New Symptoms after Radiotherapy completion

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Hi

Been a browser for a while, but not posted previously.

I was diagnosed with HPV+ SCC of oropharynx in July 2023. I underwent surgery and neck dissection in August, which was the only planned treatment.  No nodes were visible on MRI or CT scan.  Unfortunately, surgery revealed 2 positive nodes, which then required 6 weeks of radiotherapy.  This started at the beginning of October 2023.  Treatment ended on 17th November just in time to get recovered for Christmas!

Initially, I felt that I had coped well with the treatments, radiotherapy side effects were not as horrendous as I had imagined, and indeed, I seemed to fare far better than others I met during treatment.  Fatigue/tiredness was the main complaint and eating become easier as time went on.  I even managed a tiny Christmas dinner!  Taste changes were an issue but did gradually improve to some extent.

However, over the last 3/4 weeks, I have experienced a sore throat and difficult in swallowing again, dry mouth and thicker saliva.  As you can imagine, my mind went into overdrive and my appetite once again plummeted, not helped by the pain of swallowing even liquids.  I contacted my CNS who arranged for me to be seen the next day for examination and reassurance.  This check was all clear, and advise was given on using mouthwash (Difflam) and paracetamol for pain control.  The issues were apparently related to later onset radiotherapy side effects.

I am still still struggling with this soreness and pain, my eating has reduced drastically again, and having already lost 3 stones, I can't afford to lose much more before I being to look anorexic.  

Not really sure what I'm asking for here, but just thought I'd reach out and see if anyone else has experienced this after treatment had ended and you felt that you were on the way to recovery?  Just feels like I've taken a backward step.  I'm returning to work in just over a week and need to be able to sustain myself somehow.  I do have a PEG fitted, and copious amounts of Complan and Fortisip, but would really like a solution to the pain/discomfort and inability to eat/drink anything comfortably.

Any advise would be gratefully received.

Jane

T2N1M0 Right Tonsil HPV+ Diagnosed July 2023

Surgery August 2023

Radiotherapy completed November 2023

  • However, over the last 3/4 weeks, I have experienced a sore throat and difficult in swallowing again, dry mouth and thicker saliva. 

    Hi. This is the dreaded mucous and thick saliva. It’s par for the course so soon after radiotherapy has finished. It’s because the water fraction of the saliva has been trashed and only mucous is produced.  You are still very early in your recovery. 
    The following things can help. Drink lots. Use a nebuliser several times in the day to loosen the thick secretions. Keep a humidifier by the bed. Some people are helped by a drug called carbocysteine which thins the mucous down. 
    It will go but takes its time. Mine lasted for a good couple of months during which time I spat a lot. There are tales here of having to pull strands of it out with fingers….. nice! 
    Just patience. All this is normal. 

    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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  • Hi Jane.  I am just wondering if it is related to changing your toothpaste or mouthwash?   I am over 2 years post now and used Flouriguard mouthwash yesterday and it made the back of my throat so sore!!!!   Just like at the start.  I can’t really use mouthwashes and I still mainly use Oranurse toothpaste as everything else makes my mouth sore again.   Just wonder if that helps?  Well done on finishing treatment.  I took a long time to eat without pain and I stuck to things that didn’t make my throat hurt for months!  I didn’t loose any weight as I ate lots of double cream and avocados (not together!).  All the best.  Lizzie x

  • Hi Jane The dreaded mucus , it is early in yiur recovery some get the mucus during treatment some like yiu it pops along just when yiu don’t expect it. We often say our cancers are one if those that can keep on giving. I had a nebuliser which I used up to 6 times a day I also had a humidifier in the bedroom at night to help. But I was also one who had to pull the mucus out with my fingers when I couldn’t spit it. Keep on top of water aim for 3 liters each  and every day ,plus calorie wise 2500-3000 every day. My mucus went after around 3 months but the calorie and water intake I kept up for 15 month before weight started to come back We loose a lot of muscle mass so protein if vital.
    . It’s a marathon not  a sprint is what I often say. 
    Some days it’s 2 steps forward and 1 step back. 
    Hope  this helps 

    Hazel 

    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/

  • Hi all. And thank you for your supportive replies.  I have taken all your advise on board.  The comment about mouthwash may be correct as I haven't used it today and the soreness seems a little better.

    Unfortunately, I have no teeth left so it can't be toothpaste Smile I have had my dentures adjusted this week and await the start of some new ones from the end of March.  This should make chewing a little easier 

    I don't think I'm at the pint of a nebuliser just yet, but get what you mean about the need to spit frequently! I'll certainly consider getting a dehumidifier though.

    Thanks for your support x

  • dehumidifier

    No. A humidifier 

    you need something to moisten the air. 

    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

    Community Champion badge
  • Hi it’s s humidifier yiu need the room moist. 

    Hazel 

    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/

  • Hello Jane, thank you for sharing your experience and I think you did and still are doing remarkably well with your recovery. I had the same cancer HPV related, 7 weeks of radiotherapy and chemo therapy. I didn’t cope as well as you, I was very sick throughout which was never managed despite the efforts and copious amount of different meds I was given. My treatment finished on the 26th August 2022. I think I felt the need to talk as it seems to be an ongoing recovery so I hope my experience might help. I got my taste back around 8 months , my weight loss was 3 stone and remains the same. I seem to have long periods of normality (whatever that means) but then it’s a few steps back again when I have a sore throat, sore neck, dry mouth and a struggle to eat plus the panic of a recurrence, and was tonight reassured to hear from Hazel that at 15 months that weight improves. It’s very early days for you but it’s just steps forward and steps back it seems for a few years, I enjoy the respite and am getting used to the set backs. It will get better and easier with time. Take care .Debbie x

  • Hi Debbie. Yes up to 15 months it was Cream cake snd cream then gradually 2lb went on then another. Do the goodies had  to stop Octagonal sign     If I had a few bad eating days the weight would drop again  it seems our metabolism changes. Now at 5 yesrs I maintain weight snd eat normally as I did before except spicy food. 
    Hugs Hazel 

    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/

  • Hi Hazel, I remember asking your advice back in 2022 and 2023! Life moves on so quickly! It’s reassuring to know the weight creeps up again, I sometimes dip still at 16 months post treatment , eat fine and then lose my appetite I guess it’s part of the journey. So much emphasis was on keeping your weight on it creates another issue. It does get better although I think the psychological scars get overlooked and that’s something I’d like to see get more input, what do you think? Debbie x

  • Hi, some lovely reassuring replies here and it's great to share others experiences. I think you're all probably right that I am trying to run before I can walk, but then that's the way I am I'm afraid. Never had any patience! I think the constant advice to not lose weight and maintain nutrition puts pressure on you to get back to eating quickly. I was 3 stone overweight before this started, so ironically, I'm now at an ideal BMI apparently!   Every cloud as they say! 

    I think it's the frustration and niggling in the back of your mind that gets you down. Here's hoping I can manage my return to work as I really need the distraction and mental activity now 

    Keep well all!

    Jane