Amy,
we can agree to disagree. My father lived to 92 and went though some horrific things at a much older age and fought live hell to live. I am mentored by a guy who is 80 and he hates to be on any drugs. He has a daughter who is a nurse and between her and I, we have to convince him of the benefits of the drugs he takes. Many older people are suspicious of drugs or think that narcotics are bad or addictive, so they undermedicate. Some are put off by the side effects of the narcotics and don't like feeling "loopy". Those effects typically go away after a tolerance of the med is built up, in usually a week or so. We have seen this many times here.

I reiterate, his pain meds are inadequate. Response to treament is a very dynamic thing. I researched it before I even started treatment and had all of my meds lined before I needed them. My doctors gave me anything I wanted. Pain has to be managed like any another side effect of treatment. Use a 0-10 scale when speaking with the doctors (usually the MO manages the presciptions). The document in the link I refered you to below will explain how to grade pain and present that number to his doctors. 7-10 being unbearable pain. He probably needs meds for anxiety and/or depression as well.

I would guess that he is on Vicodin or Percocets or some other medium strength pain reliever and that just won't cut it at this stage.

What exactly are they giving your father for pain?

Most of us suffered by the midpoint of treatment. Radiation may SEEM easier than surgery but I can assure it's not. It was the hardest thing I have ever done.

I was only given a 38% chance of 5 year survival (or put another way, a 62% chance of dying within 5 years). Well I guess I have 1 1/2 years to go!?!? There's a chance he will be in the 30% survivors and that what's I'm betting on as well. Actually, if I read this right, you stated that he has a "30% chance of a recurrence" - that means a 70% chance of no recurrence - that's well worth the pain & suffering (I am confused by the way you present his numbers). But it should not be horrific suffering in any case. Are you his advocate or caregiver? Does he have live in help? You are wise to get on top of this now.

Your RO is being honest with you - they either give the full dose or none at all. I have yet to hear of anyone who got 1/2 treatment and survived. "How bad can this really get?" It can get really bad. Oral cancer in itself won't kill you directly (or the tumor could grow so large that it chokes you to death - which is what mine ALMOST did - I had a tumor in my throat that was bigger than a golf ball and a little smaller than a tennis ball). Typically though, it has to metasticize to a major organ for that to happen. I work with persons in the terminal phase and believe me, you don't even want to go there - especially if there is a good chance that they can cure him.

You are in California, where is he being treated?

Here's a link to the NCCN pain mamagement guidelines: http://www.nccn.org/professionals/physician_gls/PDF/pain.pdf