Just wanted to add my two cents on this topic from a longer-term perspective...

IMRT wasn't available 17 years ago when I had radiation (and since my tumor was poorly differentiated, it might not have been the recommended treatment even if it had been available). Some of my salivary glands were removed during surgery, so those are gone for good. Preventive measures such as amifostine weren't around either, and Salagen wasn't even out in trial form until more than a year after I finished radiation. My mouth got pretty well fried during the weeks of conventional radiation from my earlobes to below the collarbone, and the recovery process seemed slow and frustrating.

Notwithstanding all of the above, within a year or so I was back to eating a wide variety of foods, and as more time passed I got to the point where I could eat just about anything I wanted. My salivary function has come back more and more, to an extent I never would have thought possible. I rarely have the need to have a water bottle close by, I sing regularly in a choir, and I long ago got to the point where my quality of life was not affected at all by having had radiation. Most people who have met me in the years since treatment don't have a clue that I ever had head and neck cancer.

I know the medical profession has to do the prudent thing and advise patients about possible QOL issues, especially if they still feel the need to use conventional radiation. However, having this kind of treatment is not a guarantee of irreversible damage. It seems to me the first priority should be to follow the advice of an experienced H&N cancer team as to the best course of action to eliminate the cancer completely. No one can know for sure in advance how their QOL will be affected, and there is no need to assume that conventional radiation will lead to a life of serious limitations and disabilities.

Cathy