Mariam --

If your dad is still in so much pain, then you need to have a serious talk with his doctors about appropriate pain management. He may need to be shifted over to the fentanyl (Duragesic) patch that many folks are given when they find morphine (he's not taking oxycodone?) no longer does the job or is causing too many digestive upsets. I know my husband found that oxycodone not only caused constipation, but also a constant queasy feeling. He did much better on the patch, with the caveat that it sometimes takes a few days to adjust to it (and some never do) -- he had very vivid dreams and even some nightmares for 4-5 days, had to use a night-light! He did take tylenol for break-through pain, but always after checking his temperature. Btw, Hopkins wants you to call day or night if a temperature over 100.5 occurs. We caught a potentially serious blood infection in my husband by being on top of this.

Some tips: The Hopkins oncology nurses prefer the senna tea Smooth Move to Senakot -- it can be given by PEG and seems to work more reliably. Given with Colace. This tea can be purchased in many places, including GNC and Trader Joe's.

Mucinex (without antihistamine) can be given to thin the ropy discharges, the caveat here is that it is a pretty large tablet which, being timed-release, cannot be cut or ground up. Take up to 2 tabs every 12 hours, with ample water, or 1 tab every 6 hours (what our RO recommended). If your Dad cannot swallow it, you can substitute guafenesin syrup (sold as Tussin) -- make sure it is the guafenesin ONLY with no antihistamine. The catch here is that the pure syrup with burn his mouth so the dose must be well-diluted in at least 4 oz. water, given every 4 hours at most.

Get a warm-mist humidifier and keep it going all the time in his room.

The suction tube does work, many have said it really made a huge difference to them -- if your hospital cannot supply, a medical supply house can rent one to you. Insurance should pay.

Have him sleep with his head slightly elevated on several pillows. It helps prevent that choking feeling.

My husband hated the "magic mouth wash" and in fact, it amost caused him to aspirate food. (Our RO nurse hated it for same reason). He found that frequent rinsing with a salt/baking soda mixture and also, an l-glutamine rinse (5 g l-glutamine powder in 8 oz. water) helped. He used Ulcer-ease some (this is a phenol rinse, rather potent but numbing!) and also, the over-the-counter coating agent called Rincinol. The latter has the same ingredients as the rather expensive prescription material Gel-care, made by same company (G.U.M.)

Watch for thrush -- ask the nurse to check regularly as even with Diflucan you will only keep it "at bay" -- swishing with active yogurt or Kefir is supposed to help maintain normal mouth flora but I am not sure this works. Might be worth trying.

It is vital that your Dad do exercises to prevent trismus (restricted jaw opening) -- my husband got a TheraBite system and his insurance paid for it as it was prescribed by his ENT, but there are other exercises which though perhaps not as effective, will help. After the end of treatment, be sure he continues with these as fibrosis and scarring can "sneak up" on one -- also he will need a post-treatment swallowing evaluation (usually involves fluoroscopic barium test done about 6 weeks' out) and this may well result in his being given exercises to improve his ability to sallow, which will be affected by the treatment no matter whether he eats all the way through or not. My husband found these really helped within a few weeks and months, he did them religiously several times a day.

(Check the Oral Cancer Foundation web site -- the actual site, not the Forum) for information on some of these side effects and how to ameliorate them.

Finally, since your Dad has a tonsillar/base of tongue SCC, he shoud know that the majority of these appear to be due to human papilloma virus and he should be tested for this. If he is HPV+, it will mean something re his response to treatment (better) and chance of recurrence (far less). In the future it may also mean he could be a candidate for some of the therapeutic vaccines in trial (to ensure that the virus is truly gone from his system), so important to know this even though it will not make a difference in his initial treatment.

Gail