New guidelines for managing mucositis now available

August 11, 2020

Updated clinical practice guidelines for managing mucositis, a very common and often debilitating complication of cancer therapy, was recently published in the journal Cancer. Patients experiencing mucositis often require enteral or parenteral nutrition, consume more opioids, and experience more interruptions to cancer therapy than patients who do not experience mucositis.

The new guidelines summary, which will provide healthcare professionals better tools to deliver care for cancer patients, is the result of extensive and meticulous literature review and clinical interpretation by the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology. The MASCC/ISOO charged its Mucositis Study Group, comprised of 250 experts from 33 countries, to conduct the systematic review.

Led by Sharon Elad, DMD MSc, professor at the University of Rochester Medical Center's Eastman Institute for Oral Health, the Mucositis Study Group's major goal is to improve outcomes of patients experiencing mucositis associated with cancer therapies.

Mucositis affects the inner lining of the oral and gastrointestinal tract. Oral mucositis often leads to difficulty eating and swallowing. Gastrointestinal mucositis is associated with nausea, vomiting, diarrhea, bloating, intestinal cramping, and anal pain. For patients who are immunosuppressed, oral mucositis is associated with greater risk for bacteremia, which has possible systemic implications.

Highlights from this newly published summary paper include additional recommendations for the use of photobiomodulation therapy and benzydamine, as well as a stronger guideline statement for cryotherapy. Each of these guidelines is defined for a specific setting and cancer patient population.

"Interestingly, natural honey had sufficient evidence, when used topically and then swallowed, to suggest possible mucositis prevention for patients with head and neck cancer who receive treatment with either radiotherapy or radio-chemotherapy," said Dr. Elad.

"But it's important to note that the long-term effect of this intervention is unclear at this point," she added. "Even with the best evidence-based interventions, we don't have an ultimate guideline for mucositis in all clinical settings. Future research will hopefully identify better interventions that will relieve the patient's pain and improve quality of life."

This summary paper captures the highlights of a series of frequently cited detailed publications describing the approach to various categories of interventions. This includes the following categories for oral mucositis: (1) anti-inflammatory agents, (2) photobiomodulation therapy, (3) protocols categorized as basic oral care, (4) growth factors and cytokines, (5) antimicrobials, mucosal coating agents, anesthetics, and analgesics, (6) cryotherapy, (7) vitamins, minerals, and nutritional supplements, (8) natural and miscellaneous agents. Likewise, it includes a guidelines publication about all interventions for gastrointestinal mucositis.

The 2019/20 guidelines update is a landmark paper on the evolution of the mucositis clinical practice guidelines. The first MASCC/ISOO guidelines paper was published in 2003 and updated in 2007 and 2014. The continuous update of the guidelines is done by a large multi-disciplinary group of clinicians and scientists using meticulous methods which incur validity and applicability. Projects carried out by the various MASCC/ISOO Study Groups result in clinical practice guidelines, position papers, publications, and other products that advance supportive care in cancer.
-end-


University of Rochester Medical Center

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.