The fun starts on Wed 6 Jan with a "verification simulation". The first actual radiation (IMRT) will be Thu 7 Jan... then daily for about 30 treatments, ending about Fri 19 Feb.

Its amazing this is only 3 weeks away... I still have a swollen painful jaw (and difficulty opening my mouth) from the surgery as well as pain in my tongue/tonsil from the previous CRT which ended 26 Aug. I need to focus on some fast healing.

Tomorrow (12/18) I have my first PT session: we'll address exercises/training to compensate for the functional loss of my SCM muscle, but we'll also get started on range-of-motion exercises for my neck in order to pre�mpt the fibrosis.

Erbitux does seem to have a lot of nasty side effects, but I think it might really help. Unlike the chemicals I had last time, Carboplatin and Taxotere, which simply sensitize "fast growing" cells to radiation, the Erbitux sensitizes cells that express an abundance of EGFR (epidermal growth factor receptor) on their surface. All cells express EGFR, but SCC cells have a great deal more than usual. I'll still have some Carboplatin and/or Taxotere along with the Erbitux, but I like the idea of doing things a little differently this time since the previous CRT obviously didn't get it all.

Right after New Year (shortly before treatment begins), I'll start putting Aveeno lotion on my neck each morning and evening. I did this religiously for my last CRT and I had very few/mild skin problems... the skin finally broke in the 7th week of treatment (and I started using an astringent to help ward off infections) but it healed again about a week after treatment concluded. Things may not be the same this time around (because of the Erbitux, the different primary targeting of my neck tissues instead of my tonsil, and the shorter 6 weeks of treatment instead of 7) but I hope the skin pain/discomfort won't be any worse than before.

Charm: Thanks... its good to know the fibrosis will get better with PT. This is the most worrisome side effect for me. Like many folks, I can tolerate a lot of nasty stuff if I have a reasonable expectation that things will improve... but its especially depressing to think I'll be stuck with it forever.

Rob