The combination of propolis and sodium bicarbonate is an effective and well-tolerated therapeutic option to prevent oral mucositis (OM) in patients with breast cancer receiving chemotherapy, according to a study published The European Journal of Cancer Care.

Previous studies exploring the use of propolis, a waxy substance produced by bees that is considered to be a complementary therapy to anticancer agents, for the treatment of esophagitis, stomatitis, oral ulcers, and other conditions achieved mixed results. For this study, researchers investigated the effects of propolis in the prevention of chemotherapy-induced OM in patients with breast cancer.

Investigators randomly assigned 60 patients with breast cancer eligible to receive doxorubicin/cyclophosphamide (AC) chemotherapy to a control arm and an experimental arm. Patients in the control arm were instructed to rinse their mouth 3 times a day with sodium bicarbonate alone; patients in the experimental arm were given oral propolis in addition to the sodium bicarbonate.

Treatment was started the day after initiating the first cycle of chemotherapy, and OM was assessed on days 5, 10, and 15 by phone interview, and on day 21 when patients returned to receive chemotherapy. Incidence and severity of OM were assessed at the end of each chemotherapy cycle for more than 6 months.

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None of the patients who used propolis and sodium bicarbonate developed OM greater than grade 1 during the first cycle, whereas 16.7% (5) of patients in the control arm developed OM greater than grade 1 in the first cycle (P =.02). The incidence of grade 1 and higher OM was the greatest in cycle 2 (25%) and cycle 5 (45.8%) during cycles 2 to 8 (P <.001). 

Two patients receiving propolis stopped treatment due to the development of a mild skin rash on day 1 of treatment, which resolved upon discontinuation.

The authors of the study conclude that “although further well-designed studies with larger samples, possibly comparing propolis with placebo, are warranted to achieve definite results, this study provides clinicians with a promisingly effective, natural, harmless, cheap, and acceptable prophylaxis for OM in breast cancer patients receiving chemotherapy with AC.”

Reference

1. Piredda M, Facchinetti G, Biagioli V, et al. Propolis in the prevention of oral mucositis in breast cancer patients receiving adjuvant chemotherapy: a pilot randomised controlled trial [published online August 25, 2017]. Euro J Cancer Care. doi: 10.1111/ecc.12757.