Neck stiffness and lack of saliva after radiation treatments for throat cancer

Kenneth Blank, MD
Last Modified: November 1, 2001

Dear OncoLink "Ask the Experts,"
My dad had throat cancer about three years ago. He went through intensive chemotherapy and radiation treatments. His therapy has left him with no "real" saliva therefore making it almost impossible for him to swallow. He cannot eat or drink anything except for milkshakes and iced tea, no lemon. He has use "fake saliva". He also has a feeding tube. His newest problem is that his neck muscles are turning into scar tissue giving him headaches and neck aches because of the stiffness associated with it. Also, it is painful for him to sleep on the right side of his neck (where the tumor was) and it keeps awake.

So, what I really want to know is how his life can be made less painful. Please, if you have any information on pain relief or making his saliva better, let me know.  
Thank you.

Kenneth Blank, MD, OncoLink Editorial Assistant, responds:

Dear JL:
Unfortunately, your father has experienced quite severe side effects of radiation treatments for cancers of the head and neck. There are two separate issues that you are concerned with: your father's neck pain, and his lack of saliva.

In regard to the first issue, there are many very potent pain relief agents and muscle relaxants that should work to alleviate his discomfort. Aspirin and ibuprofen are powerful over the counter anti-inflammatory agents that are often effective. If not, pain killers in the opoid class of narcotics are often effective. Several companies produce long acting pain killers in either a pill or patch form which are commonly used with very good success in the cancer patient population.

Regarding the second issue, inadequate saliva production is a very difficult problem to manage. However, there are several steps to be taken which can help. The use of a saliva substitute will bathe the oral mucosa and keep it moist. In addition, Salagen is a fairly new medication that has been effective in increasing salivary flow in a majority of patients.

Salagen and opoid narcotics are prescription only and must be taken under the care of a physician. Given the many alternatives now available, no cancer patient should suffer in pain. For more information on pain control, please see OncoLink's Pain Management section.  
Thank You.

Kenneth R. Blank, MD
Editorial Assistant, OncoLink


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