My mom is about 15 sittings of IMRT (SCC base of tongue) down, and there is significant discolouration of the skin both sides of the neck. How long does it take for the colour to come back? Does it ever come back fully?

Also, she finds that as the IMRT goes on, there're mouth sores that are becoming quite painful, and coming in the way of food. How do you treat these sores? Is Iodine mouthwash mixed with water, as a gargle, good for it? What have you used to treat this?

There are a number of things given to patients here in USA to treat the mouth sores -- the most effective seems to be Gelclair (which is a pain-relieving coating agent) and then there are a number of mixes which contain pain-relieving and anti-inflammatory (and often, anti-microbial) materials such as Mile's mixture, "magic mouthwash" etc.

As you are in India, ask about the availability of benzydamine hydrocloride (Difflam) which is available over-the-counter in UK and Australia, and by prescription in Canada and many European and South American countries. It is a NSAID which has been found in clinical trials to be the best to relieve pain and shorten duration of mucositis. It is not yet available in USA.

Finally, pain relief will probably be necessary and this is usually some fairly powerful opiate so you MUST be proactive to get a pain-management plan in place so your mum can continue to be able to swallow and stay hydrated. In USA a lot of people get a stomach (gastric) tube to enable feeding and water while their mouths are really sore. But they still need pain relief for basic quality of life.

Hope this helps, good luck,
Gail

You do not say if your mom is getting Chemo with the IMRT. If so, she may have to avoid the use of any NSAID. In any event, her doctor will know what she should not take.

Difflam is not an oral medication, it is a mouthwash and is not contraindicated for patients getting chemotherapy -- in fact, it is used routinely in these cases in countries where it is available. It is not supposed to be swallowed!

In any case, ask your Dr about it --

Gail

Hi,

My Mom has had 2 cycles of Chemotherapy with the IMRT, one just before the IMRT began and another at about 8 sittings down. I will ask our doctor about Difflam, thanks so much for the suggestion.