I am surprised that he is not getting an adjunctive chemo treatment being that he is stage IV.

I had IMRT with chemo so I can't say with certainty what to expect but I would imagine the the side effects will be a little less. So my speculation would be:

He probably won't notice much difference until week 2 then he will start feeling the effects of the radiation. He won't feel the radiation treatments while they are happening, just the after effects. He'll start on progressively stronger pain meds at this point. His hair will start to fall out that is in the immediate radiation field and it may not ever grow back (but it's mainly the neck anyway so it's just a little less to shave). His taste buds will start to be affected and he will start having some pain swllowing. Remember that all of the side effects can be managed. He will lose more weight as time goes on, typically, but in a few cases some patients on IMRT actually gain weight (at least that's what the manufacturer says). He will have to force himself to eat, as food won't taste very good for a fairly long while.

As far as what you can do now eat, eat, eat! Put as much weight on as he can. Get your meds ordered up for thrush, constipation, long term and short term pain, etc. and have them ready. Experiment with different liquid diets to see if anything appeals to him. He must stay hydrated - 2-3 liters a day.

The drug you mentioned is Amofistine. Gail has some tips for using it - it can be a difficult drug to tolerate. Usually with IMRT most salivary function will return anyway. It depends on where they are irradiating.