Aloha, sportsfans:

In October, 2005 I was diagnosed with a malignant tumor in my tongue. In November, 2005, I had surgery where the tumor and 2 lymph nodes were removed. In December, 2005 I underwent the concurrent radiation/chemo therapy. I did have some difficulties during the therapy, but I did complete 30 sessions of the combination therapy at the end of January, 2006.

This is my concern now: I have had problems swallowing since mid-January where I have resorted to spitting in a cup, since if I try to swallow, I end up choking and coughing up residue of both saliva and phlegm. I was told by my radiologist that it would take about 4-6 weeks for me to recover, but it has been over 6 weeks and I am still not able to swallow and still spittin in a cup, as well as sleeping upright in a recliner.

Has anyone else either gone through this or going throught this now? and if so, your thoughts or experience. I guess I am like everyone else that has gone through this, where I have been feeding myself with the PEG since December 25th (thus driving the stock price of Ensure up faster than the price of gasoline in California), and a nagging fear that this condition I am in may become permanent, even though I have been assured by all concerned that I will recover. All my radiologist has told me is that it will take time.

Just looking for thoughts/advice. Thanks.

What you are describing is dysphagia. It effect people in a wide variety of degrees and for very different amounts of time... even forever. My recommendation is to see if the facility you are being treated at has a speech/swallowing therapist that you can see. There are techniques that you can learn to make this easier. How long it lasts, or to what degree, that therapy and time will tell.

I second what Brian said -- this condition may well NOT improve on its own. In fact, it can get worse. Swallowing is a complex operation. The radiation itself can damage nerves and muscles, as well as cause scarring and fibrosis in the throat and tongue. Disuse during treatment (were you advised to continue to swallow *something* throughout?) can also lead to atrophy, much as your arm would look after 6 weeks in a cast.

You are really at the point where a swallowing evaluation by a speech/ swallowing therapist should be done.This test is usually given after the immediate inflammation and rawness is healed -- about 6-8 weeks after end of treatment.

The test involves a fluoroscopic exam while you swallow (or attempt to swallow) various substances, e.g. thick liquid, puree, etc. The doctor can then determine how well everything is working and if you are aspirating any material -- which can lead to pneumonia. He/she will then prescribe a series of exercises to strengthen and restore muscle function. Sometimes, rarely, scar tissue has to be removed.

My husband's therapist cautioned that swallowing probems can get worse, not better, over time unless identified and treated up front. This is due to progressive scarring and damage to nerve and blood supply. His ENT said the same thing, and she speaks from experience having had HNC radiation herself. Both said that these exercises may have to be continued indefinitely to maintain function.

Ask your doctors for a referral for a swallowing test and possible therapy -- it should be an integral part of your HNC treatment.

Gail

Gail is right. I had the same problems you are having at 8 weeks out and, seven months later, I *still* am having these problems. Probably, in part, because I was not diagnosed as having a swallowing problem as early as I could have been (I thought I was swallowing OK because I was able to take small sips of liquid and that the phlegm problem was separate--but really I was having problems swallowing the phlegm and that could have been diagnosed earlier than it was with a swallowing test).

The earlier a problem like this is attended to, the better chance you have of regaining your swallowing ability. I was way too willing to accept "give it time, it will get better" without further attention from my RO, when I should have raised more of a fuss.

Nelie