Written by Jessica Patella, ND. This study demonstrates the positive effect of thyme honey on the management of radiation induced oral mucositis and quality of life in head and neck cancer patients.
One of the most common side effects of radiation treatment for those with head or neck cancers is radiation-induced oral mucositis 1,2, where the mucosal lining in the mouth and throat become inflamed. It can result in mouth ulcers, painful swallowing, decreased quality of life and even discontinuing treatment because of the pain 1,3. A recent study found positive effects of thyme honey in radiation-induced oral mucositis 1.
Traditionally and historically honey has been used for healing burns, surgical wounds and oral infectious because it has antibacterial properties and has been shown to boost epithelial cell growth 1,4. Previous small studies have evaluated honey for radiation-induced oral mucositis but with mixed results, therefore a larger randomized controlled trial was needed 1.
The study included 86 head and neck cancer patients with primary and non-metastatic cancer (squamous cell carcinoma) that were referred for radiation (Intensity Modulated Radiation Therapy between 50-60Gy) in the oral cavity. The patients were randomly divided equally into the intervention group or a control group. The intervention group was given 20 ml of thyme honey to dilute in 100 ml of purified water to gargle 15 minutes before and after each radiation session and six hours later (three times a day total) for seven weeks, starting on the first day of the fourth week of radiation therapy 1. The start time at the fourth week of treatment was based on evidence from previous studies of when there is a significant reduction in saliva 5. Patients in the control group used normal saline solution rinses instead of thyme honey in the same quantity and period of time. In both groups the oral rinses were not swallowed after gargling.
The patients were assessed weekly (for seven weeks) and after six months by physicians and they filled out the Oral Mucositis Weekly Questionnaire weekly and after one month and six months post treatment. The results were as follows:
Participants in the thyme honey intervention group:
- Had less severe oral mucositis as assessed by the physician (p<0.001)
- Had less limitations in swallowing, drinking, eating, mouth pain and throat pain at one month and six months based on questionnaire.
- Maintained their body weight (p<0.001)
- Had improvement in their global health scores (p=0.001)
- Quality of life was higher (p<0.001) when compared to participants in the control group 1.
In conclusion, the use of thyme honey as a gargle for those undergoing radiation therapy for head and neck cancers showed benefit in swallowing, oral and throat pain, patient weight loss and overall quality of life 1. One limitation is the absence of a double-blinding which is difficult due to the identifiable taste of honey.
Source: Charalambous, Melanie, Vasilios Raftopoulos, Lefkios Paikousis, Nicos Katodritis, Ekaterini Lambrinou, Dimitrios Vomvas, Morpho Georgiou, and Andreas Charalambous. “The effect of the use of thyme honey in minimizing radiation-induced oral mucositis in head and neck cancer patients: A randomized controlled trial.” European Journal of Oncology Nursing 34 (2018): 89-97.
© 2018 Elsevier Ltd. All rights reserved.
Posted April 28, 2020.
References:
- Charalambous M, Raftopoulos V, Paikousis L, et al. The effect of the use of thyme honey in minimizing radiation – induced oral mucositis in head and neck cancer patients: A randomized controlled trial. European journal of oncology nursing : the official journal of European Oncology Nursing Society. 2018;34:89-97.
- Al Jaouni SK, Al Muhayawi MS, Hussein A, et al. Effects of Honey on Oral Mucositis among Pediatric Cancer Patients Undergoing Chemo/Radiotherapy Treatment at King Abdulaziz University Hospital in Jeddah, Kingdom of Saudi Arabia. Evid Based Complement Alternat Med. 2017;2017:5861024.
- Mercadante S, Aielli F, Adile C, et al. Prevalence of oral mucositis, dry mouth, and dysphagia in advanced cancer patients. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2015;23(11):3249-3255.
- Belcher J. Dressings and healing with honey. British journal of nursing (Mark Allen Publishing). 2014;23(6):S22.
- Radvansky LJ, Pace MB, Siddiqui A. Prevention and management of radiation-induced dermatitis, mucositis, and xerostomia. American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists. 2013;70(12):1025-1032.
