Ask The Doctor (05-04-2007) Information on Healthline

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Question:

I am undergoing chemotherapy for breast cancer, and one of the side effects is a white, thick coating on my tongue. Can you suggest a remedy for this?

Answer:

The problem you are describing is commonly known as "thrush." It is a very common side effect of chemotherapy. Chemotherapy affects the number and function of the white blood cells. These cells are important in fighting infections caused by bacteria and fungi. Thrush is an overgrowth of a fungus due to the temporary impairment of the white blood cells caused by the chemotherapy. This overgrowth usually appears as a white coating. It is usually caused by a fungus called Candida.

If you are otherwise handling chemotherapy well, and do not have high temperatures, thrush can be treated with a topical product. The one I prescribe most is a Nystatin mouthwash, taken four times per day. This has anti-fungal properties. Another remedy is clotrimazole troches. These are lozenges that dissolve in the mouth. You use them every few hours during the day. Both of these products can be effective in clearing thrush.

If you have significant difficulty swallowing because of pain or fever, the infection may have spread down into the esophagus. Report these symptoms to your doctor right away. Usually a stronger medication such as fluconazole is needed.