Mucositis

Curcumin

Efficacy

The available evidence suggests curcumin is effective for oral mucositis. One SR (n=5 RCTs and CCTs) found that among patients with cancer in the head and neck area curcumin applied topically or as a mouthwash delays onset, reduces ulcer size, and reduces erythema, pain, and severity of oral mucositis. Furthermore, one RCT (n=32) found that curcumin delays onset and reduces severity of oral mucositis.

Safety

Curcumin is generally considered safe at doses up to 12g daily for several months. It has been recognized as safe (GRAS) by the United States Food and Drug Administration.  

Read the full version of the Curcumin summary.
 

Aloe Vera

Efficacy
The evidence for the effect of Aloe vera on oral mucositis is contradictory. One SR including 2 RCTs evaluating Aloe vera  concluded that there was weak, unreliable evidence that it may be beneficial in preventing moderate to severe mucositis. Three RCTs (n=26, n=61, n=64) reported positive results. One found aloe vera reduces incidence but not duration of mucositis; the other two found it reduced onset, severity, and pain. Three other RCTs (n=9, n=26, n=58) found that aloe vera shows no difference in the effect or has a lower effect when compared to other treatments.

Safety
Aloe vera is generally considered safe with only transient and mild adverse events. . It is possibly unsafe during pregnancy.

Read the full version of the Aloe vera summary.

Aromatherapy

Efficacy
Few trial data are available on the effect of aromatherapy on oral mucositis. Two RCTs (n=19, n=60) found that Matricaria recutita and Mentha piperita mouthwash in one study and manuka and kanuka oils in the other showed fewer complications and symptoms associated with oral mucositis.  

Safety
Generally safe and only associated with minimal adverse effects when used in appropriate dilutions.  
Allergic reactions can occur with all oils. It should not be used undiluted.

Read the full version of the Aromatherapy summary.

Colostrum

Efficacy
Only few data are available on colostrum for mucositis. One RCT (n=62) conducted among children diagnosed with acute lymphoblastic leukaemia found that peak oral mucositis severity significantly decreased among the group treated with colostrum.

Safety
In general, bovine colostrum is considered safe and well-tolerated. Reported adverse events are mainly gastrointestinal, e.g., bloating. Contraindicated in individuals allergic to dairy products. Only pasteurized products should be used.

Read the full version of the Colostrum summary.

Homeopathy

Efficacy
The evidence for the effect of homeopathy on mucositis is inconsistent and few data are available. One RCT (n=181) among paediatric cancer patients and a non-randomized controlled trial (n=20) among head and neck patients found Traumeel had no significant effect on mucositis. For chemotherapy-induced stomatitis one RCT (n=32) found that Traumeel S mouthwash was better than placebo.

Safety
Generally safe, and there are no serious direct risks associated with homeopathy. There are indirect risks if homeopathic preparations are used in place of conventional cancer treatment.

Read the full version of the Homeopathy summary.

Milk thistle

Efficacy
There are few data from small trials available. Two RCTs (n=22, n=64) found milk thistle reduces the incidence and severity of mucositis. A third RCT (n=31) found no significant difference between treatment and placebo groups.

Safety
Generally considered safe. There is insufficient information to assess safety in pregnancy and lactation.

Read the full version of the Milk thistle summary.

Ozone therapy  

Efficacy
The evidence of the effect of spirulina on oral leucoplakia is inconclusive as few data are available. A RCT (n=87) found treatment with spirulina showed regression in lesions for oral leucoplakia but the study had significant methodological limitations.

Safety
The safety of Ozone therapy has not been systematically assessed. It has been associated with risks. 
Ozone used intravenously is likely unsafe. It is possibly unsafe when injected into the spinal area or inhaled. There is insufficient reliable information on the safety of other methods of administration.

Read the full version of the Ozone therapy summary.

Selenium 

Efficacy
Few data from small RCTs are available.  The largest RCT (n=77) reported significantly lower incidence and shorter duration of severe oral mucositis, but the trial had methodological limitations. The smaller RCTs did not report significant differences between selenium and controls for incidence of severe mucositis (n=18) or loss of taste, dysphagia, dry mouth (n=39).

Safety
Selenium is generally considered safe. However, the safety of the therapy has not been systematically assessed. It has been associated with risks related to over-supplementation. Chronic selenium poisoning has been reported. Symptoms include hair loss, thickened nails, nausea, vomiting, fatigue, and paraesthesia and paralysis. Long-term supplementation may increase the risk of type 2 diabetes.

Read the full version of the Selenium summary.
 

At the time of assessment, the available evidence did not suggest no effects for any of the treatments evaluated by CAM Cancer for this symptom.