Quick Links

Recommendations Summary

ONC: Head and Neck Cancer: Radiation and Use of Honey 2007

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.

  • Recommendation(s)

    ONC: Head and neck cancer: Use of honey and radiation

    If the topical use of honey is proposed to prevent mouth sores caused by radiation treatment for patients with head and neck cancer, advise that its use may or may not be beneficial. Limited evidence shows that topical use of honey has been associated with decreased incidence of severe mucositis, weight gain and reduced treatment interruptions; however, the risks of interference with effectiveness of radiation treatment and infectious complications were not evaluated.

    Rating: Weak

    • Risks/Harms of Implementing This Recommendation

      • Care should be taken to use pasteurized honey in the immunocompromised patient population to reduce risk of infection and food borne illness.
      • Care should be taken by patients with diabetes or impaired glucose metabolism to account for any carbohydrate provided by the honey consumed.

    • Conditions of Application

      No conditions limit the application of this recommendation.

    • Potential Costs Associated with Application

      Minimal costs are associated with the application of this recommendation.



    • Recommendation Narrative

      • One small neutral quality RCT (Biswal et al, 2003) of 40 patients receiving radiation therapy to the head and neck area showed a decrease in radiation induced grade 3 or 4 mucositis,  a larger number of patients who experienced weight gain and less mucositis-related treatment interruptions when honey was applied topically to the mouth.  This study included patients of varying weight, sex, age and size of radiation field and treatment was over a 6-7 week duration.  The risks of interference with effectiveness of radiation treatment and infectious complications were not evaluated. 
      • Larger randomized, placebo-controlled studies with greater patient heterogeneity are needed to strengthen these findings.

    • Recommendation Strength Rationale

      • Based on one RCT of neutral quality, conclusion statement is Grade III.