Mouth problems with breast cancer treatment

Some chemotherapy and targeted therapies have side effects that affect your mouth.

It is important to look after your mouth throughout treatment. This will help reduce the risk of ulcers and mouth infections. The targeted therapy drug Afinitor (everolimus) in particular causes mouth ulcers and cold sores, if you usually get them. Some people need to reduce the dose or stop taking everolimus.

Speak to your treatment team about the best mouth care for your treatment.

Mucositis

Chemotherapy and some targeted therapies can affect the lining of the mouth and gut.

This can cause painful sores in your mouth and throat (like ulcers) – ‘mucositis’.

The ulcers usually appear 5 to 10 days after the start of each treatment cycle. They clear up within 1 to 2 weeks.

The signs and symptoms of mucositis include:

• painful spots, sores or bleeding in the mouth or throat
• difficulty eating, chewing, drinking or swallowing
• red or white spots in your mouth or throat.

When to contact your doctor

It is important you let your doctor or nurse know straightaway if you:

• can’t eat or drink
• cough while eating or drinking
• have trouble swallowing or talking
• have increasing pain or bleeding in the mouth
• see white spots in your mouth
• have a temperature of 38 degrees or higher.

It is important to manage mucositis early to prevent problems and get the care you need.

Mouth ulcers

The best way to prevent or reduce mouth ulcers is to have good oral hygiene. Use our tips below.

Painkillers such as paracetamol or a local anaesthetic gel can help with the discomfort of mouth ulcers. Sometimes soluble Panadol or aspirin are easier to take if your mouth is sore.

Mouth infections, cold sores or thrush

Chemotherapy can cause other mouth problems such as cold sores or thrush.

If you’re prone to cold sores, tell your oncologist before you start treatment. Also make sure you have cold sore medication available so you can use it as soon as you feel a cold sore starting.

Your doctor or pharmacist can recommend over-the-counter medication to treat these conditions.

Ways to look after your mouth health

Look after the health of your mouth with our tips below.

Visit your dentist

Before you start treatment, it’s a good idea to visit the dentist. They can make sure you don’t have any tooth or mouth infections.

Tell your dentist if you are having chemotherapy or bone-strengthening treatment. Regular appointments will help prevent problems.

Use mouthwash

Rinse your mouth a few times a day with:

• a mixture of ¼ teaspoon of salt or baking soda (sodium bicarbonate) dissolved in a cup of warm water. Use this to rinse then spit out
• an alcohol-free mouthwash to prevent irritation. Ask your doctor or nurse which ones are suitable. Some products, such as Biotene, are designed especially for chemotherapy patients

Your doctor may recommend a steroid mouthwash to prevent problems with certain treatments such as Afinitor.

Use the right products

• Use a mild toothpaste containing fluoride and a soft toothbrush to clean your teeth gently.
• Rinse your toothbrush in warm water with a teaspoon of salt to help keep it clean.
• Allow your toothbrush to dry after use and replace it regularly.
• If you wear dentures, soak them overnight and leave them out of your mouth for as long as you can during the day.

Eat and drink the right foods

• Drink plenty of water.
• Avoid foods that are very cold, very hot, crunchy or spicy.
• Choose foods that are soft and easy to swallow.
• Sucking on ice chips or an icy pole during your chemotherapy can help prevent mouth ulcers.