I just started RAD this week and due to something I saw on this site that Brian had written about treating both sides of neck to prevent micro mets in the future made me ask the RT doc if that were the case. Indeed it is.
The questions didn't occur to me until AFTER I had seen him, so I'll ask here before I ask again (prob tomorrow).
When they say "both sides" what exactly is involved? I chose IMRT RT to lessen the exposure of RAD to healthy tissue, but it seems to me if I only have a tumor on the rt side, what exactly are they "zapping" on the left? Am quite concerned about this as I have noticed a tooth on the upper left that seems to be having significant pain when disturbed or subjected to cold. (I saw a dentist 3wks ago and was assured it would present no problem) but now with RAD going into the left side I am seriously questioning what is going on.

Also, should I be taking my salagen pills already, or after I notice a change in my saliva?

I have noticed a couple of people that have mentioned putting cotton rolls between teeth/gums during RAD. What exactly does this help with?

I am trying to be "proactive" and prevent as many side effects as possible before they rear their ugly heads......any advice/experience with these (and other) problems with RT/preventing side effects would be welcome.
Thanks. Gordon

Hi Gordon, perhaps I can respond to one of your questions. Even though only my left tonsil and lymph nodes on my left neck were cancerous, both sides of my neck and my right tonsil were radiated to prevent possible hidden cancer cells in the right area. I didn't question why it was necessary because I trusted the team of doctors taking care of me and I didn't want to take any risk and regret later. One thing for sure, the radiation dosage is heavier on the left than on the right. People can tell when looking at my neck which side was cancerous because the skin on my left was more damaged than the right.

Karen stage 4 tonsil cancer diagnosed in 9/01

The path of progression of oral cancers is fairly well understood. They know from the thousands of cases that have been treated, where this disease is likely to go in what order for any given primary location. IMRT does not only treat the tumor itself, but to a lesser extent and exposure, is used to treat the areas of likely local metastasis. Therefore getting an apparently asymptomatic part of the other side of your neck radiated isn

My dr's told me there was a X% chance that cancer cells were present in the other tonsil. Resonable to assume then that there were a few cancer cells in the lymph nodes on that side as well. This is the reason for the radiation to both sides down to the collar bones. The machine was actually aimed from the left, the right, and straight on in three doses each visit.

Hi Gordon,
I received IMRT on both sides but the majority was directed to the tumor. I received the full lifetime dose of 70 gy. I had less radiation into healthy tissue. I feel that you were wise and fortunate to have IMRT available as a treatment option. The radiation oncologist told me that they were interested in many different areas, lymph nodes, etc. Like Brian said, they have enough experience to predict pretty well where the cancer is most likely to reoccur. My IMRT treatments consisted of a 45 minute session with a 9 axis treatment. The Multi Leaf Collimator (MLC) was changing shapes continually, shaping the beam.

I used cotton rolls to minimize the radiation side scatter off my gold crowns. I placed them on both sides of my teeth to protect the inside of my mouth and tongue from radiation burns. It wasn't perfect, I still had burns, but it did seem to help. I also tried teeth shields, which were much more convenient but didn't seem to work as well.

I was always able to swallow on the left side if I was careful. I had to make up some swallowing techniques to avoid the right side.

My teeth did get a little sensitive but that has pretty much returned to normal. They'll get that way from disuse also, like not eating solid foods for a while.

Did you have dental trays made for flouride treatments?