SciELO - Scientific Electronic Library Online

vol.17 número1Impact of nutrition education on nutrition knowledge of public school educators in South Africa: A pilot studyNeeds and preferences for nutrition education of type 2 diabetic adults in a resource-limited setting in South Africa índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados



Links relacionados

  • En proceso de indezaciónCitado por Google
  • En proceso de indezaciónSimilares en Google


Health SA Gesondheid (Online)

versión On-line ISSN 2071-9736
versión impresa ISSN 1025-9848

Health SA Gesondheid (Online) vol.17 no.1 Cape Town  2012




Incidence, severity and management of cancer chemotherapy related oral mucositis in Eastern Cape and Western Cape



Johanna E. MareeI; Margaretha J. CombrinkII; Tanya de LangeII; Andrea S. ToerienII; Minette BedekerII

IDepartment of Nursing Education, University of the Witwatersrand, South Africa
IIAdelaide Tambo School of Nursing Science, Tshwane University of Technology, South Africa





This study explored the incidence, duration and severity of oral mucositis in patients receiving chemotherapy in the Eastern and Western Cape, how this symptom was managed and whether the patients considered the management to be effective. An exploratory, contextual, quantitative survey was conducted. The sampling method was convenience. One hundred and sixty patients were recruited, with 106, (66.3%) participating. Data were collected by means of self-reports, using a self-administered questionnaire. Oral mucositis was a common problem, with 71.7% (n = 76) reporting to have had mucositis. Pain was not effectively managed, as 69.8% (n = 53) of respondents experienced pain whilst only 17.1% (n = 13) reported to have used analgesics. More than half of the respondents used prescribed mouth and throat preparations, whilst 28.9% (n = 22) used non-prescribed self-care measures including potentially harmful products. A significant difference was found between using non-prescribed self-care measures and the duration of oral mucositis (χ2 = 0.81; p = 0.01). The reported grade of mucositis did not influence the use of non-prescribed self-care measures, whilst the more pain patients experienced the less inclined they were to use these measures. The management of oral mucositis remains a challenge. Failure to palliate this distressing symptom can lead to the use of potentially harmful self-care measures.


Die studie het die insidensie, tydsduur en intensiteit van orale mukositis in Oos en Wes Kaapse pasiënte wat kankerchemoterapie ontvang verken asook hoe hierdie simptoom hanteer is en die sukses hiervan volgens die pasiënte. 'n Kwantitatiewe, ekploratiewe, kontekstuele opname is onderneem. 'n Gerieflikheidsteekproef is gebruik om die deelnemers te verkry. Een hondered en sestig persone is genader en 66.3% (n = 106) het aan die studie deelgeneem. Die datainsamelingsmetode was self-rapportering met behulp van 'n vraelys en beskrywende statistiek is gebruik om die data te verwerk. Orale mukositis was 'n algemene probleem, aangesien 71.7% (n = 76) van die respondente die simptoom ondervind het. Pyn was nie goed beheer nie, aangesien 69.8% (n = 53) pyn ondervind het terwyl slegs 17.1% (n = 13) aangedui het dat hulle analgetika gebruik het. Meer as die helfte van die respondente het voorgeskrewe mond en keel preparate gebruik, terwyl 28.9% (n = 22) self gemedikeer het wat potensiële nadelige preparate ingesluit het. 'n Beduidende verskil is tussen die gebruik van nie voorgeskrewe medikasie en die duur van mukositis bevind (χ2 = 0.81; p = 0.01). Die graad van die mukositis het nie die gebruik van die self-medikasie beinvloed nie. Hoe meer pyn ondervind is, hoe minder was die neiging om die mukositis self te behandel. Die hantering van orale mukositis bly 'n uitdaging. Die onsuksesvolle palliasie van hierdie simptoom kan tot die gebruik van potensieel nadelige self-sorg maatreëls lei.



“Full text available only in PDF format”




Anstay, S., 1997, 'Communication', in J. Penson & R. Fisher, (eds.), Palliative care for people with cancer, pp. 246-168, Arnold, London.         [ Links ]

Atkinson, J. & Virdee, A., 2001, 'Promoting comfort for patients with symptoms other than pain', in: S. Kinghorn & R. Gamlin, (eds.), Palliative nursing: Bringing comfort and hope, pp. 43-62, Bailliere Tindall, Edinburgh.         [ Links ]

Avritscher, E., Cooksley C. & Elting, L.,2004, 'Scope and epidemiology of cancer therapy-induced oral and gastrointestinal mucositis', Seminars in Oncology Nursing 20, 3-10, viewed 7 March 2012, from, PMid:15038511.         [ Links ]

Borbasi, S., Cameron, K., Quested, B., Olver, I., To, B. & Evans, D., 2002, 'More than a sore mouth: Patient's experience of oral mucositis', Oncology Nursing Forum 29, 1051-1057, viewed 12 July 2011, from PMid:12183754.         [ Links ]

Brown, C., Beck, S., Peterson, D., McGuire, D., Dudley, W. & Mooney, K., 2009, 'Patterns of sore mouth in outpatients with cancer receiving chemotherapy', Supportive Care in Cancer 17, 413-428, viewed 8 February 2012, from, PMid:18839221.         [ Links ]

Chan, C., Chang, A., Molassiotis, A., Lee, I. & Lee, G., 2003, 'Oral complications in Chinese cancer patients undergoing chemotherapy', Supportive Care in Cancer 11, 48-55.         [ Links ]

Cawley, K. & Benson, L., 2009, 'Mucositis', in S. Newton, M. Hickey, J. Marrs, (eds.), Mosby's oncology nursing advisor. A comprehensive guide to clinical practice, pp. 374-375, Mosby St Louis.         [ Links ]

Chen, H.M., 2008, 'Patient's experiences and perceptions of chemotherapy-induced oral mucositis in a day unit', Cancer Nursing 31, 363-369, viewed 12 July 2011, from, PMid:18772661.         [ Links ]

Cheng, K., 2006, 'Oral complications in patients with cancer', in N. Kearney & A. Richardson, (eds.), Nursing patients with cancer, Principles and practice, pp. 575-600, Elsevier, Edinburgh.         [ Links ]

Clarkson, J., Worthington, H., Furness, S., McCabe, M., Khalid, T. & Meyer, S., 2010, 'Interventions for treating oral mucositis for patients with cancer receiving treatment', Cochrane Database of Systemic Reviews 8.         [ Links ]

Douherty, L. & Bailey, C., 2008, 'Chemotherapy', in J. Corner & C. Bailey, (eds.), Cancer nursing: Care in context, pp. 267-316, Blackwell, Oxford.         [ Links ]

Eilers, J. & Million, R., 2007, 'Prevention and management of oral mucositis in patients with cancer', Seminars in Oncology Nursing 23, 201-212., PMid:17693347        [ Links ]

Eilers, J. & Million, R., 2011, 'Clinical update: Prevention and management of oral mucositis in patients with cancer', Seminars in Oncology Nursing 27, e1-e16, viewed 7 February 2012, from, PMid:22018411        [ Links ]

Elting, L., Cooksley, C., Chambers, M., Cantor, S., Manzullo, E. & Rubenstein, E., 2003, 'The burdens of cancer therapy', Cancer 98, 1531-1539, viewed 12 July 2011, from, PMid:14508842        [ Links ]

Farrell, C., Heaven, C., Beaver, K. & Maguire, P., 2005, 'Identifying the concerns of women undergoing chemotherapy', Patient Education and Counseling 56, 72-77, viewed 15 April 2011, from, PMid:15590225        [ Links ]

Feller, L., Essop, R., Wood, N., Khammasisa, R., Chikte, U., Meyerov, R. & Lemmer, J., 2010, 'Chemotherapy and radiotherapy-induced oral mucositis: pathology, epidemiology and management', SADJ: Journal of the South African Dental Association 65, 372-374. PMid:21133051        [ Links ]

Flint, S., 2006, 'Oral ulceration: GP guide to diagnosis and treatment', Prescriber 17, 32-48, viewed 13 July 2011, from        [ Links ]

Fulton, J. & Treon, M., 2007, 'Oral mucositis', in M. Langhorne, J. Fulton, S. Otto, (eds.), Oncology nursing, pp.505-523, Mosby, St Louis.         [ Links ]

Goldberg, S., Chiang, L., Selina, N. & Hamarman, S., 2004, 'Patient perceptions about chemotherapy-induced oral mucositis: Implications for primary/secondary prophylaxis strategies', Supportive Care in Cancer 12, 526-530, viewed 12 July 2011, from, PMid:15150704        [ Links ]

Harris, D., Eilers, J., Harriman, A., Cashavelly, B. & Maxwell, C., 2008, 'Putting Evidence Into Practice®: Evidence-Based Interventions for the Management of Oral Mucositis', Clinical Journal of Oncology Nursing 12, 141-152, viewed 7 February 2012, from, PMid:18258584        [ Links ]

Kearney, N., Miller, M., Maguire, R., Dolan, S., MacDonald, R., McLeod, J., Maher, L., Sinclair, L., Norrie, J. & Wengström, Y., 2008, 'WISECARE+: Results of a European study of a nursing intervention for the management of chemotherapy-related symptoms', European Journal of Oncology Nursing 12, 443-448.         [ Links ]

Kostler, W., Hejna, M., Wenzel, C. & Zielinski, C., 2001, 'Oral mucositis complicating chemotherapy and/or radiotherapy: Options for prevention and treatment', CA A Cancer Journal for Clinicians 51, 290-315.         [ Links ]

Maree, J., 2009, 'An investigation into registered nurse awareness of and practice related to cancer pain', Journal of Pain Management 3, 53-62.         [ Links ]

Miller, M. & Kearney, N., 2001, 'Oral care for patients with cancer: A review of the literature', Cancer Nursing 24, 241-254, viewed 14 July 2011, from, PMid:11502032        [ Links ]

Naidu, M., Ramana, G., Rani, P., Mohan, I., Suman, A. & Roy, P, 2004, 'Chemotherapy-induced and/or radiation therapy-induced oral mucositis-complicating the treatment of cancer', Neoplasia 6, 423-431, viewed 14 July 2011, from, PMid:15548350, PMCid:1531648        [ Links ]

Newton, S., Hickey, M. & Marrs, J., 2009, Mosby's oncology nursing advisor, St Louis, Mosby.         [ Links ]

Nishimura, N., Nakano, K., Ueda, K., Kodaira, M., Yamada, S., Mishima, Y., Yokoyama, M., Terui, Y., Takahashi, S. & Hatake, K., 2011, 'Prospective evaluation of incidence and severity of oral mucositis induced by conventional chemotherapy in solid tumors and malignant lymphomas', Supportive Care in Cancer 1-7.         [ Links ]

Quinn, B., Stone, R., Uhlenhopp, M., McCann, S. & Blijlevens, N., 2007, 'Ensuring accurate oral mucositis assessment in the European Group for Blood and Marrow Transplantation Prospective Oral Mucositis Audit', European Journal of Oncology Nursing 11, S10-S18, viewed 15 April 2011, from        [ Links ]

Rubenstein, E., Peterson, D., Schubert, M., Keefe, D., McGuire, D., Epstein, J., Elting, L., Fox, P., Cooksley, C. & Sonis, S., 2004, 'Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis', Cancer 100, 2026-2046, viewed 7 February 2012, from, PMid:15108223        [ Links ]

Sieracki, R., Johannik, T., Kopaczewski, D. & Hubert, K., 2009, 'Development and implementation of an oral care protocol for patients with cancer', Clinical Journal of Oncology Nursing 13, 718-722, viewed 7 February 2012, from, PMid:19948471        [ Links ]

Sonis, S., 2007, 'Pathobiology of oral mucositis: novel insights and opportunities', Journal of Supportive Oncology 9, 3-11.         [ Links ]

Sonis, S., Clairmont, F., Lockhart, P. & Connolly, S., 1985, 'Benzydamine HCL in the management of chemotherapy-induced mucositis. I. Pilot study', Journal of Oral Medicine 40, 67-71. PMid:3858465        [ Links ]

Sonis, S., Elting, L., Keefe, D., Peterson, D., Schubert, M., Hauer-Jensen, M., Bekele, B., Raber-Durlacher, J., Donnelly, J. & Rubenstein, E., 2004, 'Perspectives on cancer therapy-induced mucosal injury', Cancer 100, 1995-2025, viewed 7 February 2012, from, PMid:15108222        [ Links ]

The Johanna Briggs Institute, 2010, 'Chemotherapy: Mucositis management', viewed 1 October 2011, from        [ Links ]

Volpato, L., Silva, T., Oliveira, T., Sakai, V. & Machado, M., 2007, 'Radiation therapy and chemotherapy-induced oral mucositis', Revista Brasileira de Otorrinolaringologia 73, 562-568, viewed 15 April 2011, from, PMid:17923929        [ Links ]

Witt, M., 2007, 'Mucositis', in M. Haas, W. Hogle, G. Moore-Higgs, T. Gosselin-Acomb, (eds.), Radiation Therapy: A guide to patient care, pp. 563-573, Mosby, St Louis.         [ Links ]

Worthington, H., Clarkson, J., Bryan, G., Furness, S., Glenny, A., Littlewood, A., McCabe, M., Meyer, S. & Khalid, T., 2011, 'Interventions for preventing oral mucositis for patients with cancer receiving treatment', Cochrane database of systematic reviews 4.         [ Links ]

Wu, J., Beale, K. & Ma, J., 2010, 'Evaluation of current and upcoming therapies in oral mucositis prevention', Future Oncology 6, 1751-1770, viewed 7 February 2012 from, PMid:21142661        [ Links ]



Johanna Maree
7 York Road
Park Town 2194
South Africa

Received: 14 Oct. 2011
Accepted: 24 June 2012
Published: 04 Oct. 2012

Creative Commons License Todo el contenido de esta revista, excepto dónde está identificado, está bajo una Licencia Creative Commons