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  • Radiotherapy for head and neck cancers

    Last reviewed June 2012

    Radiotherapy is the use of high-energy x-rays or electrons to kill or damage cancer cells so they can no longer grow and multiply. It can be used alone or with other treatment. Radiotherapy can be given in different ways, either externally or internally.

    Before radiotherapy begins the staff will see you to plan the treatment. You will have scans and you may need to be fitted for a mask to wear so that the same location is treated at each session. You will wear the mask for up to an hour in the planning session but only for five to forty minutes during treatment, depending on the location of the cancer. You can see and breathe through the mask.

    External beam radiation

    This is the traditional way radiotherapy is given. This form of treatment is common for oral, salivary gland, laryngeal, pharyngeal, nasal and paranasal sinus cancers.

    During treatment you will lie on a table while radiation is directed from a machine into your body. Treatment itself is painless and the medical team will try to make you as comfortable as possible. It is usually given daily as outpatient treatment, Monday to Friday, for six to seven weeks. Many people are able to return to their usual activities four to five weeks after treatment ends.

    Intensity modulated radiation therapy (IMRT)

    IMRT is a type of external radiation. It is more common for cancers of the tongue, larynx and paranasal sinuses. The radiation can be shaped around the tumour, which reduces possible damage to healthy tissue. This means a higher dose can be given than in conventional radiotherapy. You will have treatment for one to six weeks.

    Tomotherapy

    This is a type of three-dimensional radiotherapy that allows the radiation beams to be shaped around a tumour more precisely. It is currently only available in a few centres across Australia.

    Internal radiation

    Also known as brachytherapy, this treatment is only occasionally used for oral cancers. Small tubes are inserted into and around the tumour while you are under a general anaesthetic. Radioactive material is then placed in the tubes. Your doctor will give you more information about this treatment.

    Radiotherapy side effects

    Many side effects of radiotherapy are temporary and they will start to ease two to three weeks after treatment. However some side effects may be present for a longer period of time or permanently.

    Side effects depend on the location of treatment, how long you have treatment for and the type of radiotherapy you have. If you have radiotherapy after surgery it may worsen or intensify the side effects experienced after your operation.

    Radiotherapy to the throat area may cause an underactive thyroid. Many people need to take thyroid medication after radiotherapy.

    Before radiotherapy it is important to have a dental appointment to check for existing problems with your teeth and to have teeth removed if necessary. This is to reduce the chance of future dental problems.

    Possible side effects from radiotherapy include:

    • dry mouth
    • dental problems
    • thick saliva that feels like mucus
    • damage to the jaw bone (osteoradionecrosis)
    • difficulty swallowing
    • blocked or swollen salivary glands
    • difficulty opening the mouth fully (trismus)
    • changes in sense of taste
    • hair loss in the treated area (particularly facial hair)
    • loss of sweat glands in the treatment area
    • fatigue
    • muscle weakness in the treatment area
    • appetite loss
    • weight loss
    • nausea or gagging due to a build-up of phlegm
    • an underactive thyroid gland (hypothyroidism)
    • skin soreness, redness, burning or ulceration
    • damage to sight or eye function
    • inflammation in the mouth or throat (mucositis)
    • thrush (white spots) in the mouth due to less saliva
    • hoarseness.

    For information about coping with some of these side effects talk to your medical team.

    Information reviewed by:  Dr Tim Iseli, ENT Surgeon, Royal Melbourne Hospital; Katrina Blyth, Senior Speech Pathologist, Royal Prince Alfred Hospital, NSW; Dr David Boadle, Staff Specialist, Medical Oncology, Royal Hobart Hospital; Geoffrey Booth, Consumer; Teresa Brown, Team Leader, Royal Brisbane and Women’s Hospital; Marty Doyle, Co-founder and Facilitator, Head and Neck Cancer Support Group, Brisbane; Dr Peter Foltyn, Dental Department, St Vincent’s Hospital, NSW; Noelene Hunt, Consumer; Dr Michael Jackson, Director, Radiation Oncology Department, Prince of Wales Hospital, NSW; Len McDowall, Consumer; and Cancer Council SA Helpline Consultant.

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