LITERATURE REVIEW ON ORAL MUCOSITIS

Literature Review on Oral Mucositis

Literature Review on Oral Mucositis

Chemotherapy

Each time chemotherapy is administered, it involves trying to find a balance between destroying the cancer cells in an effort to cure or control the disease, and sparing the normal cells to limit unwanted side effects (Helgadottir, 2007, 68). As explained earlier, because cancer cells grow and divide more rapidly than normal cells, many anticancer drugs are made to kill growing cells (Grant, 2006, 20). However, certain normal, healthy cells also need to multiply quickly, and chemotherapy can affect these cells too. This damage to normal cells is usually the cause of side effects.

The fast-growing, normal cells most likely to be affected are blood cells forming in the bone marrow and cells in the digestive tract (mouth, stomach, intestines, esophagus), reproductive system (sexual organs), and hair follicles (Neville, 2007, 58). Some anticancer drugs may also affect cells of vital organs such as the heart, kidney, bladder, lungs, and nervous system. The type and severity of side effects depend on the type and dose of chemotherapy administered and how the body reacts to the drugs.

Side Effects of Chemotherapy

Chemotherapy can reduce the bone marrow's ability to make red blood cells that carry oxygen to all parts of the body. When there are too few red blood cells, body tissues do not get enough oxygen to do their work, resulting in anemia. Anemia can make the patient feel short of breath, weak, and tired (Fischer, 2007, 30). This can be countered by medicines like erythropoietin that can boost the growth of red blood cells. Extreme cases may also require a blood transfusion. Bone marrow suppression also reduces the white blood cells being made that are in charge of fighting many types of infections (Chabner, 2008, 62). This increases the susceptibility of the patient to contract infections, usually from bacteria normally found on the skin and in the mouth, intestines, and genital tract. Anticancer drugs can also affect the bone marrow's ability to make platelets, the blood components that help stop bleeding by making the blood clot. Decreased platelet levels cause patients to bleed or bruise more easily than usual, even without an injury (Helgadottir, 2007, 69). Reduced white blood cell and platelet levels may be countered by the administration of colony stimulating factors, drugs that help raise the numbers of these cells.

Fatigue and a general sense of feeling tired is the most common symptom reported by cancer patients on chemotherapy. The exact cause is not always known and may be due to the disease, low blood counts, lack of sleep, pain, stress, and poor appetite among others. It usually appears suddenly and patients feel worn out and drained. It is usually not relieved by rest and may last for days, weeks, or months (Grant, 2006, 21). However, severe fatigue does go away gradually as the tumor responds to treatment. Some people may also experience flu-like symptoms for a few hours to a few days after ...