Turmeric

for Mucositis

Turmeric, also known as Curcuma longa, is a common spice native to India and other tropical regions. It is frequently used in Asian cooking. The active ingredient, curcumin, is believed to have anti-inflammatory and antioxidant properties.

Research Evidence Summaries

Rao, S., Dinkar, C., Vaishnav, L.K., Rao, P., Rai, M.P., Fayad, R., & Baliga, M.S. (2013). The Indian spice turmeric delays and mitigates radiation-induced oral mucositis in patients undergoing treatment for head and neck cancer: An investigational study. Integrative Cancer Therapies, 13, 201–210.

DOI Link: doi: 10.1177/1534735413503549

Study Purpose

To evaluate the efficacy of turmeric in preventing radiation-induced mucositis. Secondary endpoints included the efficacy of turmeric rinses on treatment breaks and weight loss.

Intervention Characteristics/Basic Study Process

The trial held the same recommended oral care for the treatment and comparison groups. Participants also were asked to swish after oral intake and wait 30 minutes to eat after swishing with the prescribed solution. The treatment group (turmeric rinses) was instructed to have a caregiver dissolve the contents of one 400 mg capsule of turmeric in 80 ml of boiled and cooled water. The patient was then instructed to swish 10 ml of the solution one hour prior to radiation; one, two, four, and six hours after radiation; and at HS. The comparison group was instructed to mix a povidone-iodine solution at 1 ml Betadine^® to 100 ml water and swish 10 ml twice per day for six weeks.

Sample Characteristics

N = 80
AGE: Older than or equal to 18 years
MEAN AGE: Treatment group: 56.8 years, comparison group: 55.08 years
MALES: 80%, FEMALES: 20%
KEY DISEASE CHARACTERISTICS: Patients with head and neck cancer undergoing 70 Gy radiation or radiation plus chemotherapy
OTHER KEY SAMPLE CHARACTERISTICS: No oral surgery six weeks prior to study; no previous treatment to head or neck; no high doses of non-steroidal anti-inflammatory drugs; no poorly controlled DM; no hypertension, schizophrenia, bipolar disease, or severe depression

Setting

SITE: Single site
SETTING TYPE: Outpatient
LOCATION: Mangalore Institute of Oncology, Mangalore, India

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment

Study Design

Single-center, investigator-blinded, randomized controlled trial

Measurement Instruments/Methods

Radiation Therapy Oncology Group oral mucositis grading system

Results

There was a significantly (p < 0.0001) lower rate of intolerable mucositis (grades 3 and 4) in the turmeric group. There was no significant change in treatment days lost between groups. Weight loss in the turmeric group was less (p < 0.001).

Conclusions

Turmeric rinses are beneficial in reducing grade 3 and 4 mucositis in patients with head and neck cancer undergoing chemotherapy or chemotherapy and carboplatin, compared with twice-daily povidone-iodine rinses.

Limitations

Small sample (< 100)
Risk of bias (no blinding)
Findings not generalizable
Other limitations/explanation: Comparison of povidone-iodine twice-daily rinses might not be a fair comparison, as there is not good evidence thus far that povidone-iodine rinses are a good treatment for preventing oral mucositis. Additionally, the patients clearly were not blinded. Lastly, twice-a-day rinsing versus six-times-a-day rinsing does not seem to be an appropriate comparison.

Nursing Implications

Turmeric rinses may provide some protection against oral mucositis for patients with head and neck cancer undergoing radiation and radiation plus chemotherapy; however, more research is needed. The treatment was reported as well tolerated, and there was no mention of adverse side effects.

Effectiveness Not Established