Oral and Gastrointestinal Mucositis: Considerations in Palliative Care

Mucositis is an inflammatory reaction of the mucosa of the alimentary tract (AT) caused by traditional cytotoxic agents (chemotherapy, radiotherapy) and novel anti-cancer therapies. It presents a significant burden not only to patient quality of life but also may result in diminished tumor control (through dose reductions) and increased treatment costs (due to extended hospital stays and supportive care). Mucositis symptoms may vary not only due to the treatment modality but also according to genetic, biological and social determinants. Currently the management of mucositis focuses on supportive care (i.e. symptom management), with treatments that reduce the incidence, severity, and duration mucosal injury limited. This chapter provides a clinically-focused overview of the current mechanistic understanding of mucositis as well as its presentation and assessment. We also provide an overview of current clinical practice guidelines for mucositis in both adult and paediatric settings, highlighting emerging areas of interest.