Effects of Head and Neck Radiation in the Elderly
David I. Rosenthal, MD, Director for Head and Neck Radiation Oncology at the Abramson Cancer Center of the University of Pennsylvania, responds:
It is a tough decision to make. There are never any guarantees about survival with any cancer treatment. After head and neck surgery for squamous cancer, we know certain tumor and pathology findings suggest a higher than desired risk for relapse. The consequences of relapse are often devastating, life-threatening or can be fatal. In certain circumstances, postoperative radiation can be used to substantially reduce the risks for the tumor coming back at the original site and surrounding the lymph nodes.
The trade off is a price in terms of acute and chronic toxicities and side effects, including xerostomia (dry mouth). There are some drugs that can be used to help prevent xerostomia. Amifostine (a radiation protector) may reduce the chances of developing this problem. If dry mouth develops, a medication called Salagen may help some patients increase salivation. These medications can help some people with this problem, but you need to ask his physician if he is a candidate for these treatments. As with any medication, there can be specific contraindications in any individual case.