How do you manage the thickened secretions secondary to xerostomia during head and neck radiation?

I find that the management of acute effects of RT for H&N treatment is somewhat of a dark art. What works for one patient may not work for another. The thickened secretions are from acute irritation of the salivary glands and not so much from "xerostomia" during the acute phase of RT. For thickened ...

Agree with @Dr. First Last that there is a paucity of evidence based interventions and a lot of "hit or miss" interventions. There are 2 related side effects for patients - one is xerostomia, and the other is that patients feel like they have "a lot of phlegm in the throat." I agree with salt and ba...

Some additional options to those already mentioned that work nicely:

• Tussionex
• Drink club soda or papaya juice
• Drink a solution made with a meat tenderizer (add ¼ teaspoon tenderizer to 1 cup of liquid)

1. Salt & baking soda rinse
   
   
2. Guaifenesin
   
   
3. Glycopyrrolate

I agree with all of the above. I will note that the "phlegm" is particularly bad for patients who have a significant 70 Gy volume in the posterior pharyngeal wall, especially large OPX and NPX tumors, as the fourth major salivary gland is actually embedded in the lower posterior NPX and makes a secr...

Despite IMRT, with more but even without chemo (platinoid) most vexing, variable, and problematic issue in H&N. The dysfunctional gooey saliva needs expectoration, swallowed worsens n&v, appetite, and taste loss. I prefer H2O2 or anything that bubbles, but some like NaCl/H2O: whatever works…one pati...

The take-home message is that a strategy that works for one may not work for the other. I provide them the resources that include all that has been mentioned here and also tell them to experiment strategies on their own (after discussing with the clinical team). I avoid prescribing medications since...