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By Douglas Van Nostrand, M.D. Reprinted, with permission, from page 184 of Chapters 18 of the book “Thyroid Cancer: A Guide for Patients”, (Keystone Press, 2004. Douglas Van Nostrand, M.D., Gary Bloom, and Leonard Wartofsky, M.D. See http://www.thyca.org/TCGuide.htm)

While pain and swelling of the salivary glands can occur within days of radioiodine treatment, some patients may not experience it until several months later.

The most likely cause for this appears to be a blockage of the flow of the saliva out of the glands caused by a narrowing of the ducts. This narrowing is the result of scarring due to inflammation caused by the radiation. Thus, as one begins to eat, the volume of saliva increases but cannot pass through the narrowed duct into the volume of saliva increases but cannot pass through the narrowed duct into the mouth. The gland then rapidly swells, which can be painful. In some people, discomfort can result simply by looking at appetizing food.

The pain and swelling usually are not permanent but may last for several weeks to a few months. Chronic pain and swelling also is possible.

The presence or absence of swelling and pain of your salivary gland within the first week after your treatment does not necessarily mean you will or will not experience this side effect months later.

Gently massaging your salivary glands may help reduce the swelling or pain.

Depending on the severity and persistence of the symptoms, your physician may refer you to an otolaryngologist, also called an ear, nose, and throat specialist. This physician can evaluate the swelling and pain to make sure they are not due to other causes. If the radiation turns out to be the likely cause, the physician may consider other diagnostic tests to see if any of the main ducts are narrowed and could be reopened.

If you have experienced problems with your salivary glands following a previous radioiodine treatment, notify your physician before undergoing any additional radioiodine treatment. This side effect should not necessarily prohibit you from having additional radioiodine treatments.

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