Pancreatic Cancer Mouth Sores
and Ways to Cope

Cancer mouth sores have now become part of our reality.

BUT mom still has her hair! One side effect, knock on wood, we haven't had to experience yet.

Thank goodness! The pain, constipation, fatigue, nausea and mouth sores are bad enough!

So, what's up with mouth sores, or mouth ulcers? And more importantly, what do we do about them? Once again, it was back to research mode. This is what we found:

Cancer mouth sores are sores or ulcers that form on the inside lining of your mouth (mucous membranes) or on your lips. The mouth sores appear burn-like and can be painful, making it difficult to eat, talk, swallow and breathe.

Cancer treatments are intended to kill rapidly growing cancer cells. However, there are some healthy cells in your body that also divide and grow rapidly, including the cells that line the inside of your mouth. Unfortunately these healthy cells are also damaged by chemotherapy treatment . Damage to the cells in your mouth makes it difficult for your mouth to heal itself and to fend off germs, leading to sores and infections.

And the chemotherapy treatment most likely to cause the mouth sores?

5-fu . Our favorite "fu" chemo! For mom, the cancer mouth sores began rather benignly with just a small, little spot on the inside of her lower lip. She said it was almost like a tiny canker sore. No problem. That was about a week into the 5fu continuous chemo pump. Within days, another blister-like spot had popped up. And then it was like a freight train going down hill, picking up steam until the ultimate "crash" 2 weeks later. Mom's mouth had become so painful, that even eating and talking were difficult. Add to that the increasing nausea, and she was miserable. The doctor wisely discontinued the 5fu pump at that point and gave her a week off to recover. Cancer treatment sore mouth just made it to the top of mom's "Things to Hate about Cancer" list.

Ok, we understand the why behind cancer mouth sores. But what we really wanted to know is how to get rid of the blasted things! We wanted some kind of treatment to resolve the painful blisters and get mom back on track. Here are the things that worked for us:

DO:

Avoid painful foods. Mom's diet changed once again as she found certain foods greatly aggravated her already painful mouth. She dropped most acidic foods and juices. No more tomato, orange or grapefruit juice. Even her favorite drink, lemonade, bothered her, as did her morning cup of coffee, too hot. She also found that sharp, crunchy, salty foods were a no go. Foods such as pretzels, chips and crackers were removed from her diet. Instead, she opted for softer, blander foods. Some of mom’s favorites were ice cream, milkshakes, soft fruits (bananas and applesauce), mashed potatoes, cooked cereals, soft-boiled or scrambled eggs, yogurt, cottage cheese, macaroni and cheese, custards, puddings, and gelatin.

Eat foods at room temperature or slightly warm, since hot or cold foods may be painful to eat. Although, mom did like the milkshakes and thought the cold ice cream actually soothed her mouth. But cold drinks not so much. Go figure!

Use a straw. A straw for drinking keeps liquids away from sore areas in your mouth.

Use a lip balm or petroleum jelly to coat your lips. Once the cancer mouth sores took over, even mom's lips became sore and cracked. The lip balm did help with that.

Continue cleaning your mouth. Use a soft toothbrush and a gentle touch when brushing teeth and gums. Avoid toothpaste that has whitners in them, as they may contain hydrogen peroxide which can irritate mouth sores. If it's too painful to use a toothbrush, ask your doctor or your dentist about special foam swabs, which are easier on your gums.

Rinse out your mouth several times a day. Avoid mouthwashes that contain alcohol. Mix a weak saltwater solution to swish around in your mouth or try a combination of baking soda and warm water. Here are two recipes for a homemade mouth wash:

1 teaspoon baking soda
2 cups water

or

1 teaspoon salt
1 teaspoon baking soda
1 quart water

Stir or shake the solution well, then swish it around and gently gargle. Then spit it out.

This worked for mom in the beginning, but as her cancer mouth sores and her nausea increased, this method wasn't as effective. At one of her weekly rechecks, a nurse mentioned Biotene. It is a product designed to help with dry mouth and the attending problems, such as dry, cracked lips and mouth sores. It comes in a variety of applications. We tried the Biotene Oral rinse, the toothpaste and the gum. It was marginally effective, and mom is still using it to combat dry mouth. However, the mouth sores finally overwhelmed all our coping strategies and her doctor took her off the 5fu. He also ordered her a prescription for Magic Mouthwash at that time.

Magic mouthwash worked well for her mouth sores. It is a concoction that the pharmacist mixes up and contains a number of components, such as lidocaine, maalox, and steroids. There is no one true "recipe" for magic mouthwash, but it does seem to work. It numbs and soothes your mouth. Talk with your doctor if the cancer mouth sores have become debilitating. It may help you fight through this beast of a side effect.

That's a rather exhaustive list of what worked for mom. She had two tips from friends that we didn't try, mainly because they were for preventing the mouth sores, and unfortunately, by the time we were researching the issue, mom's mouth sores were full-blown. But I will mention them here, perhaps they will work for you in a pro-active kind of way.

One is a product called L-Lysine, and the other is Peroxyl. Both can be found at most pharmacies, and mom's friends believe that they seem to prevent mouth irritations from even starting. Use this tip with caution. We do not have first-hand experience using either one of these products. Talk it over with doctor as always before starting to use them.

And finally, one last word of caution. Cancer mouth sores can range from mild to severe. When the sores become severe, it is imperative to contact your doctor. Here's a guideline to know when the mouth sores have crossed the line:

Call the doctor if:

* there is redness or shininess in mouth that lasts for more than 48 hours
* gums are bleeding
*a temperature of 100.5° F or higher when taken by mouth
*white patches on the tongue or inside the mouth
*you have taken in little food or fluid for 2 days, and
*you cannot take medicines due to sores in mouth

Thankfully, mom's mouth sores have only reared their ugly heads during the 5fu chemo treatment. Yes, it was almost 6 weeks of misery, but that treatment is done and behind her. If and when the doctor needs to revisit the 5fu chemotherapy, we'll be ready and armed.

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