Kara Morris and Christine Wylie on Oral Cryotherapy for Chemotherapy-Induced Mucositis in Breast Cancer


Kara Morris, MSN, RN, OCN; and Christine Wylie, MSN, RN, OCN, discuss the benefits of oral cryotherapy for patients receiving dose-dense doxorubicin.

Oral cryotherapy successfully reduced mucositis in a population of patients with breast cancer receiving push, dose-dense doxorubicin, according to findings presented by Kara Morris, MSN, RN, OCN; and Christine Wylie, MSN, RN, OCN, during the 48th Annual Oncology Nursing Society Congress.

“There were no patients who were unable to tolerate the cold, and 78% of our patients had success and did not develop any mucositis [following the intervention],said the nurses, who practice at Siteman Cancer Center, in an interview with Oncology Nursing News®.

Oral mucositis is an adverse event commonly experience by patients receiving chemotherapy and can lead to decreased chemotherapy adherence, because it causes pain, dehydration, and malnutrition. A retrospective, clinical record review of data from August 2020 to February 2021 showed that 67% of patients at the investigators’ institution had experienced mucositis with dose-dense doxorubicin. The investigators therefore sought to mitigate these symptoms with oral cryotherapy.

They collected data on patients with breast cancer who were beginning their treatment with doxorubicin IV push. Ten minutes before treatment, they were offered ice chips. They were offered the chips again 10 minutes following administration.

A total of 21 patients participated in the study. Each underwent 3 cycles for a total of 62 cycles. In 49 of the cycles (78%) no incidences of mucositis were reported. Mucositis was reported in 14 cycles (22%).

In the poster, Morris and Wylie acknowledge that this study looked at a small sample of patients for only 3 cycles. Because of changes in treatment, mucositis was not evaluated after cycle 4. However, oral cryotherapy is standard of care at their treatment centers, and the team is reviewing mucositis incidence in other nonbreast cancer regimens.

Cryotherapy can be a nurse-driven and cost-effective intervention to help reduce mucositis incidence and positively affect quality of life for patients with breast cancer, they conclude. Next steps in this research will include looking at opportunities to include oral cryotherapy for patients with other malignancies receiving this regimen.


Morris K, Wylie C, Bieg D, Cipriano D. Oral cryotherapy to reduce mucositis in breast cancer patients receiving intravenous push, dose-dense doxorubicin. Poster presented at: 48th Annual Oncology Nursing Society Congress; April 26-30, 2023; San Antonio, TX. Accessed May 9, 2023. https://ons.confex.com/ons/2023/meetingapp.cgi/Paper/12706

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