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Mouth, Gum, and Throat Problems
Some mesothelioma medicine can cause stomatitis - sores in the mouth
and throat. Anticancer drugs also can irritate and dry out those tissues
or cause them to bleed. Good oral care is important is therefore during
cancer treatment.
In addition to being painful, mouth sores can become infected by
the many germs that live in the mouth. Every step should be taken
to prevent infections, because they can be hard to fight during chemotherapy
and can lead to serious problems.
Keeping your mouth, gums, and throat healthy
Talk to your doctor about seeing your dentist at least several weeks
before you start chemotherapy. You may need to have your teeth cleaned
and to take care of any problems such as cavities, gum abscesses,
gum disease, or poorly fitting dentures. Ask your dentist to show
you the best ways to brush and floss your teeth during chemotherapy.
Chemotherapy can make you more likely to get cavities, so your dentist
may suggest using a fluoride rinse or gel each day to help prevent
decay.
Brush your teeth and gums after every meal. Use a soft toothbrush
and a gentle touch. Brushing too hard can damage soft mouth tissues.
Ask your doctor, nurse, or dentist to suggest a special toothbrush
and/or toothpaste if your gums are very sensitive. Rinse with warm
salt water after meals and before bedtime.
Avoid mouthwashes that contain any amount of alcohol. Ask your doctor
or nurse to suggest a mild or medicated mouthwash that you might use.
For example, mouthwash with sodium bicarbonate (baking soda) is non-irritating.
If you develop sores in your mouth, tell your doctor or nurse. You
may need medicine to treat the sores. If the sores are painful or
keep you from eating, you can try these ideas:
How can I cope with mouth sores?
- Ask your doctor if there is anything you can apply directly to
the sores or to prescribe a medicine you can use to ease the pain.
- Eat foods cold or at room temperature. Hot and warm foods can
irritate a tender mouth and throat.
- Eat soft, soothing foods, such as ice cream, milkshakes, baby
food, soft fruits (bananas and applesauce), mashed potatoes, cooked
cereals, soft-boiled or scrambled eggs, yogurt, cottage cheese,
macaroni and cheese, custards, puddings, and gelatin. You also can
puree cooked foods in the blender to make them smoother and easier
to eat.
- Avoid irritating, acidic foods and juices, such as tomato and
citrus (orange, grapefruit, and lemon); spicy or salty foods; and
rough or coarse foods such as raw vegetables, granola, popcorn,
and toast.
How can I cope with mouth dryness?
- Ask your doctor if you should use an artificial saliva product
to moisten your mouth.
- Drink plenty of liquids.
- Ask your doctor if you can suck on ice chips, popsicles, or sugarless
hard candy. You can also chew sugarless gum. (Sorbitol, a sugar
substitute that is in many sugar-free foods, can cause diarrhea
in many people. If diarrhea is a problem for you, check the labels
of sugar-free foods before you buy them and limit your use of them.)
- Moisten dry foods with butter, margarine, gravy, sauces, or broth.
- Dunk crisp, dry foods in mild liquids.
- Eat soft and pureed foods.
- Use lip balm or petroleum jelly if your lips become dry.
- Carry a water bottle with you to sip from often.
Diarrhea in Mesothelioma Patients
When chemotherapy affects the cells lining the intestine, it can
cause diarrhea (watery or loose stools). If you have diarrhea that
continues for more than 24 hours, or if you have pain and cramping
along with the diarrhea, call your doctor. In severe cases, the doctor
may prescribe a medicine to control the diarrhea. If diarrhea persists,
you may need intravenous (IV) fluids to replace the water and nutrients
you have lost. Often these fluids are given as an outpatient and do
not require hospitalization. Do not take any over-the-counter medicines
for diarrhea without asking your doctor.
How can I help control diarrhea?
- Drink plenty of fluids. This will help replace those you have
lost through diarrhea. Mild, clear liquids, such as water, clear
broth, sports drinks such as Gatorade, or ginger ale, are best.
If these drinks make you more thirsty or nauseous, try diluting
them with water. Drink slowly and make sure drinks are at room temperature.
Let carbonated drinks lose their fizz before you drink them.
- Eat small amounts of food throughout the day instead of three
large meals.
- Unless your doctor has told you otherwise, eat potassium-rich
foods. Diarrhea can cause you to lose this important mineral. Bananas,
oranges, potatoes, and peach and apricot nectars are good sources
of potassium.
- Ask your doctor if you should try a clear liquid diet to give
your bowels time to rest. A clear liquid diet does not provide all
the nutrients you need, so do not follow one for more than 3 to
5 days.
- Eat low-fiber foods. Low-fiber foods include white bread, white
rice or noodles, creamed cereals, ripe bananas, canned or cooked
fruit without skins, cottage cheese, yogurt without seeds, eggs,
mashed or baked potatoes without the skin, pureed vegetables, chicken,
or turkey without the skin, and fish.
- Avoid high-fiber foods, which can lead to diarrhea and cramping.
High-fiber foods include whole grain breads and cereals, raw vegetables,
beans, nuts, seeds, popcorn, and fresh and dried fruit.
- Avoid hot or very cold liquids, which can make diarrhea worse.
- Avoid coffee, tea with caffeine, alcohol, and sweets. Stay away
from fried, greasy, or highly spiced foods, too. They are irritating
and can cause diarrhea and cramping.
- Avoid milk and milk products, including ice cream, if they make
your diarrhea worse.
Constipation
Some anticancer medicines, pain medicines, and other medicines can
cause constipation. It can also occur if you are less active or if
your diet lacks enough fluid or fiber. If you have not had a bowel
movement for more than a day or two, call your doctor, who may suggest
taking a laxative or stool softener. Do not take these measures without
checking with your doctor, especially if your white blood cell count
or platelets are low.
What can I do about constipation?
- Drink plenty of fluids to help loosen the bowels. If you do not
have mouth sores, try warm and hot fluids, including water, which
work especially well.
- Check with your doctor to see if you can increase the fiber in
your diet (there are certain kinds of cancer and certain side effects
you may have for which a high-fiber diet is not recommended). High
fiber foods include bran, whole-wheat breads and cereals, raw or
cooked vegetables, fresh and dried fruit, nuts, and popcorn.
- Get some exercise every day. Go for a walk or you may want to
try a more structured exercise program. Talk to your doctor about
the amount and type of exercise that is right for you.
This website is sponsored by Brad Cooper* of The
Cooper, Hart, Leggiero, & Whitehead, PLLC. Cooper, Hart, Leggiero, & Whitehead is located in The Woodlands, Texas
(Greater Houston Area) and can be reached toll free at 1-800-998-9729
for more information on mesothelioma. Brad Cooper is not a medical
doctor. The information on these pages is for the education of mesothelioma
patients and their families regarding potential medical and legal
options. Patients are advised to consult with a medical doctor.
* Licensed
by the Supreme Court of Texas.
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journal abstracts
Active
symptom control with or without chemotherapy in the treatment of patients
with malignant pleural mesothelioma (MS01): a multicentre randomised
trial
The second
wave in kinase cancer drugs
Cisplatin
and vinorelbine first-line chemotherapy in non-resectable malignant
pleural mesothelioma
Cytoreductive
surgery and intraperitoneal chemotherapy for peritoneal mesothelioma.
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