You're going to meet a large number of medical professionals and their jargon can be quite intimidating. Remember, you're the customer and you need to know what they are proposing for your treatment. Also, if you don't like the sounds of a proposed treatment plan, you can always ask for a second opinion. In my case the first oncologist I spoke with said that the treatment plan that he was offering resulted in 55% of patients being cancer free after five years. The second treatment plan--and the one I chose--suggested that 85% of patients would be cancer free at five years. The first plan took 6 weeks of treatment and the one I chose took 6 months. There will be times, you'll find, that you may have to take control of your own destiny...

Clinical Trial-
There are a lot of ways in which head and neck cancer can be treated and new ways are being developed every month. Sometime in the near future we'll be able to take a drug that contains killer molecules or killer drugs that will wipe out a cancer with little or no side effects. But we're not there yet, so you have to choose from the "protocols" currently in place. For each type of head and neck cancer there are "standard" protocols and there are a number of clinical trials that are underway across this country that are looking at new, more effective protocols. 

Clinical trials are broken down into Phase I, Phase II and Phase III studies.

A Phase I study is really in its infancy. Such a study is looking at a brand new protocol or way of treating a given cancer and while it might prove to be wildly successful, there is no proof of its effectiveness.

A Phase II study builds on the minimal results observed in a Phase I study. More subjects go through the study and if it shows promise, the protocol moves on to a Phase III study.

In a Phase III study one group of patients receive the standard treatments recognized for that particular cancer. The test arm of the study gets the treatments being tested in this new protocol. 

In my case I entered a Phase III study and was randomly selected for the test arm. My arm of the study was given three types of chemotherapy which included taxotere, the drug under trial along with cisplatin and 5-fluorouracil. 

Communication Link-
    Your friends and family will want to know how your treatments are coming along at every step of the way. Unless you want to spend your evenings telling the same stories over and over again, I suggest that you set up some form of communication link that reaches out to all of your friends and family on a regular basis. Here are some ideas:

E-Mail- On the advice of my brother-in-law we set up a group e-mail list. Each week my wife wrote an update on my treatment that we sent out to a list that has grown to nearly 120 people. (Click HERE to see a sample of some of those messages.) You'll soon learn that if you miss a week you'll start getting emails from folks concerned that you've taken them off the list. Click HERE to see samples from the emails received back from those who supported me and my wife during this treatment. Their words of encouragement made us smile, built my internal will to fight, and reminded me that I was not alone in my battle. As you get further along in your recovery the frequency at which you send out the updates should grow longer.

Snail Mail- Address and stamp a bunch of envelopes that will go out periodically to all of your friends and family. Throughout your treatment all you'll have to do is write or type your message then copy it and stuff it in those envelopes.

Advanced Prescriptions-
    You're going to come home from some of your treatments feeling pretty bad. You may need pain or anti-nausea medication right away and having to wait in line at the pharmacy can be a real pain...particularly if the pharmacist says, "Oh, I'm sorry, we're out of that but we can get it in for you in a couple of days." 
    So ask your doctor for any prescriptions in advance of any treatments or pain producing tests like a biopsy. Before you begin chemo make sure you have any drugs you might need to treat the side effects. And if you get a porta-cath or PEG tube installed make sure you have the pain medication you might need to help you cope with the after-effects of those procedures.

Rally Your Friends-

Now's the time when you'll discover your true friends. Some of those folks who claim to be your friends will vanish into the woodwork when you tell them that you have cancer. If you need a ride they'll always be busy or if you call they'll cut you off short.     Then there are your real friends. They'll be there whenever you need them. Be it to give you a ride to an appointment, to pick up some groceries, to cook you a meal or to listen and share a few special moments. Some of your friends may have trouble dealing with your disease and not know how to talk with you about it. You might discover that they too had a cancer scare that you didn't know about. Or it could be that members of their family had cancer or died from it and the thought of your cancer strikes fear into their hearts. If you have the energy, reach out to them. You'll quickly learn if they are blowing you off or are just having troubles dealing with your cancer.

Check Your Teeth-

	Before you start any radiation treatments make sure that you get a dental check-up. Your oncologist might forget to tell you about this precautionary step...so ask. You should also ask about taking an antibiotic before and just after seeing your dentist as a prophylactic measure.  Your mouth will get quite sore during your radiation treatments so having any necessary treatments out of the way before you begin can really help. You should also arrange for fluoride treatments during your radiation. Get impressions taken and a pair of trays into which you'll sprits a dose of fluoride each might. Your salivary glands will get blasted during treatment and without them you are more prone to dental decay, so fluoride treatments can really help keep your teeth and gums healthy.

Good Nutrition-
You gotta eat. Good nutrition is more important during and after the next few months than at any other time in your life. At some point you may have mouth sores or nausea and won't feel like eating. However, you need the nutrients to help you fight your disease. You might also benefit from food supplements, but don't take anything unless you check it out with your medical team...there are some  nutrients that could counter the desired effects of your radiation or chemotherapy.

In all probability you will find that you have to modify your diet a bit.  If you have a biopsy you're throat will be sore so you'll probably want to stay away from salsa and other spicy foods. You also want to avoid chips, crackers and other such foods that might knock the scab off of the area where the biopsy was taken--just for a week or so.

During your radiation treatments you'll probably notice a real change in your taste buds. And you'll lose a lot of the saliva that helps you chew dry foods like bread, crackers and rice. So, when you eat a sandwich make sure you keep sipping liquid while you chew. At some point your throat might get so sore that you can't swallow anything. That's when it's a good idea to have a feeding tube already in place. Your physician will proscribe a liquid nutrient that you'll pour into your feeding tube while you sit watching TV. Hey, it's only for a short time and just think of all the pots, pans and dishes that you won't have to wash. 

When you are feeling well, try eating everything that agrees with you. And stay away from foods with acid like salad dressings, orange juice or tomato sauce. 

Speaking of beverages, my first chemo nurse, Sheila, urged me to consumer 14 glasses of liquid each day (a combination of water, juices and tea). I paid attention to her and experienced very little nausea. Of course I spent a lot of time running to the bathroom...but not because I was nauseous. Another thing I did to deal with nausea was to eat. That might sound strange, but putting food in my stomach oftentimes made me feel better. So, it's worth a try. 

During radiation you'll find that swallowing becomes difficult. I found that swallowing water was tougher than swallowing a piece of rare steak. So, I kept eating the steak and took a lot of my water through my feeding tube. By working the muscles in your throat you'll shorten your recovery time. 

Food is really important to me and so my goal was to keep eating throughout all of my treatments. While it may hurt at times, your blood will really benefit from the nutrients and eating real food also gives a great psychological boost. 

During the final weeks of my radiation I found that omelets (stuffed with ham strips and shitake mushrooms), undercooked oatmeal, shrimp scampi, baked chicken thighs, and steak went down more easily that other foods. Pasta and rice, doused with sauce went down OK and most vegetables went down without complaint.  Mashed potatoes were almost impossible to swallow.

The most important thing I learned was to overcome the loss of my taste buds. The goods news is that you won't lose your sense of smell and because smell is an important component of taste I modified recipes to boost their aromatic qualities. Thus the shitake mushroom--rather than plain mushrooms in my omelet--because they are far more aromatic than plain mushrooms. I went through a lot more oregano and basil than I normally would even though I never used any tomato-based sauces. While I can't drink alcoholic beverages I added wine to many sauces to boost the flavor profile. I usually enjoy eating leftovers but fresh cooked will go down better because it's juicier. 

During the end of my radiation treatments the pain in my throat was quite severe. It was hard to eat so I used a prescription gargle that numbed my throat before eating. That helped a bit but I still had little appetite. That's where Marinol a prescription pill that contains the active ingredient in marijuana came in handy. First of all, it helps to minimize the sensation of nausea. Second, it give you the munchies so you want to eat. And third, it is rather relaxing. If you're afraid of addiction let me point out that the other drugs the dogs often proscribe are opiate derivatives that are far more addictive.

Change Your Habits-
You've probably heard already that alcohol and smoking are the major causes of throat and mouth cancer. Well, I've never been a smoker and for years I've consumed 1.5 glasses of red wine (the amount recommended by the National Cancer Institute and the American Heart Association) to prolong life. Needless to say, I'm not nor will I ever go back to drinking any type of alcohol save for non-alcoholic beer and wine as allowed by my physician. The reason? There's a body of evidence that says there's a 70% chance this cancer will come back if I continue to drink.

As for smoking. You've probably been looking for a good excuse to quit for years