Update: one week on following 30x radiotherapy fractions.

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The Context: HPV+ SCC of tonsil. TORS to remove tumour plus neck dissection in October followed by (PATHOS allocated) chemoradiotherapy - 65 Gy over 30 fractions plus 5x weekly chemo. Treatment ended Saturday 2 January.


Well, I thought I’d got off reasonably lightly after ringing that bell last weekend. I was in some pain around the site of the op, as well as some nasty radiation burns to my neck, but was still eating quite well and had little fatigue or nausea. Then on Saturday afternoon/evening, the same day my treatment ended, things started to get worse.

The pain is on and around the site of the tonsillectomy and adjoining tongue, and it’s pretty raw to say the least. I get some respite if I don’t talk, yawn or eat, and generally keep it still but that’s tricky!  I’ve decided to move onto to much softer food, as I think even things like porridge seem to exacerbate it. I’m going to try to live off very runny Ready Brek and bland soups over the coming week in an attempt to help it to start healing over. Of course, I’m well aware that the RT may well still be working, but at least I’m 1 week through that possible scenario, however long it may last, (my hospital,leaflet said 7-10 days on average). 

I ran out of Oramorph on the Sunday. (Bad planning or what!) On Monday my gp prescribed some slow release morphine tablets and I’ve managed the past week with those plus a cocktail of paracetamol, ibuprofen, Difflam, Oxetacaine and my own bicarbonate of soda and salt water mouth wash. As expected I had bad constipation after I started the morphine, so I now take 4 sachets of Movicol daily too. 

The good news is that the radiation burns have healed up quite quickly using a product called Flaminal Hydro. I’m now just moisturising with Diprobase. The external neck pain has gone, I can turn my head properly and so am able to drive again. Just in time for lockdown! 

So that’s me one week after finishing RT. Still in pain but eating and drinking and feeling OK in myself.  I’m still managing to take an hour’s walk each day, which helps enormously. 

Wishing everyone else on, or about to begin this, worrisome journey the very best. 

  • (my hospital,leaflet said 7-10 days on average).

    Struth! Why do they do that?

    I don’t think you can expect much respite for at least three weeks  By 6 weeks you should be feeling more yourself. Most people I’ve talked to say 12 weeks is around when they have turned a corner  

    Mark so glad to hear you’re coping. Yes stick to soft foods, even maybe adding some Ensures or Fortisips. 
    Keep going with the oral care and you’ll get there. 
    You’re a great advert for positive thinking and taking your recovery into your own hands. 
    Well done, you! 

    Dani 

    Base of tongue cancer. T2N0M0 6 weeks Radiotherapy finished January 2019

    I BLOGGED MY TREATMENT 

    Macmillan Support Line -  0808 808 00 00 7 days a week between 8am-8pm

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  • Well done Mark, sounds like you’re doing all the right things. I think in these early days it’s very much a matter of whatever gets you through. And every day that passes is a day closer to recovery. Keep it up!

  • Hi Mark

    I too used the same pain killers as you and also found porridge a step too far in the early days. Ready Brek and tinned semolina were all I could manage at your stage plus Scandishakes.

    That's great you're getting some exercise in every day. 

    Linda x

    • Hi Mark it’s the one thing I try to get across when I see my oncologist or e n t consultant please don’t go say oh in a week or so things  will be on way to normal  to be honest 7-10 days would be a miracle in my opinion. I’ve been  in touch with lots in the last 30 months and to be honest it’s rare . I had a feeding tube n g and for me it was 3 weeks I had tube out then I  tried food. This was supplemented by ensures s for many many weeks. Keep doing your walk it will help immensely with radiation fatigue as well as boosting your spirits. Like Dani says  you are doing really well just keep the hydration and nutrition up. There light at the end of the tunnel 
    • Positive mental attitude got me through this phase. Along with flights I had booked on diagnosis day to Spain 8 weeks after treatment spurred me on ! Was hard but I had something to aim at. 
      Hazel xx

    Hazel aka RadioactiveRaz 

    My blog is www.radioactiveraz.wordpress.com  HPV 16+ tonsil cancer Now  6 years  post treatment. 35 radiotherapy 2 chemo T2N2NM.Happily getting on with living always happy to help

    2 videos I’ve been involved with raising awareness of HNC and HPV cancers 

    https://www.instagram.com/merckhealthcare/reel/DBs8Y0niJ8N/

  • MarkEL Well done You. I am starting to get grief now using a variety of things from the antacid one which you swallow and then can eat which helps . Tired the morphine and that helps also, Regrading constipation I  take 3 laxido a day which gets things moving but very slowly.  I am using the bicarb and salt mouthwash which I try and take a few times a day. I have stopped doing my 3 mile walk as just didn't feel up to it. Hopefully that will improve but just feel like literally doing nothing all day bar resting and nodding off. All the best for Next Week Regards Min 

  • Oh, well done Min. It sounds like you’re coping ok. It know they say that RT affects everyone differently, which isn’t always helpful, but there do at least seem to be some common threads. Certainly the constipation seems to happen to most people who take the morphine. (For me it’s been the most unpleasant part of the whole process, and that’s saying something!) And I’ve never been able to totally eradicate the pain while eating, but can lessen it enough to eat without yelping! 
    As for the walking, don’t worry about feeling tired. You must listen to your body and it’s telling you to rest. So rest.
    Try to keep swilling with the mouth wash. I got lazy for a bit and ended up with a couple of nasty ulcers on my tongue.
    As I said above, my food is pretty much all liquid now. Ready Brek (made with half Fortisip and half milk) and soups, all with extra cream for the calories. However, I’ve also found that vanilla ice cream and thick double cream quite good to eat. It slides down nicely and soothes at the same time. I just wish I could taste it! 
    All the best for the coming week. Week 4 I think?

    M

  • Hi M yes week 4 and Monday  is the big day . They have managed to get me right on the side of mouth  with the Rt which might be a ouch problem but all good in general and just a matter of getting anything in and keeping it down. Hope you are coping as best as possible . Was thinking smoke salmon chopped and scrambled eggs . Anything I start I finish so far lol All the Best Regards Min

  • Thanks for the update, it sounds like you are doing brilliant, glad the radiation burn has healed up.

    Well done on the exercise too. Oh and as far as feeling better is concerned, i was over the worst of it by about 5-6 weeks (pain)

    and started to eat normally again by about 12 weeks-- so its incredibly early days- 1 week on is as bad as it gets.

    Trev

  • Hi Min. Hi Trev.

    Min, I had scrambled eggs with smoked salmon a couple of weeks ago. It smelt lovely but tasted of nothing. It went down very easily though! I now have a long list of things I’m going to eat just as soon as (hopefully) my taste comes back and I can swallow properly, that being one of them. However, I’ll start with a Whopper meal from the Burger King we used to drive past every day after radiotherapy!
    Thanks for your words of encouragement Trev. When you say ‘1 week on is as bad as gets’ do you mean that you peaked about one week after RT ended and then gradually improved?
    It does still feel like incredibly early days from reading others’ posts in here, but I’m trying to stay philosophical about it. Each day gone is a another day towards feeling ‘normal’ again.