Cares for mouth, throat, nose (cancer and/or side effects) - long

Compiled from various sources (patients, webpages)
Check with your doctors on when and if you should use any of these and re:
medication conflicts.
J

Starts with soft toothbrushes.

1) DRY MOUTH
Dry mouth can be relieved in many patients by simple measures such as
frequent sips of cool drinks or sucking pieces of ice/chips.
Try slush or frozen popsicles or popsicle ice cubes (made by using various

flavors of koolaid) in a blender to make tasty ice chips
Fruit pastilles (sugarless hard candy). chew (sugarless) gum, drink water

Biotene is for dry mouth, so if a person is sipping water and/or club
soda, they may not need as much Biotene.
http://www.dentist.net/biotene-oral-balance-gel.asp

http://www.just4teeth.com/s.nl/sc.5/...3629/KB.248/.f

Biotene Gum Dry Mouth FAQ "The gum can be chewed for as long as you like
but should be kept in the mouth for at least 3-5 minutes to allow the
enzymes to work."

Note: Don't throw it out if you don't have a positive experence; one
patient reports that, on new try, it started working approx 6 months
later.

Biotene Gum Dry Mouth - you might have to ask a pharmacist or local
Wal-Mart to order it.
A box of 16 pieces for about $1.59 US

Biotene products are usually easier to find or order.
Biotene Dry Mouth Toothpaste
Biotene Childrens Products
Biotene Mouthwash Dry Mouth
Biotene OralBalance Dry Mouth


2) THICK MUCOUS
Cold fizzy club soda is carbonated water..
It's available in cans (maybe bottles) in grocery stores.
Swill it, gargle it, spit it out

3) PAIN
Steph's mix (for pain)
"liquid mixture of nystatin, viscous xylocaine and an anti-inflammatory "
(swish, gargle and/or swallow)
If they don't mix it, ask them for prescription and find a compounding
pharmacy. **
(anti-inflmmatory may be Motrin (Ibuprofen) or Naprox (pulverize it, or
part of it,
and mix with warm water. Stay away from timed release.


My concoction was called Magic Mouthwash (cancer center pharmacy).
It never worked more that 10 minutes at a time. I found that if I used
straight Lidocaine on a swab about every 15 minutes it did the same thing,

lasted longer and tasted better.
Take it with you in a small clean, air and water-tight container and
Q-tips to swab it on.
I suppose that could be combined with water and swished and/or gargled.


Difflam Sore Throat Rinse (UK or Australia or NZ)
Benzydamine hydrochloride belongs to a group of medicines called
non-steroidal anti-inflammatory drugs (NSAIDs). Also available in
sugar-free lozenges
Gargle with 15mI of Difflam Sore Throat Rinse every 1½ to 3 hours
Gargle with the solution, or rinse around mouth and throat, for 20-30
seconds, then spit out
Do not swallow Difflam Sore Throat Rinse
First it stings, then it numbs.
If it stings too much, dilute it a bit next time (with water).
http://www.mypharmacy.co.uk/medicine...flam_rinse.htm

You can also ask your doctor if he has some samples of Ulcerease or a
patient starter kit of Gelclair.
Ulcerease http://backupmd.com/uleasanmoutr.html
"an ideal treatment for those undergoing chemotherapy who have
significant stomatitis, painful tongues (glossodynia), mouth ulcers and
painful oral sores." (says not to swallow)
Ulcerease Anesthetic Mouth Rinse A 6 oz. bottle was about $6 US. It goes a

long way, you don't need to use a lot of it to get the effect.

Gelclair is more expensive.
Gelclair http://www.gelclair.com/
Pain relief from oral mucositis
http://www.gelclair.co.uk/
Gelclair is an oral gel that helps in the management of pain associated
with oral lesions.

Adcortyl in Orabase (applied to mouth ulcer 3 time daily):
a corticosteroid oral paste, triamcinolone acetonide 0.1% in adhesive
basis.
It is applied in a thin layer 2–4 times daily to oral and perioral lesions

(ulcers).

Aspirin + Hydrocortisoon suspension (10mls 4 times daily):
Used as a mouth wash, the topical corticosteroid and aspirin helps reduce
pain and inflammation of oral ulceration.

ORAL HYGIENE:
Oraldene moothwash, red, hexetidine 0.1%, (4 times daily: Hexitidine is an

antiseptic mouthwash and helps compensate for difficulties with achieving
good oral hygiene.
Note: Superficial infections of the mouth are often helped by warm
mouthwashes which have a mechanical cleansing effect and cause some local
hyperaemia.
However, to be effective, they must be used frequently and vigorously.
A warm saline mouthwash is ideal and can be prepared either by dissolving
half a teaspoonful of salt in a glassful of warm water or by diluting
compound sodium chloride mouthwash with an equal volume of warm water.

4) THRUSH -
Nystatin is a broad spectrum antifungal agent - nystatin mouthwash for
thrush
Nystatin oral suspension 100,000 units/mL; pastilles 100,000 units:
100,000 units 4 times daily after food, usually for 7 days (continued for
48 hours after lesions have resolved); higher doses may be needed for
immunosuppressed patients. (e.g. 500,000 units 4 times daily).
* Nystatin is not absorbed from the gastro-intestinal tract.
* Good denture care is important. Nystatin may be used as a denture soak
for the duration of treatment.

Diflucan suspension 15ml spoonful daily: a Triazole antifungal used for
controlling fungal infections. Fluconazole is very well absorbed after
oral administration (swallowed). (Steph says Nystatin is better).

Super Miracle Mouthwash
List of the ingredients in this: 1. Benadryl 2. Lidocaine -- numbing 3.
Hydrocortisone -- steroid
4. Tetracycline -- antibiotic 5. Nystatin -- antifungal
(prescription/compounded)
Swish it in mouth, then slowly let it trickle down throat


5) TOOTH PROTECTION
Biotene mouthwash (and gum or pastilles for when away from home). Some
have had no success with the gum.

Fluoride rinse for use at night; consumes sugar remaining on teeth (tooth
decay prevention)


6) NOSE CONGESTION:
Ask doctor about using the 12-hour nasal spray; helps the nose, but it's a

vasoconstrictor and might affect healing if it hits the wrong places.
No matter how careful you are squirting this stuff up your nose, some of
it will trickle down the back of your nasopharynx. The cheaper versions
come in a squirt bottle that will give a stream of liquid.
Afrin brand offers an atomizer bottle that's somewhat reusable and gives a

better dispersion, i.e. less medicine for the same coverage. If you want
to try this stuff, this is your best bet.

Eucalyptus, lavender oils can be helpful too (with some type of inhaler)
______________________________
LAXATIVE

Docusate Sodium (20ml daily)
Sennoside B (10 to 20mls daily)
Both are stimulant laxatives, swallowed. Docusate sodium probably acts
both as a stimulant and as a softening agent.

______________________________

UK ONLY
---------------------------------------------
http://www.ljf.scot.nhs.uk/exist/xml...nified12_3.xml
Scottish choices - some of their products are already listed here.
- - - - - - - - - - - - -

Mouth Cancer Forum -
http://rdoc.org.uk/groupee/forums/a/...49/m/570101147
....... the vast majority of things you need to help you through feeding,
gels and mouth washes are available via NHS prescription.

If you register and obtain a £32 NHS Certificate you can get most things
for free which includes, Ensure, packs of 27 at a time, a full range of
products for Xerostomia [dry mouth]
(Bioxtra Moisturising Gel; Glandosane; Luborant; Biotene Oralbalance Dry
Mouth Saliva Replacement Gel; Saliva Orthana; SST lozenges, Saliveze;
Salivix).
Just ask your GP and get a three month certificate and stock up!
May not be cost-saving, if some ingredients have to be switched and bought

separately.

This scheme is designed to allow people who have to pay for more than five

prescriptions in four months or 14 in a year to save money by buying a
certificate in advance is not properly
publicised and may be beyond many patients' means.
A four-month Prescription Prepayment Certificate costs about £35, while a
12-month certificate costs about £95.

- - - - - - - - - - - - -
MORE ON DRY MOUTH
From: www.arc.org.uk/ (link to the section no longer valid)
Luborant mouth spray is recommended for people with their own teeth
because it contains fluoride.

AS Saliva Orthana lozenges and Glandosane mouth spray can be used by
people with their own teeth but, because they contain no fluoride, care
should be taken with dental hygiene and a separate fluoride mouthwash
should be used.

Chlorhexidine or linseed extract mouth rinses may help.

Chew non-sugar chewing gum, other dental care products, or lozenges (e.g.
anhydrous crystalline maltose). Gels containing xylitol may be useful,
e.g. Biotene Oralbalance and BioXtra (Molar).

Take proper care of dentures.
---------------------------------------------
Artificial saliva

The four main saliva substitutes currently available on the UK market are

Glandosane™, Luborant™, Saliva Orthana™ and Oral Balance Saliva
Replacement Gel™. The first three products are sprays; Glandosane™ relies
on sodiumcarboxymethylcellulose (CMC) to provide viscosity and does not
contain
fluoride. It has a pH of 5.06 and uses carbon dioxide as a propellant.
Luborant™ also contains CMC for viscosity but its pH is higher at 6.0 and
it contains 2 ppm fluoride. Saliva Orthana™ contains mucin manufactured
from the gastric mucosa of the pig instead of CMC. Like Luborant™ it
contains 2 ppm fluoride and has a pH of 6.69.

An in vitro trial of all 3 sprays on tooth enamel showed that Saliva
Orthana and Luborant were potentially good remineralising agents. In
contrast Glandosane™ produced subsurface demineralisation; the low pH and
absence of fluoride in this product means it should not be recommended for

dentate patients (Joyston-Bechal & Kidd 1987). Artificial saliva has been
shown to offer greater symptomatic relief than water (Duxbury et al 1989).

A comparison of CMC saliva and mucin saliva found that patients preferred
the mucin saliva.
They complained that the CMC saliva felt sticky. Both types of saliva
improved denture retention. Mucin saliva tended to last longer and
therefore less was required per day (Vissink A et al 1983). Saliva sprays
are not effective unless used correctly; the whole of the oral mucosa
should be coated by several sprays of the product.

The Oral Balance Dry Mouth System™ comprises Oral Balance Dry Mouth Saliva

Replacement Gel™, Biotene Dry Mouth Anti-bacterial Toothpaste™ and Biotene

Mouthwash™. This system contains lactoperoxidase, glucose oxidase and
lysozyme to mimic the salivary peroxidase system and thus improve oral
health. The manufacturers recommend that Biotene™ toothpaste and mouthwash

are used with the gel as the presence of detergents and foaming agents in
other products can destroy the enzymes in the gel.
------------------------------------------------------------------------

If you can't find what suits you, ask your cancer center about compounding
**
some for you or seek a local compounding pharmacy.

Some are available online - random finds - no experience with any of them.

On-line compounding pharmacies includes various blends of Magic (and
other) Mouthwashes
http://saintjohnpharmacy.com/MouthSoars.html **

** There's currently a draft Senate bill, in the US, regarding (revising,
amending, creating) Safe Drug Compounding Act of 2007
As of this date, the above (CA web site is still active and apparently
there's more in possibly every country in the world. In my area, (Canada),
the compounding pharmacy requires that a prescription be written by an MD
and handed over, not over the internet. I'm sure there can be abuses,
unapproved or dangerous ingredients in them; but when considering
medications from pharmacies, nobody is checking every batch, every time,
either, so buyer beware. Everyone's different (health profile and ability
to tolerate medications and current medications use) and each person can
react differently to medications, so consult your primary physician, who
knows your current treatments, diagnoses, medical and medication history
before buying.
J