Our RO nurse hates those numbing solutions -- at least for patients who are still swallowing -- because they can lead to too much numbing and then to aspiration problems. In fact, this is probably how my husband ended up with aspiration pneumonia at the end of treatment.

Mucositis is almost inevitable with radiation and common with certain chemo drugs as well. There are no currently approved drugs to ameliorate this problem, one that is available elsewhere is benzydamine (UK, Canada and many other countries). Our dental oncologist was in a trail for this drug and said it worked against mucositis. In its absence, you have to rely on other things -- one preparation which some studies have shown quite effective in relieving pain is GelClair (prescription) or Rincinol (OTC) -- made by GUM. Multiple salt/soda rinses help heal and some have advocating adding l-glutamine (powder available from health food stores) to the rinse. Some people have found relief from rinsing (swish and spit) with cool aloe vera, need to have the edible preparation.

Your friend also needs to be sure what he has is mucositis and not thrush -- the latter may respond more effecively to oral Diflucan, which we found better than the Nystatin rinse fo Barry's thrush.

Also, if pain is the issue your friend should speak to his oncologist as he needs to have more effective pain relief prescribed -- many (most?) patients with mucositis need fairly strong pain meds in the latter weeks -- oxycodone or Duragesic patches, for example.

Besides benzydamine, there are other potentially helpful drugs in the pipeline for mucositis, and at least one has been approved for patients getting bone marrow transplants but not yet approved for patients being treated for solid tumors.

Gail