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Radiation Side Effects- Xerostomia, Mucositis, etc.

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Caught between a rock and a hard place. Radiation side effects result from therapy that may be curative or simply buy you more time. What is the head and neck cancer (H&N) survivor to do?

Anticipate, Identify, Heal. Let me explain. 

Gone are the days when the newly diagnosed cancer patient could simply turn over all the decision-making to his/her oncologist. Oncologists are knowledgeable but they do not know your priorities and your goals. You should know more about possible side effects that your oncologist does because you know your goals, lifestyle, etc.


If you are a newly diagnosed head and neck cancer patient, you should anticipate that you will develop the short, long-term and late stage side effects discussed below. I am not a H&N survivor and I developed

  • mucositis
  • radiation dermatitis 
  • xerostomia and
  • dysphagia

Chemotherapy and radiation are double-edged swords. Assume that you will develop these basic adverse events. Most H&N survivors do.


While walking down the street one day a filling in one of my teeth popped out. It took me several months to figure out what was happening to my mouth but long-story short, I had developed Xerostomia. The enamel on my teeth was eroding and a filling came out. If you understand, if you learn about this common side effect of radiation therapy to the neck, jaw region, you will not be caught off guard like I was.


If you develop any of the common radiation-induced side effect of radiation therapy for H&N survivors, you can undergo therapies shown to slow or even heal them.

I do daily exercises to keep my swallowing muscles in shape. My salivary glands are back working well. The whiskers that fell out from the radiation to my neck have never re-grown but I don’t wear a beard so I’m okay with that.

I’ve spent years researching and writing about short, long-term and late stage side effects. I’ve learning two glaring facts that the cancer survivor needs to understand.

  1. Conventional oncology does not take the time nor spend the money necessary to research short, long-term and late stage side effects. We are on our own in this regard. 
  2. Most therapies shown to manage side effects are evidence-based but non-conventional meaning not approved by the FDA.

My point, again, is to stress that cancer patients and survivors are on their own when I comes to managing their short, long-term and late stage side effects. And, in fact, this is the way it should be. We know ourselves better than our oncologists do.

If you would like to learn more about short, long-term and late stage side effects scroll down the page, post a question or a comment and I will reply to you ASAP.

Hang in there,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Head and Neck Cancer is a complicate cancer with long-term side effects

Radiation Therapy Adverse Effect Management Requires Long-term Monitoring

“Effective treatment strategies established for patients with head and neck cancers often include definitive radiation therapy for primary tumors. However, short- and long-term adverse effects (AEs) associated with these treatments necessitate a comprehensive understanding of the evidence-based management strategies for managing these events…

The cancers grouped in this classification most often include those originating from the squamous cells lining mucosal surfaces of the head and neck. “These can include the oral cavity, the nasal pharynx, hypopharynx, larynx, the paranasal sinuses, or nasal cavity, salivary glands and the thyroid,” Marenyi said. “Head and neck cancers account for nearly 4% of all cancers in the United States.”2…

Management of Short-term AEs

Starting at approximately 3 weeks into treatment, short-term effects, including in-filed alopecia, dysgeusia and xerostomia, and radiation dermatitis may begin to develop.1,3…

Radiation dermatitis has prognostic factors including age, body-mass index, and any additional systemic therapies the patient may be receiving. The toxicity is also dose-dependent and is most likely to occur in the anterior neck region….

Management of Long-term AEs

“Acute AEs can be top of mind for patients as they prepare for treatment, [however] it’s really important that they’re also educated on some of these longer-term late onset AEs,” Marenyi said.

These AEs include parotitis, dental caries, osteoradionecrosis, trismus, pharyngoesophageal stenosis, hypothyroidism, lymphedema, cognitive problems, brachial plexopathy, ototoxicity, radiation retinopathy, secondary cancers, anxiety, and depression.1…


Efficacy of mesenchymal stem cell therapy in rodent models of radiation-induced xerostomia and oral mucositis: a systematic review

“Background- Radiation-induced xerostomia and oral mucositis are serious complications of radiation therapy for head and neck cancers. Current treatment options have limited efficacy. Mesenchymal stem cell (MSC) therapy has shown promising results in supporting the restoration of glandular secretion function and the regeneration of damaged tissues…

This is the first systematic evaluation of the efficacy and safety of MSCs in radiation-induced oral complications. The results showed that MSCs exhibited good therapeutic efficacy in radiation-induced xerostomia and some improvement in radiation oral mucositis, despite differences in MSC source and graft type, the timing of administration, route of administration, dose, receptor type, and multiple models…

Results– A total of 12 studies were included in this systematic review. The study found that in animal models of radiation-induced xerostomia, MSCs could increase salivary protein secretion, improve SFR, shorten the salivary lag time, anti-apoptosis, etc. In animal models of radiation-induced oral mucositis, MSCs improve the micromorphology and macromorphology of RIOM. Moreover, the effect of MSCs on the modification of ulcer duration and latency may be related to the time of MSCs transplantation but further studies are needed.

Conclusion-In this review, we comprehensively evaluated the efficacy and safety of MSCs for the treatment of radiation-induced xerostomia and oral mucositis based on available preclinical animal studies. Our study demonstrates that MSCs are effective in ameliorating radiation-induced xerostomia, and our study also suggests that MSCs may provide some minor therapeutic benefits for radiation-induced oral mucositis. In the future, we expect more researchers to carry out further evaluations of the effectiveness and safety of MSCs in improving radiation-induced xerostomia and oral mucositis to promote faster and better development of the stem cell field.”


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