It generally begins seven to fourteen days after starting radiation. It will usually exhibit improvement about two to three weeks after the treatment stops.
Stomatitis may also develop as an indirect result of cancer treatment or the cancer itself. Chemotherapy can frequently cause the patient's infection-fighting white blood cells to drop down below normal levels. When this happens, the body may be unable to keep the normal organisms in the oral cavity in balance and stomatitis, as well as infections, may result. The severity of the stomatitis is dependent on various factors, including the diagnosis, the patient's age, the patient's oral condition before cancer treatment, and the level of oral care during therapy. The duration and severity of the low white blood count is another factor.
Deanna Swartout-Corbeil R.N., The Gale Group Inc., Gale, Detroit,