What is mucositis and why can’t I drink or eat during radiation or chemotherapy?

Mucositis is a side effect that may arise during treatment of head & neck cancer. It results in open sores called ulcerations, tenderness, and irritation to the tissues of oral mucosa, lingual region, and oropharynx. These spots can range from just a few to hundreds. There are cells that line the openings to our body and cover these open surfaces known as epithelial cells. A breakdown in these epithelial cells secondary to your radiation or chemotherapy can result in tissue changes and sores throughout the oropharynx.

Mucositis may impact the lips, gums, tongue, and throat to the point that you are not able to eat or drink without experiencing profound pain. This side effect can snowball and impact your ability to sustain hydration and nutrition. The pain one experiences when swallowing liquid and food with mucositis can cause the patient to stop eating and drinking.  The discussion of a feeding tube will often arise or increased visits to your oncologist office for fluids may be recommended.

This side effect is treated through medication by the physician. The effectiveness of the medication varies from person to person. One patient shared “That swish and swallow mouthwash was useless it even hurt to use” while another patient stated “I couldn’t have made it through treatment without the swish and swallow”. The prescribed mouthwash provides temporary relief to this side effect. It is the most effective 15 minutes following completion of this swish and swallow. We tell our patients to drink as many calories as they can following the use of this prescribed medicine. The medication creates a numbing effect lining the epithelial tissues to allow tolerance of swallowing liquids and sometimes food during it’s “on” period. The “on period” offers short term relief but 15-30 minutes of tolerating swallowing nutrition. The most important thing we share with our patients is this will go away. It is not a side effect that here to stay, upon completing your treatment it too disappears within 2-4 weeks.