My husband was treated with radiation therapy for nasopharyngeal cancer. He had 39 radiation treatments. The treatments ended four months ago. Since that time his oral secretions are diminished and we have no reason to expect that will change. Consequently he is have a very difficult time eating. Do you have any suggestions on how to alleviate this problem? I have tried to encourage small, frequent meals, sips of water with every bite of food, etc. He also is experiencing soreness when chewing.

B.S.

One of the truly nasty side effects of radiation to this area is fibrosis (scarring) of the major salivary glands. Also, there are thousands of tiny salivary glands scattered throughout the mouth, throat and nasal cavities. These "minor salivary glands" are also knocked out by radiation. The result is a chronically dry mouth.

Unfortunately, nasopharyngeal cancers are (with rare exception) not operable. Radiation therapy is the most effective treatment option available. Although the radiation therapy may well have saved his life, he has been left with a difficult problem that will most likely not go away.

Frequent sips of water is perhaps the easiest way to address this problem, but his doctor could also prescribe a saliva substitute. There are several brands of "artificial saliva" on the market. These liquids cling to the mucosa (the tissue lining the mouth and throat), providing the familiar sense of moistness that may be lacking after radiation therapy.

Soreness with chewing may be related to fibrosis of the chewing muscles. Alternatively, your husband may have chronically inflamed mucosa ("radiation mucositis"). I doubt that he has radiation mucositis, as he would have oral pain all of the time, not just with chewing. If his soreness is due to fibrosis of the chewing muscles, physical therapy and anti-inflammatory drugs may be helpful. He should discuss this problem (as well as the dryness problem) with his radiation therapist.