Multinational study highlights importance of oral mucositis management
A new study titled ADOPT (Awareness Drives Oral Mucositis PercepTive) has emphasized an opportunity to improve the wellbeing of patients undergoing cancer treatment through stronger proactive management of oral mucositis (OM).
OM is a common side effect of cancer treatment that results in inflammation and/or ulcerative sores in the lining of the mouth or throat. Mundipharma Pte. Ltd., a leading pharmaceutical company in cancer supportive care, sponsored the ADOPT study that was carried out in two phases between April to September 2015 in Hong Kong, Malaysia, Singapore, Taiwan, South Korea, Philippines and Saudi Arabia. The study involved 175 cancer patients diagnosed with OM and 105 oncologists managing the condition.
The study revealed that 70% of oncologists and 80% of patients rank OM as one of the top three most important side effects to treat. However, while the presence and potential of OM is acknowledged and treated by oncologists, more could potentially be done to proactively prescribe treatment prior to the onset of OM symptoms.
The study showed that while up to 85% of oncologists place a greater emphasis on relieving and delaying OM symptoms to complete cancer treatment, less than half (46%) of the oncologists initiated prophylactics for OM at the beginning of cancer therapies, with only 16% of patients acknowledging that medications were given to them before the onset of OM symptoms.
According to the study, oncologists recognize that OM can have an impact on cancer treatment outcomes due to adjustment of treatment regimen or the disruption of chemotherapy or radiotherapy if the OM becomes severe. For patients with moderate-to-severe OM, 70% of physicians will delay patient’s chemotherapy/radiotherapy, and over 50% will re-adjust cancer drug dosages.
“Even though the negative implications of oral mucositis on cancer therapy as well as quality of life are well known, the ADOPT study has demonstrated that the proactive management of oral mucositis can be improved,” said Dr.JeeveKanagalingam, Head and Neck Cancer Surgeon, Investigator of ADOPT study. “Enhanced proactive management may improve cancer treatment outcomes, reduce the disease and financial burden and improve patients’ quality of life.”
Kanagalingam added: “Currently, there is limited well-established evidence on agents that may reduce the incidence and severity of oral mucositis. Guidelines have suggested improving oral health could be critical to reduce disease severity. Some studies have suggested that povidone iodine mouthwashes, also commonly known as Betadine, due to its antiseptic, anti-inflammatory and haemostatic properties, may play a suitable role OM management.”
Raman Singh, president ofMundipharma Asia Pacific, Latin America, Middle East and Africa, stated, “These results from the survey demonstrate an opportunity to improve outcomes for patients undergoing therapy through better OM prevention and management measures.”
“Significant strides have been made in the cancer care arena and making informed decisions as to the suitability of a product for the management of OM is an important, albeit complex, task. We are confident that the Betadine Gargle and Mouthwash can be an effective and economical supportive treatment option for OM,” he said.
Understanding, preventingand managing OM
OM is a common complication that occurs in patients receiving chemotherapy or radiotherapy involving the oral cavity. It is inflammation and/or ulcerative sores in the lining of the mouth or throat. OM is more likely to be caused by some types of cancer and their treatments.For example, OM occurs in virtually all patients with head and neck cancer receiving radiotherapy and in up to 68% of patients receiving chemotherapy. When OM manifests, it can be challenging and costly to manage.
As OM can cause pain, it creates an adverse impact on patients’ quality of life and wellbeing. Pain from OM may compromise food or nutritional intake and cause weight loss, which becomes more significant as the symptoms worsen.
Although there is no modality that can entirely prevent OM, prophylactic measures to reduce the occurrence and severity of OM are often more affordable and readily available compared with OM treatments. Good oral care remains the cornerstone for reducing the chances of developing OM. If and when OM develops, regular brushing and flossing, as well as rinsing with antiseptic mouth rinses can prevent infections and keep the mouth moisturized. Using a PVP-I mouthwash can also help to reduce the severity of symptoms and reduce the duration of OM, probably through controlling inflammation and removing free radicals, both of which are important components in the development of OM.
