Hi Kellie,
I was a smoker and quit in 1976.

Pain meds: There are 2 types of pain meds:

1. Long term opioids such as duragesic (i.e. the patch) and they usually start it 25mg and up it 25mg at a time until the desired pain releif is acheived. These adjustments have to be done under supervision from the doctor. This is typically used to mask the ongoing pain from the radiation and mouth sores. I never even got a buzz off of it. I was up to 3 patches in the end and some have even more. It takes a full day for the effect to kick in.

2. Short term opioids such as Morphine Sulphate are used for "break through" pain when certain events, like eating or drinking or brushing your teeth, push the pain threshold over the top. These should be taken 30 minutes or so prior to the need. It's a good idea to "med up" before going in for exams as well (especially in the beginning). Morphine is relatively fast acting.

Her pain levels will continue to increase until almost a month or more after she completes radiation (the gift that keeps on giving). This is NOT the time for heroics. It is well recognized that appropriate pain management is a benefit to faster healing (not to mention a basic patient right) They may have to try different meds in case she has reactions to some of them - some people get a little wiggy with morphine for instance (although I wasn't one of them). She'll know when she needs more - her pain level will go up to 3-4 or higher. Use the pain scale to communicate this situation with the doctors.

They usually do an MRI or CT with contrast post Tx. Its probably a little too soon for a PET/CT because the scar tissue can give erroneous results. The main concern post Tx is recurrence at the primary site and they will be performing a palpation and "look, see" (usually with mirrors and sometimes with a scope) every 6 weeks for the first year.

The first PET/CT is usually used to verify the cancer site and then to look for other sites as part of a triage and assessment for treatment protocol. The biopsy is the gold standard for confirming the site and type of the cancer.