Tom --

Our Hopkins radiation oncologist and our radiation physicist both said that there is no advantage to using conventional radiation as they are actually getting better results from IMRT (re cancer control) -- more radiation delivered to target and less to non-target -- and that the dry mouth from conventional radiation is pretty bad. Thus at Hopkins all HNC patients are now on tomo-IMRT or regular IMRT. Having said that, you should ask about using amiphostine to protect parotid (large salivary) glands -- not an easy drug to take but it does work. However I would also ask seriously "why not IMRT" -- assume they have it, Moffit is a large center, and even our local hospitals have it now. My husband had to have his last 3 treatments on conventional radiation (3-D conformal) when tomo-IMRT went down for a week and those three treatments caused more inflammation in front of mouth and tongue than 30 days of tomo-therapy. The radiation tech said a lot of their IMRT patients made the same observation. Fortunately that soreness went away rather quickly (gone now 2 weeks' out) and he is left dealing with the results of 33 days' on the base of tongue and tonsil bed -- primary target area -- but even that is starting to clear up.

One thing we were advised -- by a breast cancer oncology nurse -- is to pre-condition the skin with Biafine and Radicare Gel (obtain these from your hospital) as soon as you know you are having radiation. Both of these product's directions say the same thing, start using before treatment starts. Barry did it for about 2 weeks before and I think it really helped as his skin never got really broken, just slightly reddened like a mild sunburn. Keep using these materials throughout treatment and until skin heals.

You will also need to consult a dentist (who has experience with radiation effects on teeth and jaw) to see if any dental work needs to be done, and to get fluoride trays made which you will use for years if not forever. Ask him about exercises to reduce the risk of trismus.

Again, all of this is on the OCF web site...

Gail