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Oral Thrush During Chemotherapy

Coping with Oral Thrush

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Updated April 22, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Oral thrush can occur in people undergoing chemotherapy, especially in those who are prescribed steroids. It is caused by Candida albicans, a fungus that is found naturally in small amounts in the body.

Candida is also found in the mucous membranes of the mouth. Chemotherapy and medications like steroids can cause an overgrowth of the fungus. When the immune system is weakened, as in cancer treatment, the growth of the fungus is not as easily regulated by the body.

There are other reasons why someone may develop oral thrush. High doses of antibiotics or taking them for an extended time period can cause thrush. Diabetics with high blood sugar are also at risk of developing it, as well. Poorly fitting dentures may also be a culprit.

Symptoms of Oral Thrush

Symptoms include:
  • White, creamy patches or lesions on the tongue or the inside of the mouth. Some people describe it as looking like cottage cheese or yogurt that is spread on the inside of the cheeks, tongue or back of the throat.

  • Burning sensation inside the mouth or throat. This causes the most discomfort in people with oral thrush.

Treatment for Thrush

Most patients find relief with a topical drug called Mycelex (clotrimazole). It is prescribed as a lozenge, also called a troche. As the lozenge slowly dissolves in the mouth, the medicine is absorbed into the bloodstream. Each lozenge generally takes about 20 to 30 minutes to dissolve and is usually taken five times a day.

Another type of medication, nystatin, is also commonly prescribed in a troche or liquid form. With liquid nystatin, you swish and swallow the medication. Some people report nystatin tasting bitter or acidic, but ask your pharmacist if he or she can add flavoring to it. Mint flavoring is a popular recommendation, as it works well to mask the bitterness.

Diflucan (fluconazole) is another medication used to treat thrush. For people undergoing chemotherapy, it is most often prescribed in a tablet form. Common side effects of Diflucan include headaches, nausea and dizziness. In some cases, Diflucan may be prescribed to prevent thrush in people undergoing cancer treatment.

While Diflucan is an excellent drug for treating oral thrush, it can be expensive to those who do not have health insurance or have maxed out on their prescription drug plan. There is a generic available, so be sure to ask your doctor before he or she writes the prescription. If you are paying out of pocket, be sure to shop around before filling the prescription. Some patients have found certain pharmacies to be be considerably less expensive than others. Some dental insurance plans will also pay for Diflucan.

Doctors may also prescribe a mouthwash that is a combination of several medications to treat oral thrush. It is often referred to as "Magic Mouthwash" or "Mary's Magic Mouthwash," and consists of a mixture of several different drugs to treat the thrush and also to relieve discomfort caused by the infection. It is important to note that Magic Mouthwash or Mary's Magic Mouthwash are not trade names, but nicknames for the formula. There are several different formulas and it is at a doctor's discretion to determine which drugs to include and the appropriate dosage. With a quick Google search, you can learn the formula for this mouthwash, but please do not attempt to make it at home. It's best to leave that work to a pharmacist.

It is important to finish the medication as prescribed, even if your symptoms improve or go away. If you decide to stop taking the medication before it is finished, please talk to your doctor beforehand.

How to Relieve Itching and Burning of the Mouth Caused by Oral Thrush

Some people find relief from the burning sensation caused by thrush by eating and drinking cold foods and drinks. Popsicles, ice cream, smoothies and crushed ice beverages can temporarily help the burning sensation. Chilled soups make for excellent snacks or side dishes. Check out these recipes for chilled soups:

If you have thrush, use a soft tooth brush until the infection clears. Avoid alcohol-based mouth washes as they may exacerbate the burning sensation.

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