Loss of swallowing function is unfortunately very common post-treatment and is why many oncologists get on patients' cases to try and swallow *something* (even if only sips of water) all the way through. If your husband can manage to do this then he may not lose function completely, but it is sure to be compromised.
By now your husband should have been referred to a speech/swallowing therapist for a barium swallow evaluation to determine where his problems lie. Even if he had eaten food all the way through, like my husband did, there will be inevitable damage to the muscles, tendons and nerves which support the very complex swallowing reflex. INSIST that your husband get such a test, which involves a fluoroscopic analysis of his swallowing (or lack of it) when challenged with a thin liquid, thick liquid, puree and solid. They will also analyse any speech problems which may have developed.
The therapist will then design a series of exercises to strengthen the muscles of the tongue and pharynx, etc., which hopefully will (over time) help restore more-or-less normal function. My husband did these for months, and saw a lot of improvement.
The pain issue is more complex. The reaction to the fentanyl (vivid dreams, hallucinations) does occur and in some people, they find they cannot adjust. My husband had problems for about a week but not severe as some, who cannot take the drug.
The neuraligia issue is worth exploring, I myself had a severe facial neuralgia about 10 years ago from what we eventually discovered was a deep infection below a tooth, but everyone initially thought was something far more serious! It responded to a low dose of an anti-seizure drug which allowed the inflamed nerves to recover, and "broke the pattern" of pain.
Finally, some centers (eg. Hopkins) are using acupuncture for pain of cancer patients that will not respond to the usual drugs, so this could also be explored. Even if your hospital doesn't do it, there may be a center near you.
I should add that if your husband was a non-smoker, and had a BOT cancer, there is a high probability it was due to human papilloma virus which is a biologically different cancer with a better response to treatment and much reduced risk of recurrence. If your center did not test him for this (with a DNA PCR test) then you should explore having a samples ent to Johns Hopkins for analysis. Cancer treatment centers should ALL be testing for this now as it affects prognosis, follow-up and any comparison of efficacy of various treatment plans. There are also rumblings that preferred treatment as well should be different, although it is not at this time.
Gail
