Chemotherapy-Induced Oral Ulcers and Sore Throat: A Self-Care Guide for Hong Kong Patients
Mastering dietary adjustments, medications, and daily care can reduce side effects and maintain treatment and quality of life.
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For cancer patients in Hong Kong, radiotherapy and chemotherapy are powerful weapons against cancer. However, their side effects often interfere with daily life, one of the most common being oral ulcers (mouth sores) and sore throat. Since oral mucosa consists of rapidly dividing epithelial cells, it is highly susceptible to chemo- and radiotoxic injury (Sonis, 2004). These symptoms not only make eating difficult but can also cause malnutrition, weight loss, and fatigue(Elting et al., 2008). Therefore, learning how to prevent and manage oral ulcers is essential for completing treatment smoothly.
Introduction
Impact of Oral Ulcers
Studies show that over 60% of head and neck cancer patients develop oral mucositis or ulcers during treatment (Trotti et al., 2003). Among these, 70–80% experience weight loss, and in severe cases, treatment may even be interrupted (Peterson et al., 2015). Pain and swallowing difficulties significantly affect food intake, which over time can further weaken strength and immunity.
Dietary Adjustments: From the Patient’s Perspective
Many Hong Kong patients report that eating becomes a burden when mouth sores or sore throat occur. At such times, choose soft, minced, or pureed foods, such as tofu, steamed fish, steamed egg custard, mashed potatoes, or congee (Arends et al., 2017).
High-protein diets are especially important, as protein supports oral mucosal healing. Recommended protein intake for chemotherapy patients: body weight (kg) × 1.5 g/day (Arends et al., 2017).
Suitable food options include:
- Fruits: Bananas, papaya, or fruit purées
- Protein sources: Fresh fish, eggs, lean minced meat, tofu
- Soft vegetables: Loofah, amaranth greens, winter melon
- Staples: Congee, thin noodles, sweet potatoes, oatmeal
- Dairy: Milkshakes, pudding, yogurt (for extra calories if needed)
Patients should also drink at least 2000 ml of water daily to maintain oral moisture and metabolic function (Jensen et al., 2013).
Prevention and Daily Care Methods
In addition to diet, daily practices can reduce discomfort:
- Avoid irritating foods: Alcohol, spicy, or highly acidic drinks worsen ulcer pain.
- Food preparation: Mince food or add broth to improve smoothness.
- Lower food temperature: Avoid hot foods; choose room-temperature or slightly chilled options.
- Oral hygiene: Use a soft-bristle toothbrush; rinse after meals with alcohol-free mouthwash or salt water (Lalla et al., 2014).
- Nasogastric feeding if necessary: When eating becomes impossible and nutrition is at risk, doctors may recommend temporary feeding tubes (Hong Kong Cancer Fund, 2020).
Common Medications and Supportive Therapies
In Hong Kong oncology practice, doctors may prescribe or recommend:
- Oral ointments (Triamcinolone acetonide): Anti-inflammatory, effective in reducing ulcer symptoms (Nicolatou-Galitis et al., 2013).
- Topical anti-inflammatory sprays (Benzydamine): Provide local anesthetic and pain relief, best used 15 minutes before meals (Lalla et al., 2014).
- Oral protective gels: Form a protective coating on mucosa to reduce friction.
- Anti-inflammatory toothpaste (with glycyrrhizic acid): Lowers IL-8–mediated inflammation, relieving gum swelling and pain (Yuen et al., 2017).
- Glutamine: Some studies show it can reduce mucositis severity and diarrhea (Savarese et al., 2003).
- Ice chips or popsicles: Oral cryotherapy during chemotherapy reduces drug exposure in oral mucosa (Mahood et al., 1991).
- Vitamin C and B complex: Aid tissue repair.
- Pain medication: From acetaminophen (paracetamol) and NSAIDs to opioids for severe pain, as prescribed (Epstein et al., 2007).
Patient Experience: Coping with Pain and Treatment
Many Hong Kong patients share that early management of oral ulcers prevents worsening. Patients should promptly report side effects to the healthcare team rather than “enduring” them, which may delay treatment. Keeping a side effect diary and working with doctors and dietitians to adjust strategies is key to completing therapy successfully (Hong Kong Cancer Fund, 2020).
Conclusion
Oral ulcers and sore throat are common side effects of chemotherapy and radiotherapy, but with the right dietary choices, medications, oral care, and professional support, patients can minimize their impact. For patients in Hong Kong, maintaining close communication with healthcare providers and actively managing side effects not only ensures treatment completion but also preserves quality of life.
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References
- Arends, J., Bachmann, P., Baracos, V., Barthelemy, N., Bertz, H., Bozzetti, F., … & Preiser, J. C. (2017). ESPEN guidelines on nutrition in cancer patients. Clinical Nutrition, 36(1), 11-48.
- Elting, L. S., Cooksley, C., Chambers, M., Cantor, S. B., Manzullo, E., & Rubenstein, E. B. (2008). The burdens of cancer therapy: Clinical and economic outcomes of chemotherapy-induced mucositis. Cancer, 100(9), 1995-2005.
- Epstein, J. B., Schubert, M. M., & Peterson, D. E. (2007). Oral complications of cancer therapy. In Supportive Care in Cancer Therapy (pp. 25-40). Springer.
- Hong Kong Cancer Fund. (2020). Support and information for cancer patients. Retrieved from https://www.cancer-fund.org
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