Economic and Quality of Life Issues
Chemotherapy and radiation therapy are designed to destroy the rapidly dividing cancer cells. Since the oral mucosa consists of cells that rapidly rejuvenate, therapies also destroy them. Oral mucositis manifests itself as redness, irritation, swelling and open mouth sores that can cause pain ranging from mild to severe. Oral mucositis is a serious side effect of radiation therapy and chemotherapy. The pain associated with the condition can have a debilitating effect on the patient.[1] Oral mucositis is graded on a scale developed by the World Health Organization (WHO) and the National Cancer Institute (NCI) on a scale of 0 to 5. A grade of 0 denotes no disease, while a grade of 5 indicates death due to toxicity.
Economic Factors
Mucositis of a middle to severe grade can result in open wounds in the mucosa that can serve as portals of entry for bacteria and predispose patients to infection. [2} Infection has increased the morbidity and mortality of patients with mucositis. [3] Mucositis can be so severe that patients must be fed by total parenteral nutrition (TPN) and be given parenteral narcotics to relieve the pain. [4] All of which contribute to substantially increased health costs for these patients. The increase in health costs directly attributable to mucositis are estimated to be approximately $3,000 per episode. [5]
Quality of Life Factors
Quality-of-life is usually measured in four areas: physical, emotional, social and functional. There is a decrease in the quality-of-life of all patients suffering from mucositis in one or more of these areas. Mucositis symptoms can range from pain in the oral cavity to inability to tolerate food or fluids. These symptoms are considered to be part of physical well-being. [5] Impairment of speaking and eating are functional problems as well as social. Patients rate social functioning and speech as strong quality of life (QOL) issues; and impairment of these issues by mucositis greatly reduces the patient’s self esteem and QOL. [5}
MUCOTROL
Mucotrol is an intervention that is used to minimize the toxicity of mucositis. Mucotrol is an oral soluble wafer that is allowed to dissolve slowly in the mouth. It is indicated for the management and relief of pain associated with oral lesions and diffuse apthous ulcers. Recommended dosage is three times per day, or as needed. No cases of Mucotrol overdose have been reported to date. Mucotrol is sugar-free and requires no water for use thus making it an extremely convenient product. Efficacy has been established by a double blind placebo controlled study. In this study a significant reduction of 34.63% in mean WHO mucositis scores were seen with Mucotrol while no reduction in mean WHO scores were seen with the placebo controlled group. [6]

MUCOTROL HIGHLIGHTS
Indicated for the relief of pain associated with mucositis.
Mucotrol is an oral chewable wafer that requires no water.
Available in bottles of 45 oral wafers.
Recommended dosage three times a day.
No known interactions with other medications.
Sugar-free and non-irritating.
Effectiveness established by a double blind study
Only contraindication is sensitivity to one of the ingredients.
Mucotrol can be stored and transported at room temperature
REFERENCES
1. Sonis ST, Oral Mucositis in Cancer Therapy, The J Support Oncol 2004; 2(suupl 3):003-008
2. Rappaport AP, Watelet LF, Linder T, etal: Analysis of factors that correlate with mucositis in recipients of autologous and allogeneic stem-cell transplants. J Clin Oncol 17: 2446-2453, 1999
3. Gamis AS, Howells WB, et al: Alpha Hemolytic Steptococcal Infection During Intensive Treatment for Acute Myeloid Leukemia: A Report From the Children’s Cancer Group Study CCG-2891. J Clin Oncol 18: 9, May 2000
4. Sonis ST, Oster G, Fuchs O, etal: Oral Mucositis and the Clinical and Economic Outcomes of Hematopoietic Stem-Cell Transplantation. J Clin Oncol 19: 8, April 2001
5. Peterman A, Cella D, Glandon G, Dobrea D, Yount S: Mucositis in Head and Neck Cancer: Economic and Quality-of-Life Outcomes. JNCI Cancer Spectrum 29:45-51, 2001
6. Naidu MU, Ramana GV, Ratnam SV, Sudhavani T, Naidu KJ, Roy P, Suresh P, Rani PU, Mohan IK: A randomized, double-blind, parallel, placebo-controlled study to evaluate the efficacy of MF 5232 (Mucotrol), a concentrated oral gel wafer, in the treatment of oral mucositis. Drugs RD, 2005;6(5):291-8
Cura Pharmaceutical Co.