Liz,
Externally, fair skinned people tend to fare worse in RT. "Radiacare" works well (usually the rad techs can give you samples) and they may prescribe some prescription creams as well like "Desonide" (mainly for itching/scratching - which is VERY bad -NEVER scratch!) Moisturing creams ot lotions with Aloe Vera seem to work the best). Be careful to arrive for RT treatments with dry, clean skin - no lotions or creams - they can have a "bolus" effect and exacerbate the skin damage. I would avoid petroleum based products in general. The "fair skin" shouldn't make any difference internally as I will explain below.

The good news is that the skin on the neck is the first thing to heal post Tx. Internally may be another matter.

Internally, he will probably have burns, mucositus, blisters, thrush, etc., and other damage from the RT and it takes the longest time to heal. He may lose his voice for a time and will have pain swallowing (possibly even severe if unmedicated). It will also take time for the damaged eustacian tubes to recover and this can cause hearing problems and pain (from fluid build up in the ear) as well. This can take months to turn around.

The general rule is 1 month of recovery for each week of RT. I have seen very few beat this rule in the 5 years I have been on the board. He will also lose muscle tone from being sedentary from all of the pain meds, malnutrition and cancer fatigue.

As Bill stated above, we all respond differently to treatment but what he and I described is pretty much the norm. He will start to turn the corner about a month or so post Tx and progress will be very slow in the beginning - measured in 3 week increments (for any even barely noticable improvements) for another month then healing will pick up. Not having side effects from treatment is nonsense, it's a matter of degree.

I personally feel that patients should have the worse case scenario explained to them rather than a "blue sky". Prepare for the worst and hope for the best. Emotionally it is better to lower expecatations and be realistic about what to expect. Kind of like boot camp - you know that it's going to suck so you just take it one day at a time, suck it up, and get through it.

Davids "repost" is a fairly detailed and accurate description. I also lost my high frequency hearing response but it returned as soon as the eustacian tubes regenenerated.

Im summation, RT is not a walk in the park - it is more difficult than surgery and recovery is slow and tedious. Acceptance of the realities of this is the key to getting through it.