My dad was previously treated for Oral Cancer (Left Tongue Glossectomy, Left SND, CCRT) in early 2009 and had slowly recovered but everything came crashing down when he was diagnosed for recurrent nodal metastasis on his right neck.

He was put on pallative DCF chemo for 3 cycles to reduce tumor size prior to surgery, which did not happen. He just had RND and Flap. Biopsy reports says PNI, ECE and soft-tissues from Carotid artery and prevertebral are positive.

He is up for reirradiation and I am feeling terrible with the thought that he has to go through all that again!

Is there any means to preserve his salivary secretion (whatever he has got now after recovery)?

Has anyone been on Salagen (pilocarpine)? Not sure if we get that in India but will try to source, if it is effective and RO is OK with it.

I was given pilocarpine to help with my lack of saliva. It didnt work for me. It only made me sweat which wasnt what I had hoped would happen. Ive seen this used with success by several others on the forum.

Look for posts by Charm. He has gone thru radiation twice. Im sure he will have some tips for your father.

Good luck with everything!

Thanks Christine. At this time I need more than Good luck!

Just hoping that my dad's cancer goes away.

Then I offer you blessings and prayers too. Take care eshwar... You are an awesome caregiver!

ive taken pilo and it wasnt much help! take care you and your dad are in my prayers

Hi Eshwar,
I responded to your PM but now have a clearer picture of what is happening with your Dad. I had my second round of radiation in late 2009 and had a similar treatment plan to what your father had 1st time around - Radiotherapy twice a day for 3 weeks with weekends off. I do have permanent issues with almost no saliva and difficulty eating, speaking and swallowing. I initially had a naso-gastric tube put in during my last week of treatment but 5 months later was given PEG which is now permanent. Despite this I consider the treatment to have been a success - the mets to my neck, which were reduced in size surgically prior to treatment, were completely killed off with the radiation. I have a good quality of life and travel and get enjoyment out of simple pleasures everyday. (My speaking issues are not related to the two rounds of Radiotherapy - that is the cumulative result of several partial glossectomies, a tissue transplant and two partial mandibulectomies and related teeth removal) Good luck to you and your father!

Thanks Sue for the detailed response. Docs have been putting all efforts to help him get through this. I am also hoping that my dad has good quality of life after the treatment. Ofcourse, his teeth also may not survive the second onslaught of Radiotherapy (already in bad shape). He may not like the idea of PEG though, if it is required at a later date. Since it is going to be unilateral RT, hoping that it will not dry up his remaining salivary glands.

Dear Eshwar,
You are an awesome caregiver to your father! So informed and up to date on all the issues-- do you have medical background as well? I have researched alot, and learned more than I ever thought I would on OC.
It is a challenge every day and is a hard road, caregiving. I am struggling with it constantly, wondering if I'm nagging John too much to eat more, not exert himself, etc. etc. I cannot imagine the blow to his ego being limited so. Up to now he has been active, and every doc we see says he's a young healthy guy except for his cancer, which blows him away.
He has just started on O2, which is a big step for us. His shortness of breath has been excruiciating, and his pulse/ox just went below 90 which got them to finally order it with insurance approval.
Hoping this O2 will give him the boost needed to get thru this rough TIC treatment and shrink his tumors as this is our last resort.
Best wishes to you and your dad for complete recovery from this next phase.

Hi Bonnie, hope John's doing fine.

I do not have a medical background but like you I too researched and learned alot. I understand the challenges of caregiving. My dad would not listen to my mom so I am the one who become an arbitrator.

While he was undergoing his TPF, it was difficult for him to even open his mouth because of mucositis and he had to depend lot on semi-liquid diet. I had informed him of the consequences of abstaining food, so he never complained and started having smaller but frequent meals. I and my wife used to cook him soupy noodles with all veggies (also capsicum, onion and garlic) without any spices, which he found easier to eat. He maintained 135 lbs throughout the treatment.

My suggestion for John is that have him eat what he likes more frequently, do not force him too much. You will have to research a bit on food as well to help him.

Few suggestions, from my dad's experience:
- Soupy Noodles
- Cooked Porridge and Pulses/Legumes e.g. Mungbean. You can add Yogurt
- Cornflakes and Cold milk
- Ice-cream (probably melted)
- Banana and other hardskinned fruits (check with doctor though).
- Apple Juice (Tropicana 100%)
- Hard boiled egg.
- Coconut Water

O2 treatment will help him recover and carry on with TIC. Tell him about my Dad. At 66, he is still fighting and doing his best to maintain health.

Hope to hear from you soon. Take care, you are also an awesome caregiver.

Eshwar,
Thank you for the menu ideas. Yes, John is eating alot of the same type foods. I am trying to get more protein in him as well via whey protein shakes with fruits and ice cream.
The O2 is helping alot so far. Having to keep on top of the pain meds for his Neulasta bone pain.
He is encouraged by your Dad's story too. Thanks so much for sharing. Hope to hear more about his recovery soon.

Take care of yourself.