Mouth and Throat Cancer Guidelines

Guidance for Head and Neck Cancer Patients During Radiation Therapy:

This note offers comprehensive guidance for head and neck cancer patients undergoing radiation therapy, covering common side effects, prevention, dos and don’ts, home remedies, dietary changes, supplements, and medications used.

This note is based on international standards (like NCCN, ASTRO) and kindly provided by Dr. Narendra Rathore (MB Hospital, Udaipur).

1. Common Side Effects of Radiation Therapy:

Radiation to the head and neck can increase tissue sensitivity, leading to various symptoms.

2. Prevention:

The following measures can help reduce the severity of side effects:

Oral Care: Keep the mouth clean to prevent infection. Use a mild, non-alcoholic mouthwash (like salt or sodium bicarbonate solution) regularly during the day.
Skin Care: Keep the radiation area soft, clean, and moisturized. Use doctor‑recommended moisturizers (e.g., Vaseline).
Hydration: Drink 2–3 liters of water daily to reduce dryness of the skin and mouth.
Dental Check-up: Visit a dentist before starting radiation therapy.
Nutrition: Consume a calorie‑ and protein‑rich diet under dietitian supervision to prevent weight loss.

3. Dos and Don’ts:

✔ Do:

Rinse the mouth 3–4 times daily with a salt or baking‑soda solution.
Use the moisturizer as advised by your doctor.
Wear soft, cotton clothing to avoid friction around the radiation area.
Drink water frequently and use sugar‑free gum or lozenges to keep your mouth moist.
Report severe symptoms (pain, difficulty swallowing, or infection) immediately to your doctor.
Ensure adequate rest.

✖ Don’t:

Avoid alcohol‑based mouthwash, strong soaps, or lotions.
Avoid spicy, heavy, or acidic foods that may irritate the mouth or throat.
Refrain from smoking or alcohol.
Do not scratch the radiation area.

4. Home Remedies:

✔ With your doctor’s approval only:

Honey: Take 1 teaspoon of honey or mix it in water/milk.
Warm salt‑water gargles: Helps soothe inflammation.
Aloe Vera gel: Apply to the affected area for cooling relief.

⚠️ Do not apply any remedy to open wounds, injuries, or inside the mouth/throat.

5. Dietary Changes & Supplements

According to ESPEN guidelines, diet plays a vital role:

Soft‑liquid foods:
- Thin lentil soup with rice
- Cold curd and rice
- Carrotsoup
- Mashed potatoes with butter and salt
Eat 5–6 small meals a day.
Include high‑calorie proteins like milkshakes or supplements such as KABIPRO.
Drink 8–10 glasses of water, coconut water, or light juice.
Avoid spicy, fried, oily, or acidic foods.

Supplements (doctor-supervised only):

Protein powder
Omega‑3 fatty acids
Multivitamins (Vitamin D, B‑complex)
Zinc
Probiotics

6. Consultation with Your Oncologist

Following NCCN guidelines, regular follow‑ups, symptom monitoring, blood and scan tests, and treatment adjustments are essential. Maintaining a daily diary (pain, diet, mouth/throat status) is highly beneficial.

7. Commonly Used Medications

(Based on MASCC, NCCN):

For pain: Paracetamol; for severe pain, Tramadol/Morphine
For mouth pain: Lidocaine gel or mouthwash
To prevent infection: Antibiotic mouthwash (e.g., Benzimidine, Lidocaine/Antacid combo)
For dry mouth: Biotin, Pilocarpine
For inflammation/pain: Hydrocortisone, antiseptic rinse
For diarrhea: Loperamide, fiber supplements (psyllium)
If oral feeding is inadequate: Enteral nutrition (e.g., Ensure)

Note: Some of these medications may not be available in your area.

⚠️ Precaution: Take all medications only under your oncologist’s guidance, as some may interact with cancer treatment.

🌟 Additional Suggestions

Stay connected: Receive emotional and practical support from yourself, family, and counselors.
Mental health: Practice meditation, deep-breathing, or calming music.
Join support groups.

📝 Important Note

Side effects of radiation therapy are manageable with proper care and awareness. Stay in contact with your doctor, follow their instructions, and use home/supportive measures thoughtfully.

You are not alone on this journey. ❤️