Jane,

Based on what I read in my surgeon's writeup, some of my salivary glands were removed during surgery, so certain ones were already gone before radiation even started. At the time I was treated, IMRT wasn't around, so I had general field radiation and most of the remaining salivary glands got pretty well fried. However, within a year or so after my radiation, I was in clinical trials for Salagen and was one of those that benefited noticeably from taking it (and I've continued with it ever since). Between my daily doses of that -- 3 times a day, with meals -- and using Biotene mouthwash and gel, and staying reasonably hydrated with water, my salivary function has improved quite a bit over time. I can eat basically anything I want to (other than the spiciest curries), and I've been singing in choirs for the past 13 years.

Regarding your question about why they don't do radiation right away -- sometimes they do. This is not a "one size fits all" situation. Depending on the location, size and other characteristics of a particular tumor, the sequence may vary from one case to the next (or it may be possible to do radiation without surgery, or vice versa).

The teeth and gums do need ongoing attention for the rest of your life after treatment. I have my teeth cleaned at least 4 times a year and see a periodontist at least twice a year. At this point (age 55) I still have all my original teeth, so the regular preventive maintenance has worked so far.

I'm glad you're continuing to look into further treatment options -- please keep us posted and feel free to keep asking questions.

Cathy