Medicine Wheel: The Body
Medicine Wheel: The Body
Medicine WheelSpritualPhysicalEmotionalMental


Radiation and chemotherapy often harm healthy cells anywhere in your body. You may notice some pain and sores in your mouth and throat during your cancer treatment. Remember that side effects may not be the same for you as they are for another cancer patient. These problems may change from one cancer treatment session to the next. Most oral problems will get better when the cancer treatment ends.

    EXAMPLES of how to manage oral side effects during cancer treatment
    Mouth dryness (not enough saliva). You need saliva (spit) to swallow. You need to drink a lot of water or other nutritional drinks. This will help in keeping your mouth moist.
    Mouth sores. If you have open sores in the mouth from the cancer treatment, make sure you still nourish your body with healthy soft foods. Any foods can hurt if you have a lot of mouth sores. You can ask your cancer care team what foods are best for you to eat. Open sores in the mouth and throat can hurt with swallowing, drinking and eating foods. Even eating white bread that is usually gentle on the mouth can hurt. Any food that is large and bulky will be hard to chew. It is important to have food cut into small bites. This will make it easier to swallow.
    Food tastes bad because there may be damage to the taste buds, the sense of smell, and the limited saliva (spit) in the mouth. The mouth dryness makes it hard to move the food around in the mouth to chew. The taste buds and the sense of smell are what make food taste good or bad. When these don't work the way they should it is hard to eat. This makes the eating unpleasant.


Why do some patients get mouth sores and others do not?

"Risk Factors" refer to behaviors / exposures to something that increases your changes of having a problem. The more risk factors you have are related to the severity and length of time you have the oral problems.


Risk Factors for oral problems can be due to the type of treatment:
  • High dose chemo, radiation, or chemoradiation delivered to the head or neck will usually have oral problems
  • The higher the number of chemo treatments the more likely you are to have oral problems
  • The types of chemo drugs (5-FU, cyclosphosphamide, methotrexate, cisplatin) can increase your risks

Patient-related risk factors:
  • Neutropenia (noo-troe-PEE-nee-uh) is an abnormally low count of neutrophils, white blood cells that help your immune system fight off infections, particularly of bacteria and fungi. You have several types of white blood cells, and between 45 and 70 percent of all white blood cells are neutrophils … Severe neutropenia - fewer than about 500 cells per microliter of blood - bacteria normally present in your mouth and digestive tract can cause infections. http://www.mayoclinic.com/health/neutropenia/MY00110, cited 01-12-2012)
  • Poor oral hygiene
  • Impaired salivary function
  • Use of alcohol and tobacco
  • Poor nutrition
  • Age (children and elders are more likely to have oral problems)
  • Genetic factors
  • Gender (women are more likely to have oral problems than are men)
Modified from Sonis et al (1999) Barasch et al (2003), and Brown (2010), as cited in J Adv Pract Oncol 2011.


What is radiation treatment?     Radation Treatment Link

Radiation treatment (also called radiation therapy) is the process by which highenergy radiation is used to kill cancer cells and shrink tumors.

Damaging the blood vessels going to the tumor. Tumors are less able to repair DNA damage than normal cells or can be starved for food and oxygen, leading to cell death. Treatment to the head and neck area can result in mouth sores or decreased saliva that can both cause pain and discomfort that makes eating and swallowing difficult.

The damage to these tissues and glands depends on the amount and kind of radiation used, the total dose, and the size of the area getting radiation. Damage caused by radiation therapy affects the tissues for the rest of the patient's life. The hard and soft tissues inside the mouth are more easily damaged after treatment has been completed. The normal ways of cell repair do not work as well once cells have been exposed to radiation.

Side effects from radiation treatment are usually caused by soreness to skin in the treatment area.

The special dental considerations surrounding after-treatment care last forever.

However, most of the side effects caused by radiation therapy resolve in time after completion of treatment.

The tissues inside the mouth and throat are very tender to radiation treatment. The salivary (spit) glands inside the mouth are especially sensitive to radiation treatment.


What can I expect?

Your radiation doctor will discuss any side effects that could become permanent after the treatments are completed.


    "My main thing to do this video is to help huh, other natives and cancer patients to… kind of know what they're getting into when they get throat cancer.

    First I had chemotherapy. My treatments were 24-hour treatments for seven full days and then I had a few weeks off; then I go in for another one I did this five or six cycles…Then I went, went back and he [the provider] said we are to have to do radiation on you. So l went through the full 26 cycles of radiation.

    I've had many side effects. I lost my teeth. I almost had to have my tongue removed but because of the radiation. My jaw deteriorated so last September I went to the University of Washington in Seattle, and I had to have huh a bone removed out of my leg and replaced it my jaw to replace the jawbone. …it does affect a person a heck of a lot. Especially, if you have to live the rest of your life as I do with our own considerable amount of disfiguration because of possible surgeries.

    During my treatment phase, I did a lot of native medicines along with scientific stuff that the doctors were doing.

    I just want to be an example to other Indian people and to mainly help our younger people that their way of life has a lot to do with. If you put yourself at risk of contracting this disease because of the life I lead up to my diagnosis was not too good. I was…I was heavy into alcoholism, and I chewed Copenhagen for approximately 38 years. So apparently this is the combination of the two according to the doctor is what caused my cancer. "


Why am I having discomfort and pain?     see pain leaf for more information

The discomfort and pain affects each person differently. Cancer related pain depends on both mind and body factors.

Mouth--related pain can result from having head or neck cancer. It is also a likely side effect of radiation or chemotherapy.

How you have felt pain in the past, your age, personality, and other things can influence how you manage any pain.


How can I reduce the oral problems?

Your dental professional (dentist or dental hygienist) can provide proper dental care and education prior to cancer treatment to reduce oral problems in your mouth.

It will be important to schedule a dental appointment before you start cancer treatment.

Keep and use lip balms like BURTS beeswax because it naturally moisturizes the lips.

Stay away from spicy foods like chili and acid drinks like orange juice as they may bother your mouth.

You will want to get yourself saliva substitute product like BIOTENE to help stimulate saliva (spit) flow and moisturize the mouth.

Keeping your mouth and body hydrated is very important. Drink liquids like water, Gatorade, vita water (ask your nutritionist what would be best).


What is chemotherapy treatment?     Chemotherapy Link

Chemotherapy is the general word for any treatment, which involves the use of chemical agents (medicines/drugs) to stop cancer cells from growing.

In general, chemotherapy uses drugs that travel through the bloodstream to reach and affect cells all over the body.

Chemotherapy is a helpful way to treat many cancers. Chemotherapy can get rid of cancer cells at sites far away from the original cancer.

As a result, chemotherapy is considered a systemic (affecting the entire body) treatment.

For example, a systemic disease such as diabetes can affect the whole body during cancer treatment.

Click on Commercial Drug Name to see the common Effect

Commercial Drug Name Generic Drug Name Mouth sores
[most people have]
5-FU adrucil, efudex fluorouracil
Adriamycin® doxorubicin
Cytoxan® cyclophosphamide
Cytosar-U cytarabine
Etophphos®,Toposar®, VePesid®, VP=16® etoposide
Folex® methotrexate
Gemzar® gemcitabine
Herceptin® traztuzumab
Nolvadex Tamoxifen
Taxotere® docetaxel
Oncovin vincristine
Xeloda capecitabine
Zoladex® goserelin
CAUTION: This table is just a summary. Medications are changing and new medications are coming out all the time. Please check with your healthcare provider about specific medications and oral (mouth dryness, sores) side effects.
http://www.mayoclinic.com/health/mouth-sores/CA00054    cited on 01-13-2012
http://www.nlm.nih.gov/medlineplus/druginfo/meds/a696031.html
http://www.askapatient.com/viewrating.asp?drug=19726&name=ZOLADEX




    "I really hated chemotherapy; you can just feel it all over your body you can taste in your mouth.

    She used dry stink weed with little bit of water and should put it in her mouth. Like chewing tobacco chew on it and swallowed the juices, and I decided to try it. I just wanted to try it.

    I find that traditional medicine cured my esophagus, what the… what a normal medicine couldn't do today. I don't even drink my coffee in the morning. The first thing I do is drink my stink weed. And if I have no time to make like when I'm traveling I bring a bag with me and I just chew it and drink the juice. It really does work. These people who have experience with this made me a believer I never used to believe. I believe because it worked on me."


What can I do to help my body heal?

It is important to listen to your body while going through cancer treatment. Remember, you are one with your body, mind and spirit. The act of remaining in harmony is very important.

Remain mindful to your body and practice ways to bring healing. One example could be learning to breathe deeply. You can begin doing this for 5 to 10 minutes, three to four times a day. First, close your eyes and get in a comfortable position. (1) Relax your neck and shoulder muscles, (2) Breathe in for two seconds through your nose, keeping your mouth closed, (3) Breathe out for four seconds through your mouth. After doing this exercise you will become aware of how your neck and shoulders start to feel soft when you move your body. This exercise will help get more oxygen to your body and help you relax and start the healing process.

The journey thorough healing will be much faster if get to know your body.

Remember, you will make the road to healing by walking.





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