Supportive Treatments for Oncology Patients: Not Just Icing on the Cake

Oral mucositis is a frequent and debilitating complica-tion of cancer chemotherapy and radiation therapy. The symptoms range from mild odynophagia to severe tis-sue inflammation, edema, and mucosal bleeding that can make eating impossible and—in its most severe form— necessitate intubation to protect a patient’s airway. A vi-cious cycle can ensue as patients experience progressive mucositis during treatment, with worsening pain and dys-phagia leading to reduced oral intake and resulting in malnu-trition, weight loss, fatigue, and deconditioning. Oral ulcers also increase the risk for bacterial and fungal colonization and for systemic infection in immunocompromised patients (1). Although best characterized in the setting of myelo-ablative high-dose chemotherapy for patients undergoing hematologic stem-cell transplantation (HSCT), oral mu-cositis is a common toxicity of many chemotherapy agent