The Impact of Honey on Chemotherapy and Radiation-induced Oral Mucositis

PURPOSE Integrative nursing framework and Faye Abdellah’s 21 Nursing Problems theory guided this review focusing on holistic care including cost efficient complementary therapies such as honey addressing social problems, such as poverty. These theories are based on meta-theoretical perspectives consistent with nursing values, beliefs, and theoretical perspectives. Chemotherapy and radiation-induced mucositis, the inflammation and ulceration of the oral mucosa, affects 40% of chemotherapy patients and 90% of head and neck cancer patients receiving the addition of radiotherapy. Honey has been reported as an effective supportive care for reducing mucositis. The purpose of this literature review was to determine if honey can be used as adjuvant therapy to reduce the frequency and severity of OM in adult oncology patients undergoing chemotherapy and/or radiation. METHODS A literature review was performed using PubMed, CINAHL, and OVID Medline databases limited to primary studies from the past 5 years using the search terms, “honey AND mucositis,” “honey AND oncology,” “honey AND chemotherapy,” and “honey AND radiation.” After an initial review of 41 articles, results included 5 studies who met the criteria three randomized control trials (RCT), a single-blinded RCT study and a double-blinded RCT trial. RESULTS Honey products demonstrated statistically significant results (p < .05) in lower grades of OM and delayed weight loss. Several of the studies showed that the honey intervention groups maintained a mild mucositis score of 2 or less. One randomized control trial (N = 72) using a thyme honey oral rinse showed a better quality of life throughout the intervention and at 6 months follow-up. CONCLUSIONS The supporting evidence identifies honey as a possible cost-efficient improvement to patient care. When compared to conventional treatments, honey performed better at preventing OM from advancing beyond grade 2. Further study is needed to explore the correlation between honey, OM grade level and weight loss prevention.