Oral mucositis, dysfunction, and distress in patients undergoing cancer therapy

Aims and objectives. This study investigated the patients' self-reported oral dysfunction in relation to oral mucositis and examined the extent to which oral dysfunction and distress correlated with oral mucositis. Background. Oral mucositis is the most symptomatic problem of patients in cancer therapy. However, the levels of oral functional impairment and distress in response to oral mucositis are not thoroughly assessed and researched. Design and method. This study employed a descriptive cross-sectional design. Eighty-eight subjects presenting with WHO grade >= 2 oral mucositis during 7-14 days after the initiation of chemotherapy and the last week of head and neck irradiation were enrolled in the study. Subjects were asked to indicate their intensity and distress of oral mucositis and associated oral dysfunction using 1-4 and 0-4 point rating scales, respectively. Results. Dry mouth and distorted taste were reported by 63 (72%) and 55 (63%) subjects separately. Fifty (57%) and 35 (40%) subjects reported having weight loss and dysphagia, respectively. The mean intensity and the distress score of oral mucositis and oral dysfunction reported by the subjects ranged from 1.96 to 2.51 and 1.58 to 2.09, respectively. The intensity of oral mucositis was significantly correlated with the intensity (r = 0.4-0.6) and the distress scores (r = 0.4-0.6) of oral dysfunction. Conclusion. The findings have demonstrated that the intensity and the distress of oral dysfunction in patients with cancer therapy induced oral mucositis were moderately high from the patients' point of view. The data also supported the correlations between the intensity and the distress of oral mucositis and oral dysfunction. Relevance to clinical practice. Patients treated with chemotherapy and radiotherapy for cancer most often suffer from a multitude of intense and distressing oral dysfunctions in conjunction with oral mucositis. Increased attention and treatment of the oral dysfunction noted are essential for the early identification and relief of distress.