Hina Khan suffering from mucositis: Know all about this side effect of cancer treatment

Hina Khan, who is battling Stage 3 breast cancer, is continuously sharing her treatment and recovery journey with fans, updating them about personal decisions, challenges and more. She recently took to Instagram to reveal that she is struggling with ‘mucositis', a painful side-effect of chemotherapy.

She wrote, "Another side effect of chemotherapy is mucositis. Although I am following the doctors advice to treat it, if any of you have been through it or have known any useful remedies, please suggest. It's really hard when you can't eat. It will greatly help me."

Less than a week after this development, she took to Instagram Stories to give an update on her fight against mucositis, revealing that the condition is better now. Posting a selfie, she wrote, "This is for each one you.. My Mucositis is much better.. I read all your comments and suggestions.. You all hv been a great great help.. Sending you all tons of love".

Mucositis is a common side effect of chemotherapy and proper information and guidance is key to combat it. Mid-day.com speaks to medical experts who reveal the symptoms, causes and measures to navigate the condition.

What is mucositis?

"Mucositis is inflammation of the mucosa, the mucous membranes that line your mouth and your entire gastrointestinal (GI) tract," reveals Dr. Pritam Kataria, Medical Oncologist, Sir HN Reliance Foundation Hospital, Mumbai.

He further explains, "Between 20-40 per cent of patients with solid tumours receiving chemotherapy develop mucositis, usually within five to fourteen days of starting treatment."

Explaining why chemotherapy causes mucositis, Dr. Atul Narayankar, Consultant Medical Oncologist, Wockhardt Hospitals, Mira Road, says, "Cancer patients undergoing radiation and chemotherapy can suffer from this condition as these treatments are known to damage the cells of the mucosa and tend to take a toll on the mouth and abdominal organs."

Dr. Kataria further clarifies, "Cancer treatments are a common cause of mucositis. Whether or not they are targeting cancer, the following treatments frequently cause mucositis: chemotherapy, radiation of the head, chest or neck and bone marrow transplants."

"The cells in the body's mucous membranes divide rapidly, similar to cancer cells. Chemotherapy and radiation therapy attack cancer cells and any other rapidly dividing cells, including those of the mucous membranes along the oral cavity and GI tract.

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How does mucositis affect the body?

Given how common this condition is, it is important to be prepared for its effects while undergoing chemotherapy or radiation therapy.

Dr. Kataria states, "Mucositis can cause difficulty in eating or loose stools, leading to loss of appetite and weight loss. Also, there could be fatigue and pain while eating."

Dr. Narayankar adds, "One known to have this condition will experience severe pain owing to radiation therapy and will find it difficult to eat food or drink liquids. It can also cause bleeding while one is brushing teeth.

This condition can further cause mouth infection and severe mucositis can lead to interruptions or reductions in cancer treatment, leading to a bad prognosis of the disease. This condition can impact one's quality of life as one will have nutritional problems."

Although generally severe, the condition doesn't impact everyone in the same way.

"The incidence and severity of mucositis vary between chemotherapeutic agents, the number of chemotherapy cycles, the dose of chemotherapy, and from patient to patient," informs Dr. Kataria.

Dr. Narayankar states, "This is a temporary condition and will go away on its own after a while. One with this condition shouldn't panic and seek timely help from the expert."

What are the symptoms of mucositis?

For early diagnosis and intervention, one must look out for the following signs and symptoms of mucositis.

"The signs and symptoms of this condition include having extremely dry and sore mouth ulcers that can be painful, mouth infection causing bad breath, bleeding, white patches with pus, high saliva production and swallowing difficulty," explains Dr. Narayankar.

Most symptoms of mucositis affect the mouth. However, the GI tract is also affected. Dr. Kataria states the following GI symptoms:
• Diarrhea
• Blood in the feces
• Stomach cramps

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How to prevent and treat mucositis?

Dr. Kataria shared the following measures for managing mucositis:
• Sometimes, mucositis could be caused due to reduction in blood count. So, managing WBC count is important.
• Doctors may prescribe topical pain relief medications, antifungal lozenges or antiseptic mouthwash.
• Keeping the oral cavity clean is important.

Measures for prevention of oral mucositis include:
• Avoid all tobacco products.
• Stay hydrated.
• Keep the lips and mouth moist.
• Eat a healthy, balanced diet.
• Avoid hot, spicy or salty foods.
• Limit the intake of hot, fizzy or alcoholic drinks.
• Avoid hard or crunchy foods.

Dr. Narayankar suggests the following measures to manage mucositis:
• One should suck on ice cubes from time to time, opt for a sugar-free gum to keep the mouth moist.
• Tackle the problem of dry lips with the help of a lip balm recommended by an expert.
• Eating soft, moist foods like soup, jelly, frozen fruits and vegetables, ice-cream, milkshakes, cheese, mashed potatoes, eggs, custards and puddings can be beneficial for patients.
• Be sure to avoid foods loaded with sugar.
• Brushing teeth with a soft brush and drinking enough water is advised for patients.
• Use a mouth wash only after consulting an expert.

Nutritional aspects of mucositis

Since mucositis mainly affects the mouth and the GI tract, eating becomes a challenge. In such a situation, it is difficult for the body to get desired nutrients for functioning properly. How can this be navigated?

Fauziya Ansari, Dietitan, Apollo Spectra Hospital, Mumbai, says, "When dealing with mucositis, maintaining healthy nutrition levels can feel like a daunting task. One may experience difficulty in eating food or even swallowing a few sips of water."

In order to navigate that, she says, "Look for foods that are easy to chew or swallow that do not trigger your mouth ulcer or inflammation. For optimal nutrition, you can add additional nutritional shakes, smoothies or juices made from a range of vegetables, fruits or protein powders. Focus on foods that provide maximum protein such as yogurt, lentils, chia seeds, tofu, paneer, milk, soybean, mushroom, spinach, rajgira (amaranth) barley, oats and dry fruits."

She further states, "Ensure that you drink an adequate amount of water to stay hydrated. You can try eating in smaller portions, making it easier for you to chew or eat while maintaining a nutritional balance. Be mindful about your eating habits. Chew your foods slowly and savour each bite to create a better connection with the food during this tough time."

She gives the following tips:

• If you are dealing with mucositis then you need to make mindful decisions when it comes to food.
• Select foods that are gentle on your digestive tract and mouth as they can further lead to allergic reactions causing diarrhea, constipation, gas, bloating, and vomiting.
• In case you feel difficulty chewing then you can blend or puree blanched vegetables into soups or stews.
• Opt for soft fruits like bananas, strawberries, avocados, papaya, grapes, plum, kiwi, dragon fruit, watermelon, oranges and cheery. These fruits are packed with essential nutrients like vitamins, minerals, fibers, antioxidants, zinc, folic acid, potassium, magnesium, and calcium.
• Avoid foods that are spicy, acidic, oily, rough textured or hot food.
• Opt for healthy drink alternatives like coconut water, almond milk or soy milk for maximum nutritional intake.
Disclaimer: This information does not replace professional medical advice. Kindly consult a qualified medical professional for personalized guidance.