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Thrush

Patients & Caregivers

Thrush is a common occurrence for people going through cancer therapy. It happens when the immune system is not working fully, and when the balance of microbes, including bacteria and fungus, changes. Thrush is caused by a fungus known as candida albicans. It tends to be seen in individuals undergoing cancer therapy who have reduced saliva flow, dental plaque, or mouth sores.


You may or may not have discomfort, but some have described a burning feeling or a metallic taste. It may appear red or white and some have reported a smell like yeast. Thrush can be a concern because it can spread to other areas so it is important to try to prevent or treat.

Prevention

Strategies to prevent thrush include good oral hygiene and removal and cleaning of any dentures or oral appliances at night. Some researchers have recommended probiotics containing lactobacillus which are available over the counter at most drug stores. Talk to your pharmacist to see if this might be helpful. You can also talk to your doctor about other anti-fungal agents. Some have also recommended choosing a diet with more vegetables, nuts, eggs and fish as opposed to dairy, sugars, and carbohydrates.

 
Management

Talk to your doctor about treatment strategies, most of which require a prescription. There are both pills that are taken internally or topic agents. Sugar-free lozenges are available as those with sugar can increase risk for tooth decay.

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Clinical presentation of the primary forms of oral candidosis. (a) acute pseudomembranous candidosis; (b) chronic erythematous candidosis; (c) acute erythematous candidosis; and (d) chronic hyperplastic candidosis. David Williams & Michael Lewis (2011) Pathogenesis and treatment of oral candidosis, Journal of Oral Microbiology, 3:1, DOI: 10.3402/jom.v3i0.5771.

As stated above, sucrose content of Nystatin suspension content can be high and would contribute to increased tooth decay in individuals at high risk, including those with dry mouth. If a topical lozenge or rinse is used, one should be selected without sugar in cases of individuals with natural teeth.

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Labeling from Nystatin Oral Suspension. Note that second ingredient is sugar. From https://fda.report/DailyMed/b95ce95e-ea57-99d5-e053-2a95a90ab217

 

For more information about thrush and oral health, see these resources:

You may also wish to learn about:

More information regarding the following topics will be coming soon:

  • Oral Mucositis​

DISCLAIMER: THIS WEBSITE DOES NOT PROVIDE MEDICAL ADVICE

The information on the Rhode Island Cancer and Oral Health Resource Guide, including but not limited to, text, graphics, images, and other external materials are for informational purposes only. The Partnership to Reduce Cancer in Rhode Island does not provide medical advice. The information on this website is not intended as a substitute for professional medical advice, diagnosis, or treatment. 

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