Hi son of patient,

I must say, you’re well versed with head and neck cancer at this time! I remember knowing nothing when I was first diagnosed, not even who an ENT or an Oncologist was, even though I was seeing both lol, but we learn quickly!

With that, I’ll try to answer your question:

I know some treatments can be different for tonsil cancer in the oropharynx, which I had, vs oral cancer

My initial cancer, primary in tonsils, and bilateral lymph nodes were treated with 70Gy IMRT, lesser to uninvolved lymph nodes. They didn’t want to do chemo at that time, due to my poor condition from prior Cherno about 9 months earlier, which floored me, so that wasn’t offered with my first radiation treatment.

I’ve had IMRT radiation for a recurrences with 25 sessions, 50Gy, after about 30Gy with Intraoperative Radiation. In my case, my RO, Radiation Oncologist, said 50Gy would not be enough! Prior to that, my then current RO and another, only offered 50Gy, and when they heard who I was seeing, they said I was in good hands, so I didn’t see them.

I received a printout, and was informed of the possible side effects from radiation. Hopefully they counciled all parties, gave you one, if not, you can ask for one and any questions.

It takes about two weeks or 10 radiation sessions for most of the side effects to start showing, but some things can start earlier in some people. Side effects depends on the radiation dosage in Grays, areas radiated, duration, and frequency, if I got most right lol. A few years ago, I knew it like the back of my hand!

Magic mouthwash was a savior as was taking thrush medication, pain meds like oxycodone, later on it was a stronger opioid, and having my mouth sprayed out daily at the radiation center. I didn’t have it for my initial radiation, but having mouth guards were helpful, so I have heard.

Side effects are broken down into short term, less than 3 months, and long term side effects lasting longer than 3 months.

It can be rough from midtreatment to just as long as radiation lasted, in my case 7 weeks, then other side effects.

I think dry mouth persisted for years! Maybe two years ago it seemed to lessen, and no longer use OTC dry mouth products, but still carry and use bottled water.

Depending on area radiated, the thyroid can be effected by hypothyroidism long term, so I take thyroid medication daily.

All my teeth were removed due to recurrences, and treatments, but you wouid need prescription fluoride treatment and impeccable oral care to help preserve the teeth, but sometimes that’s not enough in some cases.

I would suggest another opinion or two at a CCC or CC, I think it was the best thing I did. Hopefully, there is more time for you to do so. Treatments from surgery to end of radiation should be kept around 100 days from what I recall.

I hope this helps, and probably mixed up my responses. I think most will fall into place once treatments start!

All the best,

Paul