Effectiveness Not Established

Date Palm Pollen

for Mucositis

Date palm pollen is produced by flowers on male date palm trees. It has been investigated as a topically administered treatment for oral mucositis in patients with cancer. 

Research Evidence Summaries

Elkerm, Y., & Tawashi, R. (2014). Date palm pollen as a preventative intervention in radiation- and chemotherapy-induced oral mucositis: A pilot study. Integrative Cancer Therapies, 13, 468–472. 

Study Purpose

To determine the effectiveness of date palm pollen (DPP) in the prevention and treatment of oral mucositis in patients undergoing radiation and chemotherapy for head and neck cancer

Intervention Characteristics/Basic Study Process

Two grams of DPP in powder form were mixed in 125 mL of water by the subjects. Patients were instructed to swish and swallow nightly for 42 days starting the day before treatment. The Oral Mucositis Assessment Scale (OMAS) was completed at days 0, 15, and 29. The first 10 subjects were enrolled in the treatment arm and the next10 subjects were in the control arm.

Sample Characteristics

  • N = 20  
  • MEDIAN AGE = 43.5 years (treatment), 47.5 years (control)
  • MALES: 55%, FEMALES: 45%
  • KEY DISEASE CHARACTERISTICS: The treatment group included squamous cell carcinoma, adenocarcinoma, and Hodgkin’s lymphoma. The control group included squamous cell carcinoma only.
  • OTHER KEY SAMPLE CHARACTERISTICS: Chemotherapy consisted of cisplatin 100 mg/m2 every three weeks for three cycles; radiation therapy consisted of 50–72 Gy in 200 cGY conventional fractionation. The treatment group included two patients who received radiation therapy only.


  • SITE: Single-site
  • SETTING TYPE: Outpatient
  • LOCATION: Not indicated

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment

Study Design

Controlled trial; control group received facility standard of care

Measurement Instruments/Methods

  • Oral Mucositis Assessment Scale (OMAS) 
  • Visual Analog Scale (VAS)


The mean OMAS score was lower in the DPP-treated group with statistically significant differences on day 15 (p < .05) and day 21 (p < .05). The mean oral pain intensity level was lower in the DPP group on day 15 (p < .05) and day 21 (p < .05). Only one patient in the DPP group required soft food compared to 80% in the control group. There was a significant difference in the mean impact on swallowing on day 15 (p < .05) and day 21 (p < .05).


There was a significant reduction in the severity and incidence of mucositis as indicated by the OMAS and the VAS pain scales.


  • Small sample (< 30)
  • Risk of bias (no blinding)
  • Risk of bias (no random assignment)
  • Other limitations/explanation: Assessments were completed on days 0, 15, and 29, and the patients were told to self-administer the treatment for 42 days. Patients in the control group received 20 mg/g miconazole, rebamipide, and oral analgesics as needed. The authors reported no treatment compliance issues.

Nursing Implications

Although the mechanism of DPP is not totally clear, nurses should recognize that there are many plant derivatives that may have positive effects on oral mucositis. Larger, randomized trials of these agents are needed.