This means that, like cancer cells, they are easily killed by chemotherapeutic agents. As cells in the mouth die, they release molecules called cytokines, which cause inflammation that further damages mouth tissue. The resulting breaks and ulcers then make it easy for germs from the mouth to enter the bloodstream and cause systemic infection, particularly since the immune defenses are also hurt by chemotherapy. On top of that, patients often have so much pain from mouth sores that they can't eat or absorb much-needed nutrients. With head and neck cancers, which will be diagnosed in about 30,000 Americans this year, the main problem is the radiation that patients get after surgery.
Radiation can destroy saliva glands, as well as blood vessels and bones in the mouth and jaw.
Without saliva, patients have difficulty swallowing, chewing, speaking and fighting infection, which means tooth decay can become rampant. In addition, radiation can damage blood vessels and the jawbone to such a degree that if a person later needs a tooth extracted, the bone may never heal. Taken together, this means that patients with head and neck cancer should get major dental work done before radiation. As a result, a number of new drugs to prevent or treat mucositis are now in testing. At the University of Connecticut Health Center in Farmington, Dr. Douglas Peterson, head of oral diagnosis, has completed a study in stem cell transplant patients of a drug called misoprostol, already on the market for stomach ulcers.