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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18654
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My brother has cancer of the tongue. He had 18 hours surgery

Resolved Question:

My brother has cancer of the tongue. He had 18 hours surgery to remove partial tongue
and replace with thigh muscle. His lymph nodes on his neck was cleared. After a month he went for chemotherapy and radiation therapy for 6 weeks. He completed his chemotherapy
and radiation therapy. He complained of tightness of his throat and difficulty to cough out
the phlegm. He told me that as the days go by, the neck tightness became worse and he regretted going for radiation therapy. Is there any treatment for this kind of condition? I'm
a nursing officer and I feel so helpless as I do not know how to help him. He has complained
this problem to his ENT doctor and his surgeon but no remedy was given to him. Could you please advise me what I can help him. Thank you very much.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
It will help if you could provide some further information:
Is the neck tightness affecting the ability to swallow or speak?
If it is affecting his ability to swallow, does it affect solids or liquids (or both)?
Does it affect the range of motion of the neck?

Customer: replied 3 years ago.

He speaks with a slur. He has PEG tube for his feeding. He can't swallow solids or liquid, only saliva. When he speaks or move his neck, he felt the tightness of the neck.

Expert:  Dr. D. Love replied 3 years ago.
Are they expecting that he will regain the ability to swallow?
Does the throat tightness cause any shortness of breath?

Customer: replied 3 years ago.

His Doctor did not inform him about his ability to swallow later on. The throat tightness gets him to cough out phlegm quite often. When he has difficulty coughing out the phlegm he will experience shortness of breath.

Expert:  Dr. D. Love replied 3 years ago.
Thank you for the additional information.

There are several issues to consider in this situation.

Throat tightness is one of the possible complications of radiation therapy because of inflammation that is caused by the radiation. There is no direct treatment of the problem, although it may improve spontaneously.

However, there are several option to consider to ease the symptoms associated with the problem. It may help to ease inflammation or discomfort associated with the problem by using an anti-inflammatory medicine, either orally or by gargling with aspirin. Since he is unable to swallow, gargling may also be an issue, but his doctor can say whether he can try to gargle. Gargling with warm salt water also may be soothing. It also may help to use a medicine to help the body clear the phlegm, such as guaifenesin. If he were swallowing, it would be common to consult with a Speech Therapist, as these also assess the swallowing function, but this is less of an issue since he is not swallowing.

If the tightness is more severe and there is a small passage through the area, then it may be necessary to consider a dilation of the area. A tight passage is usually more of a problem with swallowing than with breathing, as the tightness needs to be greater to affect breathing, but a tight passage that affects either function may need dilation. Since he is not swallowing, the issue would be whether it is causing any shortness of breath, and primarily shortness of breath that is not associated with coughing.

If you need any clarification, please let me know.

Dr. D. Love and 3 other Medical Specialists are ready to help you
Customer: replied 3 years ago.

My brother was given tab.Fluimucil 600mg for his phlegm. He was also given some solutions for him to gargle. He still has fungal infection on his mouth and given Nystatin cream to apply. He had been assessed by the Speech Therapist and found not ready to take orally. Could you please elaborate more on Dilation of the area and by whom when his condition warrants such treatment.

Expert:  Dr. D. Love replied 3 years ago.
Dilation is most often done by using a balloon instrument that is passed through the tight area deflated and then inflated to stretch open the tight area. The is something that would be done by the ENT physician if it were necessary.