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My father had tongue cancer and underwent partial glossectomy with a forearm flap and neck dissection, followed by 30 radiation sessions. It has been 3 months since the radiation ended, but he feels his neck tightness is getting worse day by day. The doctor checked and said the fibrosis is mild, and his CT scan looks clear. However, the tightness is not improving, and even pain medicines are not helping much. Could you please tell what else could be reason ?
Answers (14)
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Avoid fried food and spicy food
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Radiation-Induced Fibrosis (RIF):
Very common after head & neck radiation.
Causes stiffness, tightness, and reduced mobility due to scarring and collagen deposition in soft tissues.
Often progressive if not managed with physiotherapy.
2. Post-Surgical and Post-Radiation Lymphedema:
Neck dissection + radiation can impair lymphatic drainage, leading to swelling and tightness.
3. Nerve-Related Pain (Neuropathic Component):
Radiation and surgery can cause nerve injury/neuropathy, leading to burning pain, tightness, or spasm-like sensations.
Ordinary painkillers (NSAIDs, opioids) are often ineffective; neuropathic pain medicines (gabapentin, pregabalin, duloxetine) may help.
4. Muscle Spasm or Fibrotic Contracture:
Muscles and soft tissue around the surgical/radiation field may contract and cause tight, pulling sensation.
5. Psychological Component:
Chronic cancer treatment often leads to anxiety and heightened perception of discomfort, worsening symptoms.
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✅ What Can Help:
Physiotherapy & Stretching Exercises: Specialized neck physiotherapy is the most important treatment for radiation fibrosis and stiffness.
Lymphedema Therapy: Manual lymphatic drainage and compression may help if swelling is present.
Neuropathic Pain Medications: Gabapentin, pregabalin, or duloxetine (under oncologist/pain physician guidance).
Steroids or Pentoxifylline + Vitamin E: Sometimes used to reduce radiation fibrosis.
Speech & Swallow Therapy: Helps if associated with swallowing/tongue mobility issues.
Pain & Palliative Care Specialist: They can tailor treatment beyond routine painkillers.
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👉 Since the CT scan is clear and no recurrence is seen, cancer relapse is less likely.
The most probable cause is radiation-induced fibrosis and/or lymphedema, which require rehabilitation and neuropathic pain management, not just routine pain medicines.
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Radiation induced fibrosis, can consult a pain physician for the same , he/she can provide u the exact solution for the same
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Hi.
Ling fibrosis is a very common complication of radiation therapy.
Further clinical examination is required to determine the lung status.
Please consult a doctor with the latest ct scan.
Next Steps
Consult a doctor
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You may consult another Cancer Surgeon if you so desire.
There is no point in consulting Doctors from other Specialities.
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You can consult me directly on Practo, or reach out via WhatsApp:
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Right fibrosis due to radiation.
Physiotherapy can help.
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Connect
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Dr. Vinod Kumar Verma
General Physician
9 yrs exp
Gurgaon
-According to your query and sign and symptom you want to know about the cause and Treatment of disease as you have mentioned as above as -
-Please take consultation for better evaluation and best Treatment as it need complete history of patient as personal and family history.
Please follow good life style as
• take plenty of fluid and
• take less spicy and fatty foods and
• take home made food only and
do exercise regularly with yoga and meditation and
• keep positive attitude to fight any disease and any problem of your life . ....
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Dr. Manoj Kumar
General Physician
9 yrs exp
Dehradun
Need few more details
Kindly consult
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Dr. Kamlesh Kalsariya
General Physician
6 yrs exp
Ahmedabad
Physiotherapy
Next Steps
consultation
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Dr. Siddesh Venkatraman
General Physician
1 yrs exp
Mumbai
After head and neck radiation, neck tightness and stiffness is very common due to radiation-induced fibrosis. It can sometimes progress for several months even after treatment ends. Mild fibrosis on examination does not always reflect how tight the tissues feel, and pain medicines often donât fully relieve this discomfort.
Other possible contributors to neck tightness include:
Scar contracture from surgery (partial glossectomy and neck dissection).
Muscle spasm or postural changes from limited neck movement.
Lymphedema or tissue swelling in the neck and shoulder region.
Rarely, recurrence or secondary complications (but CT and doctorâs exam are reassuring).
What can help:
Physiotherapy / targeted neck exercises to maintain range of motion.
Massage, myofascial release, or supervised stretching.
Heat therapy may reduce stiffness temporarily.
If pain is severe, ask your doctor about neuropathic pain medications (like gabapentin or pregabalin), which sometimes work better than standard painkillers.
Regular follow-up to ensure no recurrence is important.
Bottom line: Worsening neck tightness after radiation is usually due to fibrosis and scar tissue, not necessarily cancer recurrence. Physiotherapy and specialized exercises are often the most effective treatment.
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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