Barb --

Ask what sort of radiation your husband will be receiving -- if he has IMRT they should be able to spare some of his salivary function, though it will certainly get bad before it gets better.

With amifostine (ask about this too), it can help preserve more salivary function, but it's a nasty drug to take. Some folks get through the whole treatment (like my husband) but usually not without a struggle, some have to stop part-way through but (per our radiation onc) even a half-course helps. Our RO, one of whose areas of expertise was salivary-sparing, told us that IMRT can preserve about 50% if the plan is configured to do this (this will depend of course on what areas have to be radiated), and amifostine can add about 10-15% to this.

My husband also had a BOT (and tonsillar) tumor, spread to two nodes, it was human papilloma virus positive as are a majority of cancers presenting at these sites. He received 33x tomoTherapy IMRT at Hopkins, both sides radiated, amifostine and also, carboplatin only -- this in summer '05. (His medical onc rarely uses Taxol as she has not found it to add much benefit and it can cause severe allergic reactions, plus peripheral neuropathy, in some patients.) He had a pre-existing hearing loss too, the reason for no cisplatin, and several tests post-treatment have shown no further damage so the carbo- was a good call. He has good salivary function, which is improved by taking the drug Evoxac 2x a day.

If your husband was a non-smoker, you might ask about HPV testing as this type of oral cancer appears to respond better to chemmoradiation and has a relatively low recurrence rate. The initial treatment would be the same but it does provide some optimism.

Gail