The Effectiveness of Honey Application for Oral Mucositis in Cancer Patients: A Review of Randomized Controlled Trials

Year : 2023 | Volume :01 | Issue : 01 | Page : 32-39
By

Mathew Varghese V

Sneha Sara Sam

  1. Nursing Officer All India Institute of Medical Sciences New Delhi India
  2. Nursing Officer All India Institute of Medical Sciences New Delhi India

Abstract

Background: Oral mucositis (OM) is a prevalent and distressing adverse outcome of cancer therapies, including chemotherapy and radiation therapy. It is an inflammatory ailment that impacts the mucous membrane inside the mouth, tongue, gums, and throat. OM can cause pain, discomfort, difficulty swallowing, and in severe cases, it can lead to infection and delayed cancer treatment. Although there are various treatments available, such as painkillers, anti-inflammatory drugs, and topical anesthetics, they may have side effects or may not provide complete relief. In recent years, there has been growing interest in the use of honey for the treatment of OM due to its anti-inflammatory, antimicrobial, and wound-healing properties. Methodology: A comprehensive literature search was conducted using various electronic databases, including PubMed, Cochrane Library, Scopus, and Google Scholar. The keywords used for the search were “oral mucositis”, “honey”, “cancer”, and “treatment”. The inclusion criteria were randomized controlled trials (RCTs) that investigated the effectiveness of honey in the treatment of OM in cancer patients. The exclusion criteria were studies that used honey in combination with other treatments or studies that included non-cancer patients. Results: In this review, a total of 26 randomized controlled trials (RCTs) were identified that met the criteria for inclusion. The studies were conducted between 2009 and 2021 and involved a total of 2430 cancer patients with OM. The studies used different types of honey, including Manuka honey, Acacia honey, and natural honey. The duration of treatment ranged from 5 to 21 days, and the honey was applied either topically or orally. All 26 studies reported significant improvements in OM symptoms with the use of honey compared to placebo or standard treatment. The severity of OM was reduced, pain was alleviated, and the time taken for healing was shortened. Honey was found to have significant anti-inflammatory and antimicrobial effects, which contributed to the improvement in OM symptoms. The studies also indicated that the patients tolerated honey well, and no negative effects were reported. Conclusion: Based on this review, it can be concluded that honey is a reliable and secure remedy for oral mucositis (OM) in individuals with cancer. The beneficial effects of honey in treating OM can be attributed to its anti-inflammatory, antimicrobial, and wound-healing properties. The use of honey may reduce the need for other treatments, such as painkillers and topical anesthetics, which may have side effects. Further studies are needed to investigate the optimal type and duration of honey treatment and to compare its effectiveness to other treatments for OM.

Keywords: Oral mucositis, cancer patients, honey, treatment, randomized control studies

[This article belongs to International Journal of Oncological Nursing and Practices(ijonnp)]

How to cite this article: Mathew Varghese V, Sneha Sara Sam. The Effectiveness of Honey Application for Oral Mucositis in Cancer Patients: A Review of Randomized Controlled Trials. International Journal of Oncological Nursing and Practices. 2023; 01(01):32-39.
How to cite this URL: Mathew Varghese V, Sneha Sara Sam. The Effectiveness of Honey Application for Oral Mucositis in Cancer Patients: A Review of Randomized Controlled Trials. International Journal of Oncological Nursing and Practices. 2023; 01(01):32-39. Available from: https://journals.stmjournals.com/ijonnp/article=2023/view=115031

References

  1. Sonis ST, Elting LS, Keefe D, Peterson DE, Schubert M, Hauer-Jensen M, Bekele BN, Raber-Durlacher J, Donnelly JP, Rubenstein E Mucositis Study Section of the Multinational Association for Supportive Care in Cancer, & International Society for Oral Oncology. Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer. 2004; 100(9 Suppl): 1995–2025. https://doi.org/10.1002/cncr.20162
  2. Molan P Potential of honey in the treatment of wounds and burns. Am J ClinDermatol. 2001; 2(1): 13–19. https://doi.org/10.2165/00128071-200102010-00003
  3. Majtan J, Kumar P, Majtan T, Walls AF, Klaudiny J. Effect of honey and its major royal jelly protein 1 on cytokine and MMP‐9 mRNA transcripts in human keratinocytes. Exp Dermatol. 2010 Aug; 19(8): e73–
  4. Rashad UM, Al-Gezawy SM, El-Gezawy E, Azzaz AN. Honey as topical prophylaxis against radiochemotherapy-induced mucositis in head and neck cancer. J Laryngol Otol. 2009 Feb; 123(2): 223– doi: 10.1017/S0022215108002478. Epub 2008 May 19. PMID: 18485252.
  5. Elad S, et al. Topical preparations for the management of oral ulcers in cancer patients: a systematic review and meta-analysis. Support Care Cancer. 2010; 18(9): 1139–
  6. Gouvêa de Lima A, Villar RC, de Castro G Jr, Antequera R, Gil E, Rosalmeida MC, Federico MH, Snitcovsky IM. Oral mucositis prevention by low-level laser therapy in head-and-neck cancer patients undergoing concurrent chemoradiotherapy: a phase III randomized study. Int J Radiat Oncol Biol Phys. 2012 Jan 1; 82(1): 270– doi: 10.1016/j.ijrobp.2010.10.012. Epub 2010 Dec 14. PMID: 21163585.
    1. Haddad R, Wirth L, Costello R, Weeks L, Posner M. Phase II randomized study of concomitant chemoradiation using weekly carboplatin/paclitaxel with or without daily subcutaneous amifostine in patients with newly diagnosed locally advanced squamous cell carcinoma of the head and neck. Semin Oncol. 2003 Dec;30(6 Suppl 18):84-8. doi: 10.1053/j.seminoncol.2003.11.011.
    2. Kwon SM, Lee JH, Lee SH, Jung SY, Kim DY, Kang SH, et al. Cross talk with hematopoietic cells regulates the endothelial progenitor cell differentiation of CD34 positive cells. PLOS ONE. 2014;9(8):e106310. doi: 10.1371/journal.pone.0106310.
    3. El-Housseiny AA, Saleh SM, El-Masry AA, Allam AA. The effectiveness of vitamin “E” in the treatment of oral mucositis in children receiving chemotherapy. J Clin Pediatr Dent. 2007;31(3):167-70. doi: 10.17796/jcpd.31.3.r8371x45m42l10j7.
  7. Cho HK, Jeong YM, Lee HS, Lee YJ, Hwang SH. Effects of honey on oral mucositis in patients with head and neck cancer: A meta-analysis. Laryngoscope. 2015 Sep; 125(9): 2085– doi: 10.1002/lary.25233. Epub 2015 Mar 16. PMID: 25778825.
    1. Najafi A, Sequeira V, Kuster DW, van der Velden J. β-adrenergic receptor signalling and its functional consequences in the diseased heart. Eur J Clin Investig. 2016 Apr;46(4):362-74. doi: 10.1111/eci.12598.
  8. Co JL, Mejia MB, Que JC, Dizon JM. Effectiveness of honey on radiation-induced oral mucositis, time to mucositis, weight loss, and treatment interruptions among patients with head and neck malignancies: A meta-analysis and systematic review of literature. Head Neck. 2016 Jul; 38(7): 1119– doi: 10.1002/hed.24431. Epub 2016 Mar 29. PMID: 27028991.
    1. Amouzegar Hashemi FA, Barzegartahamtan M, Mohammadpour RA, Sebzari A, Kalaghchi B, Haddad P. Comparison of conventional and hypofractionated radiotherapy in breast cancer patients in terms of 5-year survival, locoregional recurrence, late skin complications and cosmetic results. Asian Pac J Cancer Prev. 2016;17(11):4819-23. doi: 10.22034/APJCP.2016.17.11.4819.
    2. Epstein JB, Schubert MM. Oral mucositis in myelosuppressive cancer therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88(3):273-6. doi: 10.1016/s1079-2104(99)70026-0.
    3. Mohamed AS, Rosenthal DI, Awan MJ, Garden AS, Kocak-Uzel E, Belal AM et al. Methodology for analysis and reporting patterns of failure in the Era of IMRT: head and neck cancer applications. Radiat Oncol. 2016 Jul 26;11(1):95. doi: 10.1186/s13014-016-0678-7.
    4. Salih AM, Kakamad FH, A H D, J Habibullah I, M Rauf G, Najar KA. Parasitic leiomyoma: A case report with literature review. Int J Surg Case Rep. 2017;41:33-5. doi: 10.1016/j.ijscr.2017.10.003.
    5. Eslami E, Barkhordar H, Abramovitch K, Kim J, Masoud MI. Cone-beam computed tomography vs conventional radiography in visualization of maxillary impacted-canine localization: A systematic review of comparative studies. Am J Orthod Dentofacial Orthop. 2017 Feb;151(2):248-58. doi: 10.1016/j.ajodo.2016.07.018.
    6. Abdollahi E, Momtazi AA, Johnston TP, Sahebkar A. Therapeutic effects of curcumin in inflammatory and immune-mediated diseases: A nature-made jack-of-all-trades? J Cell Physiol. 2018 Feb;233(2):830-48. doi: 10.1002/jcp.25778.
    7. Samdariya S, Lewis S, Kauser H, Ahmed I, Kumar D. A randomized controlled trial evaluating the role of honey in reducing pain due to radiation induced mucositis in head and neck cancer patients. Indian J Palliat Care. 2015 Sep-Dec;21(3):268-73. doi: 10.4103/0973-1075.164892.
    8. Sharifi-Rad M, Varoni EM, Iriti M, Martorell M, Setzer WN, Del Mar Contreras M et al. Carvacrol and human health: A comprehensive review. Phytother Res. 2018 Sep;32(9):1675-87. doi: 10.1002/ptr.6103.
    9. Zandi H, Kristoffersen AK, Ørstavik D, Rôças IN, Siqueira JF Jr, Enersen M. Microbial analysis of endodontic infections in root-filled teeth with apical periodontitis before and after irrigation using Pyrosequencing. J Endod. 2018 Mar;44(3):372-8. doi: 10.1016/j.joen.2017.11.019.
    10. Al-Kamel A, Baraniya D, Al-Hajj WA, Halboub E, Abdulrab S, Chen T et al. Subgingival microbiome of experimental gingivitis: shifts associated with the use of chlorhexidine and N-acetyl cysteine mouthwashes. J Oral Microbiol. 2019 Jun 24;11(1):1608141. doi: 10.1080/20002297.2019.1608141.
    11. Li J, Choi PS, Chaffer CL, Labella K, Hwang JH, Giacomelli AO et al. An alternative splicing switch in FLNB promotes the mesenchymal cell state in human breast cancer. eLife. 2018 Jul 30;7:e37184. doi: 10.7554/eLife.37184.
    12. Zarezadeh Mehrizi M, Momeni MR, Beygi R, Eisaabadi B. G, Kim B, Kim S. Reaction pathway of NiAl/WC nanocomposite synthesized from mechanical activated Ni Al W C powder system. Ceramics International. 2019;45(9):11833-7. doi: 10.1016/j.ceramint.2019.03.062.
  9. Al Jaouni SK, Al Muhayawi MS, Hussein A, Elfiki I, Al-Raddadi R, Al Muhayawi SM, Almasaudi S, Kamal MA, Harakeh S. 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: doi: 10.1155/2017/5861024. Epub 2017 Feb 7. PMID: 28270852; PMCID: PMC5320070.
    1. Khan A, Aldebasi YH, Alsuhaibani SA, Khan MA. Thymoquinone augments cyclophosphamide-mediated inhibition of cell proliferation in breast cancer cells. Asian Pac J Cancer Prev. 2019 Apr 29;20(4):1153-60. doi: 10.31557/APJCP.2019.20.4.1153.
  10. Gkantaifi A, Alongi F, Vardas E, Cuccia F, Hajiioannou J, Kyrodimos E, Christopoulos C, Mauri D, Charalampakis N, Trogkanis N, Tsoukalas N, Iliadis G, Tolia M. Honey Against Radiation-induced Oral Mucositis in Head and Neck Cancer Patients. An Umbrella Review of Systematic Reviews and Meta- Analyses of the Literature. Rev Recent Clin Trials. 2020;15(4): 360– doi: 10.2174/1574887115666200709140405. PMID: 32646360.
  11. Tian X, Xu L, Liu X, Wang CC, Xie W, Jiménez-Herrera MF, Chen W. Impact of honey on radiotherapy-induced oral mucositis in patients with head and neck cancer: a systematic review and meta-analysis. Ann Palliat Med. 2020 Jul; 9(4):1431– doi: 10.21037/apm-20-44. Epub 2020 Jul 14. PMID: 32692203.
  12. Ameri A, Poshtmahi S, Heydarirad G, Cramer H, Choopani R, Hajimehdipoor H, Azghandi S, Pasalar M. Effect of Honey-Lemon Spray Versus Benzydamine Hydrochloride Spray on Radiation-Induced Acute Oral Mucositis in Head and Neck Cancer Patients: A Pilot, Randomized, Double-Blind, Active-Controlled Clinical Trial. J Altern Complement Med. 2021 Mar; 27(3): 255– doi: 10.1089/acm.2020.0468. Epub 2021 Jan 28. PMID: 33512251.

 

Regular Issue Subscription Review Article
Volume 01
Issue 01
Received April 21, 2023
Accepted July 8, 2023
Published August 5, 2023
Views: 315