It may develop a whitish coating. The lips are dry and cracked. If intervention is not made, and sometimes, despite intervention, the body progresses to the Exhaustion Stage where the saliva is thick and ropey, blisters and ulcerations are present, bleeding may occur from cracks on the lips and sores on the palate and buccal mucosa. The outer epithelial layer is very thin or nonexistent in some areas. The mouth is red, edematous and painful.
Infection can easily occur and the nutritional status of the patient is definitely jeopardized.
Everyone has a wide variety of pathogens present at all times on the skin, in the mouth and in the GI tract. In a healthy individual with a fully functioning immune system, these seldom prove to be a problem. In an individual with cancer, however, who is compromised not only by the disease, but also by the treatment, major problems can result. With the loss of the protection provided by the mucosal lining due to thinning and ulceration, the door is open to invasion of a systemic nature by these pathogens. It is important to note that sometimes, nothing can be done to prevent mouth sores associated with treatment.