An 11-item face-to-face survey was conducted in 99 consecutive patients with advanced
cancer to determine the prevalence, intensity, reporting and treatment, presumed cause(s), and importance of mouth
pain and dryness. Sixteen of the 99 patients (16%) reported experiencing mouth
pain at a mean intensity corresponding to 5.5 +/- SD 2.21 on a 0 (no
pain) to 10 (worst possible
pain) numerical scale, and 88 (88%) patients reported dry mouth at a mean intensity corresponding to 6.2 +/- SD 2.21. Nine (56%) of the 16 patients with mouth
pain and 39 (44%) of the 88 patients with
mouth dryness reported these symptoms to their attending physician(s). Sixty-nine percent (27/39) of patients who reported having a dry mouth were advised by their physician(s) to pursue one or more treatments. The most common treatments recommended (and frequencies) were
drinking water/taking sips of fluid (13), gargling with
bicarbonate mouthwash (4), using an
artificial saliva spray (4), and using an oral fungal
suspension for
thrush (4). The most common findings on
oral examination included: possible
thrush (53 patients), upper and lower
dentures (33 patients), and multiple dental restorations (23 patients). The causes most frequently assumed to be responsible were ill-fitting
dentures for mouth
pain, and medications and possible oral
fungal infections for
mouth dryness. The mean values given for the importance of the symptoms of mouth
pain and dryness relative to other symptoms or problems experienced by the patients were 4.4 +/- SD 1.84 and 3.6 +/- SD 1.67, respectively, on a Likert scale ranging from 1 (not important) to 7 (great importance).
Mouth dryness was more frequently reported than mouth
pain. The mean rating for the intensity of mouth
pain was higher than that for
mouth dryness, although both were of moderate importance to patients relative to other symptoms or problems experienced at the time. Patients tended to underreport mouth
pain and dryness, and physicians tended to address such complaints inadequately.