Hi victor,
My husband had a big surgery after radiation. The initial plan for him was just IMRT to the tonsil, but one month after completing that, his PET lit up in that area with obvious residual tumor. So he had surgery including neck dissection and resection of the tumor with a forearm free flap as many of the posters here have had and described. There was worry that the radiated tissues would be slow to heal, but Mike actually healed fairly quickly and had a great cosmetic result from the surgery. Of note, he did not have a PEG tube. He had not had one with radiation because he didn't have concurrent chemo (and was 40 pounds overweight). With his surgery they put in a nasogastric feeding tube, but he had that removed after one week since he was able to swallow a little bit. Swallowing and eating were certainly no fun, and he lived on Boost/Ensure for the first few weeks following surgery, but doing it this way worked well for Mike and helped him maintain his ability to swallow. Now 18+ months out from surgery he still has some trouble with certain foods (any meat that isn't super tender, large pieces of lettuce, etc.), but can eat and drink pretty much anything he wants. He still complains about the taste of certain foods, especially sweets, but laughs that that doesn't seem to stop him from eating them! All in all his graft has healed well (both inside his mouth and on the forearm)and he is thankful that the docs were able to get in there and remove the cancer since the radiation hadn't completely done the trick.

Best of luck to you, Victor. There are lots of people here who will be able to give you advice and support.