Head and Neck Cancer Treatment in AU and NZ
Head and neck cancers are a range of cancers that start in the head and neck area.
There are 4 main areas where these cancers grow:
- Nasal cavity and paranasal sinuses: The nasal cavity is the nose and the parts in it. The paranasal sinuses are air-filled spaces in the bones of the face.
- Oral cavity: This is all parts of the mouth, such as the lips, gums, cheeks, hard palate, floor of mouth and the front of the tongue.
- Throat: This is both the pharynx and larynx. The pharynx is the area at the back of the nose, mouth and neck. The larynx contains the vocal cords.
- Salivary glands: These are used for making saliva that helps to digest food.
Radiation Therapy and Head and Neck Cancer
The best person to talk to about radiation therapy for head and neck cancer is a radiation oncologist. You can ask your doctor for a referral to a radiation oncologist to learn if radiation therapy is an option for you.
The Treatment Team
Doctors make a treatment plan for each person based on the:
- type of cancer
- where the cancer is
- what other treatments have been tried
- the person’s health.
Treatment can include radiation therapy or surgery. Doctors often give radiation therapy and surgery if the tumour is high risk.
Sometimes, doctors offer chemotherapy with radiation therapy.
The type of treatment a person gets is worked out by a team of doctors and health professionals often called a Multidisciplinary Team.
A highly trained radiation oncology team takes care of people having radiation therapy. This includes radiation oncologists, radiation therapists, medical physicists and radiation oncology nurses.
Role of Radiation Therapy for Head and Neck Cancer
Radiation therapy is often the main treatment for head and neck cancers. In fact, cancers of the throat are often just treated with radiation therapy. Radiation therapy protects things such as speech and offers good cosmetic results.
Chemotherapy may be used during radiation treatment to enhance the cancer killing effect of radiation therapy.
In some cases, radiation therapy is used with surgery. Cancers in the nasal cavity or paranasal sinuses are often treated with surgery with or without radiation therapy and chemotherapy.
Cancers in the salivary glands are also usually treated with surgery with or without radiation therapy afterwards.
Types of Radiation Therapy used In Head and Neck Cancer
External Beam Radiation Therapy (EBRT) is the most common type of radiation therapy used in head and neck cancers.
Radiation oncologists often use Volumetric Arc Therapy (VMAT) or Stereotactic Radiosurgery (SRS) which are advanced types of external beam radiation therapy, to carefully deliver radiation to the areas that need to be treated.
These advanced techniques allow the doctor to target the radiation on the cancer while limiting radiation to healthy parts of the body.
Doctors usually do radiation treatment once a day, 5 days a week from Monday to Friday.
Near the end of treatment some people receive 2 treatments a day to make up for any missed days. The length of treatment is 5-7 weeks.
Immobilisation Mask
People wear a mask during radiation treatment to keep their head and neck still. The mask ensures the radiation beams target the cancer accurately while minimising exposure to healthy body parts nearby.
A new mask is made for each person and is secured to the treatment table. The mask helps the doctor position the radiation accurately on the cancer being treated.
In this video, Targeting Cancer ambassador Julie McCrossin explains why people with head and neck cancer need to wear protective masks during treatment.
Why We Wear Masks For Head and Neck Cancer Radiation Therapy Treatment
In this video, Julie and the Radiation Oncology team explain how an immobilisation mask is made.
Targeting Cancer Julie’s Story- The Making of the Immobilisation Mask
General Information About Side Effects of Radiation Therapy
Radiation therapy is more effective with fewer side effects than ever before.
Recent advances mean radiation oncologists can effectively treat the cancer while getting less radiation on healthy body parts. This means much fewer side effects.
Side effects from radiation therapy vary between people, even for those having the same treatment.
While some people feel no side effects, some feel mild side effects, such as tiredness or skin redness during and/or just after treatment. These usually get better within a few weeks.
The treatment team will offer advice and medicine to help with side effects.
Serious side effects that start later (months to years after the radiation therapy) are rare.
Before starting treatment, your radiation oncologist will talk to you about side effects and answer your questions.
The side effects of radiation treatment can be split into 2 groups:
- Early side effects which occur during and shortly after radiation treatment.
- Late side effects which can occur months to years after radiation treatment.
For more information, go to the Potential Side Effects page.
Early Side Effects of Radiation Therapy for Head and Neck Cancer
Early side effects occur during and shortly after radiation treatment.
Common early side effects of radiation therapy include:
Fatigue: This is very common in the second half of treatment and varies between people. Fatigue may continue for several weeks after treatment.
Other side effects of radiation treatment may come from body parts close to where the radiation is targeted.
Soreness in the mouth/throat: This can cause pain and problems with swallowing. This often happens early in treatment and makes it hard to eat and drink. Doctors can provide advice and medicine that helps. This usually gets better 4-8 weeks after treatment.
Dry mouth and/or thick saliva: The parts of the mouth that make saliva can be affected by radiation, which makes the mouth dry. Sipping water or using artificial saliva helps. Some people also get thick saliva. Salt water mouth washes and breathing humidified air can help. Mouth dryness usually gets better over time but may not get right back to normal.
Different taste and/or loss of appetite: Some people lose their taste or say food tastes different. For example, sweet foods may taste salty or metallic. This sometimes reduces enjoyment and causes hunger to drop. This usually gets better in time, through some people have a long-term change.
Skin changes: Some people get red, itchy skin. This usually gets better 4-6 weeks after treatment. Doctors can offer advice and medicine that helps.
Hair loss: Some people lose their hair in the area treated. How much hair grows back depends on the radiation dose to the skin. If the skin is in or near a high dose area, the hair loss will last. Hair loss due to low dose radiation generally grows back.
Ear ache or blocked sensation: This can occur due to swelling of the tube that connects the middle ear to the back of the nose.
Hoarse voice: Some people notice a change in voice if there is swelling and irritation of the voice box due to treatment.
Breathing difficulty: If a person’s airway is inflamed and swollen from treatment this can cause breathing problems. In rare cases, this swelling is significant and causes noisy breathing which should be seen by the doctor.
Late Side Effects of Radiation Therapy for Head and Neck Cancer
Late side effects vary between people and can happen a few months to a few years after treatment.
These side effects may never occur, occur once, continue over time, or come and go.
Dry mouth: For some people a dry mouth carries on in the long term. If this happens it helps to drink lots of water and use artificial saliva.
Teeth and jaw issues: Teeth are more at risk of tooth decay after treatment. It helps to keep your mouth and teeth clean and visit the dentist. Be sure to tell your dentist if you have radiation therapy.
Neck stiffness: Sometimes the soft tissues of the neck become hard and stiff. This may mean your neck doesn’t move as well. In most cases this is mild, but in some cases the stiffness can be bad. A physio can help.
Neck swelling: Some people notice a swelling in their neck, often under the chin. This is due to poor flow of lymph fluid. A physio or occupational therapist who specialises in this can help. This is a cosmetic problem that usually gets better in time.
Troubles with swallowing: Some people have problems swallowing after treatment. Doctors provide ideas to help with this. A feeding tube may be needed if someone has troubles eating.
Hair loss: Permanent hair loss can occur in the area that has been treated.
Skin changes: Thinning and dryness of skin and changes in skin tone can happen after treatment. Blood vessels may be more noticeable.
Change in voice: Hoarseness of voice usually gets better after treatment but sometimes it lasts for several months. Rarely, there is a lasting change in voice, especially if the voice box is treated.
Underactive thyroid gland: This can make people feel tired and can usually be fixed with medicine.
Soft tissue damage: This is rare and causes non-healing sores.
Damage to the jaw: This is rare but it can happen after post treatment dental surgery due to less ability to heal and an increased chance of infections.
Breathing difficulty: This is rare and due to swelling of the airway.
Narrowing of the arteries: There may be an increased risk of stroke if the arteries to the brain are shrunk by radiation therapy. People can try and control blood pressure, do regular exercise and stop smoking to reduce the risk of this.
Nerve/spinal cord injury: Irritation of the spinal cord causing an electric-like feeling can occur several months after treatment. This usually doesn’t need treatment and gets better in time. Long-term effects are very unlikely.
Cataract: This is very rare.
Second cancer: Cancers caused by radiation therapy are a very rare side effect.
Other Useful Resources for Head and Neck Cancer
Find additional information about cancer types, research groups, and support groups.
Radiation Oncologist
The best person to talk to is a radiation oncologist. You can ask your doctor for a referral to find out if radiation treatment is right for you.
GPs and Health Professionals
Information for any health professional involved in a patient's cancer care with a particular focus on primary care providers.
Talking to Your Doctor
Your GP or other doctors in the cancer team can organise a referral to a radiation oncologist.
Treatment Centres
Search and find your closest Radiation Oncology Treatment Centre.