Radiation side effects with H&N cancer. When will they ever end?

After receiving a full course of radiotherapy for squamous cell carcinoma to the left tonsil area, lingering side effects had to be faced. My very professional oncologist said I should snap back in a month or three however I was his first for an upper throat radiation. Aside from the normal expected side effects during and shortly after radiotherapy, some side effects can last for years.

Head and neck radiotherapy is unique in the fact that vital life areas are being attacked with radiation. The mouth, sinus, gums, salivary system, esophagus, airways, swallowing, vocal chords are all effected. It isn’t like we can stop breathing or swallowing to allow us time to heal. Other areas are usually less complicated.

Because the recovery years are hopefully behind me, I thought I would share with anyone interested and dealing with side effects and assure you that with time things usually get better. I will begin with four side effects and add a few over the next few weeks. This is not to say it is a complete list or that you have or may expect any or all of these side effects. We are all different in our treatments and recoveries.

Don’t be alarmed. I am in my sixties now, in very good health, and enjoying life.

1) Dry mouth. Probably the most common and bothersome. I keep water with me always and at my bedside. Mints help as well. This has improved over the last ten years but I wouldn’t win a spitting contest.
2) Nerve issues on the face and neck. Known as “creepy crawlies” or “bugs on the face” the feeling that something is there although that clearly is not the case. Sometimes rubbing the face or drinking cold water helped. This occurred initially several times per day but after a few years it became infrequent and lasted roughly seven years.
3) Nerve shocks on the left arm and shoulder or sometimes just a dull pain of the upper arm. The shocks would startle me and those around me I’ve been told. Lasted about five years.
4) Neck cramps. Some call this “lock jaw” but it is not the actual tetanus disease and only lasts for usually less than a minute. Mine was often initiated by yawning, a sneeze, a cough, and on occasion eating or talking. Rubbing the area helped and indeed it often felt like a cramped muscle in the neck. Unfortunately this stayed with me for roughly fifteen years.

More next week. If you have any questions or comments or wish to add I would welcome that input. Until then please know time heals all wounds as they say.

Interested in more discussions like this? Go to the Head & Neck Cancer Support Group.

@cbarton

My wife had head and neck cancer at 28 , she’s was 52 and still had side effects.
For 24 years she had zero saliva , she just became accustomed to bringing water anywhere she went.
The “lockjaw” was more severe than most. When she got cold, stressed,or made certain movements it would lock up and be like a migraine for the day.
She unfortunately had a recurrence at 52.
The proton therapy was easier than her previous radiation, only sore in a small area.
She was not able to this second go around.
I blame her outcome over Covid. When she knew there was a problem, she couldn’t get a appointment anywhere, by the time she took her out photos and sent them to md Anderson, it was to far along.
Another side effect was spicy things and cold liquids hurt.
If you feel like your concern isn’t being paid attention to by your doctor, go get a second opinion right away. Early detection is critical for a good outcome.

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Sounds like everything I have gone through. Thank God for mayo. No one in my area wanted to help me do to my trismus. Since you can't open your mouth we don't know what to do. 5 years of pain and burning. Teeth falling out or breaking or infections in them. Some day I will have new teeth and be able to eat real foods. I'm sorry you guys are going through all this. My cancer was stage 4 squamous cell carcinoma of the sinus cavity. 30 treatments of radiation. Thank God I'm cancer free but it has been rough. God bless you

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@cbarton

My wife had head and neck cancer at 28 , she’s was 52 and still had side effects.
For 24 years she had zero saliva , she just became accustomed to bringing water anywhere she went.
The “lockjaw” was more severe than most. When she got cold, stressed,or made certain movements it would lock up and be like a migraine for the day.
She unfortunately had a recurrence at 52.
The proton therapy was easier than her previous radiation, only sore in a small area.
She was not able to this second go around.
I blame her outcome over Covid. When she knew there was a problem, she couldn’t get a appointment anywhere, by the time she took her out photos and sent them to md Anderson, it was to far along.
Another side effect was spicy things and cold liquids hurt.
If you feel like your concern isn’t being paid attention to by your doctor, go get a second opinion right away. Early detection is critical for a good outcome.

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I’m so sorry for your loss. Just know it’s not your fault. I had the same issue, but with insurance. A simple tonsil removal turned into weeks of radiation and chemo. It could’ve been so much easier on my body. Still I’m grateful to be alive. My heart aches for you.

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My wife had head and neck cancer at 28 , she’s was 52 and still had side effects.
For 24 years she had zero saliva , she just became accustomed to bringing water anywhere she went.
The “lockjaw” was more severe than most. When she got cold, stressed,or made certain movements it would lock up and be like a migraine for the day.
She unfortunately had a recurrence at 52.
The proton therapy was easier than her previous radiation, only sore in a small area.
She was not able to this second go around.
I blame her outcome over Covid. When she knew there was a problem, she couldn’t get a appointment anywhere, by the time she took her out photos and sent them to md Anderson, it was to far along.
Another side effect was spicy things and cold liquids hurt.
If you feel like your concern isn’t being paid attention to by your doctor, go get a second opinion right away. Early detection is critical for a good outcome.

REPLY
@darcybechtel67

Thanks so much for talking with me. It means alot. 😍😘

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@darcybechtel67, you may also wish to join @hrhwilliam and others in this related discussion:
- Mandible Reconstruction with Fibula Free Flap. Is this an option? https://connect.mayoclinic.org/discussion/mandible-reconstruction-with-fibula-free-flap-is-this-an-option/

I sense your concern, but admire your tenacity in getting answers and experiences from others.

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@stephenrfleury

My wife, and caretaker, and I decided early in the development of my treatment plan, that Mayo was the expert and I certainly wasn't. We decided to assume Mayo and the care team was right and we would follow their lead. Whatever they suggested, we did. For us, it worked out great, given the circumstances.

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Sounds good. I have so many issues with our doctors here. I was my own advocate and made the decision to go there in September so I'm going to keep going. They were amazing. I like to ask questions. Thanks again for your time and help. Happy Thanksgiving to you and your family 🦃😅🥧

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@darcybechtel67

Did you second guess yourself asking if you were doing the right thing? We're you scared or overwhelmed? I'm 56 years old maybe I'm overthinking. I'm in good hands right? Scared

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My wife, and caretaker, and I decided early in the development of my treatment plan, that Mayo was the expert and I certainly wasn't. We decided to assume Mayo and the care team was right and we would follow their lead. Whatever they suggested, we did. For us, it worked out great, given the circumstances.

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@hrhwilliam

I did what had to be done on the recommendation of doctors who knew more about the situation than I did. It took a few months to decide and schedule after the initial consult.
Scared? There would have to be something wrong with a person if they weren’t scared. But I give worry to God. I can only do my part and the rest is up to him. Lesson learned from military service. Concern is one thing but worry won’t change an outcome.
Rough road ahead but no regrets now looking back. I’m physically normal again after years of struggle.
Good luck to you on this adventure.

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Thanks so much for talking with me. It means alot. 😍😘

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@darcybechtel67

Did you second guess yourself asking if you were doing the right thing? We're you scared or overwhelmed? I'm 56 years old maybe I'm overthinking. I'm in good hands right? Scared

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I did what had to be done on the recommendation of doctors who knew more about the situation than I did. It took a few months to decide and schedule after the initial consult.
Scared? There would have to be something wrong with a person if they weren’t scared. But I give worry to God. I can only do my part and the rest is up to him. Lesson learned from military service. Concern is one thing but worry won’t change an outcome.
Rough road ahead but no regrets now looking back. I’m physically normal again after years of struggle.
Good luck to you on this adventure.

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@darcybechtel67

Thanks 🙏 I'll keep you posted if you want 😍😍😍😍

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Did you second guess yourself asking if you were doing the right thing? We're you scared or overwhelmed? I'm 56 years old maybe I'm overthinking. I'm in good hands right? Scared

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@hrhwilliam

Oh don’t give it a second thought. You are not bugging me. I have other things going on this week and have been traveling so I don’t always get back with a response right away.
Don’t dwell on your teeth issue too much. Mayo dental will be involved with the mandible resection and can help you determine the best path forward, which may include dentures or partials. You can’t build a strong house without a good foundation.
They will or should ask if you are alone at pre surgery as there is help for you if needed. Going home from hospital you will need help and that will be roughly five days post surgery, perhaps a day or two more. If you don’t have assistance then I believe they make other arrangements for you such as a transfer to a rehabilitation or nursing facility temporarily until you are walking well and done with the feeding tube. They can certainly answer any questions pre surgery so take notes and explain your situation.
For me I had several return trips over several months. About six months of healing before my teeth prosthetic was started, which was also a few appointments as well. None of this is fixed in a week or even a month. Just take it one step at a time.

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Thanks 🙏 I'll keep you posted if you want 😍😍😍😍

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