Chemotherapy has several side effects, including mouth ulcers and inflammation, also called mucositis. The condition affects an overwhelming number of cancer patients on high-dose chemotherapy, as well as 80% of patients with neck and head malignancies.
Severe pain, higher local and systemic infection risk, dysfunction, and bleeding from the oral cavity, mouth and pharynx are all associated with mucositis.
This in turn prolongs their in-hospital treatment period due to their heightened physical pain, and limitations in patient nutrition.
In addition, oral ulcers can cause oral microflora to enter the blood and induce septicaemia, especially in immunocompromised patients. However, no specific medication has been developed to treat or prevent mucositis.
Because of previous studies having reported the wound-healing effects of omega-3 fatty acids, researchers at Iran's Kerman University of Medical Sciences conducted an RCT to assess the efficacy and method of omega-3 administration to treat and prevent mucositis in patients undergoing chemotherapy.
The healing power of fatty acids
They recruited 60 patients who were developing WHO grade 1 oral mucositis, dividing them equally into a placebo group (11 male, 19 female) and a group given omega-3 fatty acids (12 male, 18 female).
They assessed mucositis in the participants, based on WHO, Oral Mucositis Weekly Questionnaire and Western Consortium for Cancer Nursing Research criteria at baseline, then in the first, second and third weeks of chemotherapy, until they had been cured of mucositis.
Using WHO criteria, the researchers then observed differences in the severity of mucositis between the two groups in the first, second and third weeks of treatment.
The patients who had received omega-3 supplementation experienced less severe pain during the three weeks of treatment, and the researchers wrote: "At one and two weeks after starting the study, the severity of mucositis was significantly lower in the omega-3 group compared with the control group.
"After two weeks, there was no evidence of mucositis in the patients taking omega-3, and the patients reported satisfaction with their drug.
"Based on the present findings, patients taking omega-3 compared with the placebo exhibited a better ability to eat, and the difference between the two groups was significant."
They added that in the omega-3 group, patients took four to nine days to recover from mucositis, compared to at least 10 days in the placebo group. In fact, 12 patients in the latter group took more than 16 days to recover.
They concluded: "Omega-3 fatty acids are a safe, effective method for preventing and treating oral mucositis in patients receiving mucotoxic cancer chemotherapy.
"According to the findings in this study, omega-3 fatty acids in oral form have a significant effect on wound-healing induced by oral mucositis.
"These results may be useful to introduce new groups of substances or drugs, with omega-3 fatty acids being used in their synthesis asprophylaxis."
Vol. 29, Issue 12 (December 2017)
"Effects of Omega-3 Fatty Acids Against Chemotherapy-induced Mucositis: A Double-blind Randomized Clinical Trial"
Authors: Maryam Alsadat Hashemipour, et al.