Hi Sophie,

You are seeking advice about a very gray area of cancer survivorship - that being expectations on quality of life over the medium to long term. The specific situation you face is somewhat unusual in that one salivary gland has been removed and potential damage to others is likely. I suspect no one will venture to estimate the level of saliva production post tx.

Even if there is no saliva and he encounters all the side effects associated with this, he can weigh this and other potential side effects that reduce QOL against the potential of recurrence.

The primary question is how much better might he reduce the chance of recurrence by getting rads. Avoiding recurrence is generally first and foremost for most of us facing treatments. Kill the cancer and keep it away!

Secondary are QOL issues. At some point, usually after a long battle of repeated treatments and reduced QOL, one increasingly faces the balance of QOL against further treatment. This is almost always in palliative situations and each person at some point faces the inevitable outcome that the cancer has dictated and decides further reduction in QOL is not worth the benefit derived from more treatment.

It seems your husband is FAR from facing this scenario at this point and seems like the primary focus should be on survivability. Continue to ask and seek as much as you can from the doctors as to what their experience suggests as being the likely compromises and side effects he will experience and what the risk of recurrence are from passing on the rads. Hopefully that provides sufficient data to make an informed and comfortable decision.

Don