Fall 2001 - The Radiation
Radiation simulation came two weeks after meeting with our new radiation oncologist. The simulation process was longer than we thought, about 45 minutes, but easier than others had reported. This was mainly due to the materials used to make the mask -- an open netlike substance that ended up resembling a fencing mask.
A couple of days after radiation, Mike picked up his new prosthetic device (he had been wearing the base since shortly after surgery). What a treat! Not only did his voice return to about 95% of its former quality, fluids no longer reflux up his nose. He is now eating almost anything.
Radiation, scheduled for 30 treatments or 5 times a week for 6 weeks, started on September 11th. The first week was really rough, mostly due to Mike fracturing a rib ov er the weekend. Talk about bad luck! His saliva got thicker already, nothing tastes good and he is more fatigued.
Week two is now in progress. His biggest problems are all oral related. Eating has become a real chore and is rarely done. The feeding tube is his main source of nutrition -- we're so glad the surgeon opted to have this placed. His weight has held -- for now. He doesn't drink anything except water and cola, coffee is totally out. Smells have become a real problem for him, whether food or other, they often make him nauseous. His fatigue is better, mostly due to the rib healing fairly quickly. Dry mouth, thick saliva, foul tastes, no appetite -- and they promise it will get much worse.
Through weeks three-five, side effects worsened. Drinking is non-existent, although he has been warned that this could lead to scarring in his esophagus. New pain medication, Durogesic patch, brought on drastic vomiting and the addition of another prescription, Zofran ($32/pill taken 3 x day) to help that. The phlegm in his mouth has gotten very, very thick. He rinses his mouth often with the baking soda, salt and water solution. It seems to cut the mucous down and cleanses his mouth.
His skin is getting harder on the surgical side and redder on both sides. Under his neck has gotten quite raw, regardless of how much Radia-Care gel is used so they have given him a heavier cream to apply there.
The final six treatments of photon beam radiation has supplemented with electron beam radiation to the sides/back of his neck. This is to ensure there are no stray cancer cells around the area where the spinal accessory nerve was (remember, that nerve was removed during the radical neck dissection).
The mask is not used during these sessions so a green paint was used on both sides of his neck to lay out the treatment field area. The mouthpiece is still used, to help protect his tongue from the radiation beam. He gets "zapped" from both sides, but one side at a time.
As we roll into the last week of treatment, fatigue, extremes of feeling hot or cold, and a general sense of malaise have added to the dry mouth, skin irritations and sore throat. We have been told that the symptoms will grow during the week or two following the last treatment.
The radiation oncologist expects most symptoms to improve over the next couple of months except for the dry mouth. That will remain a permanent problem since the major salivary glands on both sides of his mouth have been "killed". Over time his taste and appetite will return, but the feeding tube will stay until he has not used it for at least a week.