I think your doctor needs to see more radiation patients. Most of the value of IMRT is the ability to map out some or all the salivary glands. This means a better chance of recovering some salivia after treatments end. Sometimes this recovery takes many months which is why your doctor dosn't see the difference. There are several people here that had IMRT and now have most of their salivia back. This is a big deal (I think) and well worth insisting on IMRT if you can get it. If you want to know what it is like to have no salivia then take an entire sleeve of saltine crackers and stuff them into your mouth. Then try to imagine that feeling 24 hours a day.

In my opinion, saliva loss (Xerostomia) is the single worst long term side effect of radiation treatments. Besides affecting ease of eating, it also creates a problem for future dental care and general daily comfort.

Either treatment will probably cause the same bad effects during treatments. (no easy way out) However you do have a reasonable chance to be able to work at least light duty while being treated.

Hound them until you know the plan and hound them more if they want you to get XRT (non IMRT) radiation.

Mark, 21 Year survivor, SCC right tonsil, 3 nodes positive, one with extra-capsular spread. I never asked what stage (would have scared me anyway) Right side tonsillectomy, radical neck dissection right side, maximum radiation to both sides, no chemo, no PEG, age 40 when diagnosed.