Does anyone have a clue what the incidence of secondary cancers (caused by
radiation therapy) are? I'm trying to figure it out by doing Medline searches,
but it's really not that clear to me.  Also, what are the chances of having
salivary cancer (parotid) as a result of head and neck radiotherapy? And what
are the symptoms? And who do you talk to if your parotid gland is blocked and
swollen, your physician or your dentist? (when I first complained about
intermittent blockage of my parotid gland, my PCP told me to suck on lemon
candy....now that it seems to be completely blocked, I think I need to talk to
someone else..)

Any info would be greatly appreciated.

Kelley

The rates for secondary cancers after radiation therapy are a bit higher
than that of a healthy person getting cancer for the first time.  This
is partially due to cancer patients (no matter what treatment cured
them) having intrinsically higher rates (possibly due to a breakdown in
DNA repair pathways) as well as due to the irradiation.
But why don't you get that salivary gland checked out with ultrasound?
A much more common cause of swelling, pain and loss of function of these
glands is sialolithiasis, or stone-formation in the gland with
subsequent blockage of the duct. This may also be due to changes in
salivary production after irradiation of head & neck cancer (a more
common side effect is chronic dryness of the mouth, or xerostoma).
Find a local radiologist thats good at small-parts US, he should be able
to help.

JN

Thanks very much for your input/advice. I went to see my dentist; she
said it's not my parotid causing the problem. She said it's a swollen lymph
node near the parotid gland (and she sent me to an {*filter*}surgeon). He
said it's definitely a lymph node and sent me back to my primary care
physician (he actually told me to see my oncologist because the lymph node is
pretty hard, but my oncologist is "out of network" and I see him only once a
year for my checkup). I'm seeing my primary care physician in two days. I
recently had a ultrasound of my thyroid (and all around my neck) because I
have hypothyroidism from the radiation, but nothing showed up (of course, the
gland that's swollen is slightly above where they looked, and definitely
hard to get at....under my ear, between my jaw and a tendon in my neck!!). My
primary care physician said she might order a fine needle biopsy, depending on
whether or not she thinks the node feels hard.

Kelley

JN