October is Breast Cancer Awareness Month, a time to recognize both the importance of cancer treatment and the everyday needs of people living with breast cancer. Mouth sores, dry mouth, vaginal dryness, and painful intercourse can affect eating, drinking, talking, and intimacy. Managing these symptoms matters during treatment and in the months and years that follow.
Westmoreland Pharmacy + Compounding does not compound medications to treat cancer itself. Our pharmacists work with patients and healthcare providers on individualized supportive care prescriptions when a commercially available product does not meet a patient’s needs. The goal is to help address specific symptoms while staying coordinated with the oncology team.
Sometimes it’s not just the medication that matters. It’s what we put it in—and what we leave out.
That’s especially important when patients are dealing with sensitive or irritated tissue. The ingredients we choose, the base we use, and even the ingredients we leave out can all be important parts of an individualized preparation.
How Compounding Fits Into Cancer Supportive Care
Cancer-directed treatment focuses on the disease. Supportive care focuses on symptoms, treatment side effects, and quality of life. It can be provided alongside cancer treatment and continue afterward. Compounded preparations do not replace an oncology treatment plan.
Compounding involves preparing a customized medication for an individual patient. A provider may consider it when a patient needs a strength or dosage form that is not commercially available, has difficulty swallowing, or needs to avoid an ingredient.
Oral Care for Mouth Sores and Dry Mouth
Some cancer treatments can cause painful mouth sores, ulcers, inflammation, or dry mouth. These symptoms may make eating, drinking, swallowing, and even talking uncomfortable. Because mouth pain and dryness can have different causes, they may require different approaches.
Magic Mouthwash for Painful Mouth Sores
“Magic mouthwash” is a common name for certain compounded oral rinses, rather than one standard formula. Ingredients vary according to the symptoms and the prescriber’s treatment goal.
A formula may include lidocaine for temporary pain relief; diphenhydramine, an antihistamine used in traditional formulations; or an aluminum and magnesium hydroxide antacid as a coating vehicle. A prescriber may select nystatin when treating oral thrush, or a corticosteroid such as dexamethasone for certain types of oral inflammation. Not every patient needs every ingredient.
Our pharmacists can work with the provider to select an appropriate formula and evaluate potential irritants. Alcohol, strong mint or menthol, cinnamon oil, citrus flavorings, and acidic ingredients may cause additional burning in an already sore mouth. Leaving out an unnecessary flavor or ingredient can be part of making a preparation easier to tolerate.
Follow the prescription’s directions, including whether to spit out or swallow the rinse and when it is safe to eat or drink afterward. Rinses containing lidocaine can cause numbness that affects swallowing. Report mouth pain that interferes with food or fluids promptly to your care team.
Xylitol Oral Rinse for Dry Mouth
Dry mouth may call for a preparation focused on moisture and comfort rather than a combination intended for painful sores. Westmoreland offers a compounded xylitol oral rinse formulated in a specialized base designed to coat oral tissues and help maintain a moist, comfortable feeling.
Xylitol provides sweetness without relying on strong flavors or menthol. The base is an important part of the preparation, helping determine how the rinse feels and coats the mouth. This rinse is intended for symptom support, not to restore salivary gland function or replace dental care. Your oncology team and dentist can recommend an oral care plan, since dry mouth can increase the risk of tooth decay and infection.
Nonhormonal Support for Vaginal Health
Breast cancer treatment, particularly therapies that reduce or block estrogen, can contribute to vaginal dryness, burning, irritation, and painful intercourse. These symptoms can persist after treatment and affect comfort, relationships, and quality of life. And unfortunately, they aren’t always easy to talk about.[TM2.1] They deserve a conversation with your healthcare provider.
Nonhormonal moisturizers and lubricants are commonly considered first for people with a history of hormone-sensitive breast cancer. When an available product is unsuitable, a provider may discuss a compounded cream, gel, or suppository with our pharmacists. The choice depends on the symptoms, tissue sensitivity, and treatment history.
Hyaluronic Acid Vaginal Suppositories
One preparation available through Westmoreland is a nonhormonal vaginal suppository containing hyaluronic acid and vitamins A and E. Hyaluronic acid helps retain moisture and support vaginal hydration, while vitamin E has shown potential benefits for vaginal dryness in small clinical studies. Vitamin A is another ingredient used in certain vaginal preparations, although its individual benefits for vaginal dryness are less established. The combination has also been studied in postmenopausal women, with encouraging preliminary results. As with any compounded preparation, the ingredients and dosage form should be selected based on the patient’s individual needs.
The suppository base also matters. A lipid-based suppository offers an alternative to water-based gels and may be a better fit for some patients depending on their comfort and sensitivity. Neither is automatically better. Our pharmacists and the prescriber can consider the dosage form, how it delivers the ingredients, and what a patient finds comfortable. Ask about compatibility with condoms or other barrier products, since some lipid-based preparations may affect latex.
Fragrances, dyes, certain solvents, and preservatives can irritate some patients. Compounding may allow unnecessary ingredients or identified irritants to be excluded when the formulation’s stability and safety permit.
Lidocaine Gel for Pain at the Vaginal Opening
For women experiencing localized pain at the vaginal opening, a provider may also consider a lidocaine gel applied to the sensitive tissue before intimacy, as directed. Lidocaine provides temporary numbing and may help make intercourse more comfortable for selected patients; It does not treat the underlying cause of dryness or every type of pelvic pain. Research in breast cancer survivors has evaluated an aqueous lidocaine preparation.
Persistent pain, bleeding, unusual discharge, or new irritation should be evaluated. Your oncology team and gynecologist can help identify the cause and determine which nonhormonal options fit your care plan.
Other Medication Needs During Cancer Treatment
Nausea, skin irritation, pain, and difficulty swallowing can also complicate treatment. Many effective commercial medications are available. If the prescribed form is unsuitable, our pharmacists can work with the provider to explore alternatives. For example, if mouth sores or difficulty swallowing make tablets or capsules painful to take, certain medications may be compounded into a liquid suspension to make administration easier. Not all medications can be safely converted to another dosage form, so factors such as stability, absorption, and effectiveness must be considered.
*Do not crush tablets, open capsules, or change how a medication is taken without instructions from your oncology team or pharmacist. Ask the care team before applying products to a radiation treatment area, and report new or worsening pain for assessment.
Nutrition and Supplements During Cancer Treatment
Good nutrition is an important part of supportive care. Eating enough calories and protein, staying hydrated, and addressing nausea, mouth sores, or appetite changes can help support nutritional needs. Your oncology team or a registered dietitian can help adjust your eating plan. Supplements may also have a role when there is a specific need. For example, Integrative Therapeutics developed its ProThrivers™ Wellness supplement line with cancer survivors in mind, including a sleep-support formula containing melatonin, magnesium, L-theanine, and magnolia. Our pharmacy team can help patients explore appropriate supplement options in coordination with their healthcare providers. Always share medications and supplements with your oncology team, as some may interact with cancer treatments.
Why the Details of Compounding Matter
Sometimes it’s not just the medication that matters. It’s what we put it in—and what we leave out.
At Westmoreland Pharmacy + Compounding, we look at the entire preparation. What ingredients does the patient need? What type of base or dosage form makes the most sense? Are there unnecessary ingredients that could contribute to irritation?
Sometimes the best approach isn’t adding more ingredients. It’s choosing the right ones.
Our pharmacists work with healthcare providers to develop individualized prescriptions that consider these details. Whether it’s a mouth rinse for painful sores, a moisturizing preparation for dry mouth, or a nonhormonal vaginal product, our goal is to help patients find appropriate options for their individual needs.
Because being more comfortable with everyday things like eating, drinking, and intimacy can make a meaningful difference during and after cancer treatment.
Have questions about a compounded supportive care prescription? Contact Westmoreland Pharmacy + Compounding or call 866-944-6505. We can discuss your individual medication needs with your healthcare provider.
Compounded medications are not FDA-approved, and the provider and pharmacist must evaluate whether a proposed formulation is appropriate.
