Side effects of radiotherapy for laryngeal (larynx) cancer

Radiotherapy often makes people feel tired. Tiredness may get worse as treatment goes on. If you are having radiotherapy alongside other treatments, such as surgery or chemotherapy, you may feel more tired. But there are things you can do to help, such as:

• get plenty of rest
• do some gentle exercise, such as short walks
• drink plenty of fluids
• ask others for help with everyday jobs.

After treatment finishes, you may continue to feel tired for weeks or months. If it does not get better, tell your cancer doctor or specialist nurse.

We have more information about coping with tiredness (fatigue).

The lining of your throat may become swollen, sore and inflamed. This may affect your swallowing and make eating and drinking more difficult. Your doctor can prescribe liquid painkillers to help with this. Try to take these before meals to make eating easier.

Your speech and language therapist (SLT) will talk to you about any swallowing or eating problems you may have. It is important to try to keep eating and drinking for as long as possible during your treatment.

Your team will give you advice on foods that are easy to swallow. They may also give you nutritious or high-calorie drinks.

Most people manage to eat soft, moist foods while their throat is sore. Some people can only manage a liquid diet.

The soreness usually lasts for a few weeks after radiotherapy has finished. But some problems may continue for longer, depending on the area treated. 

We have more information on eating and drinking after treatment.

Some people find the soreness stops them eating or drinking enough. This is more common if you have chemoradiation.

If this happens, your doctor might suggest you have nutritional support so that you do not lose too much weight. This means you have liquid food that contains all the nutrients you need. You will have this through a feeding tube that goes into your stomach. 

You can also have liquids and medicines through the tube. If doctors think you might have problems eating, they may suggest putting in a feeding tube before you start treatment.

Nutritional support can:

• prevent weight loss and make sure you get enough fluids and nutrients
• help you feel less weak or tired
• make you feel less stressed about having to eat
• allow the sore area to heal and help you recover faster
• allow you to eat smaller amounts when eating is uncomfortable
• give you enough calories to help prevent you needing any breaks in treatment.

Your SLT will assess whether you can still swallow food and fluids safely while you have a tube in. If you swallow safely, you will still be encouraged to eat and drink normally with a tube in place. This will happen even if you can only manage small amounts at a time.

When treatment has finished, you are usually encouraged to stop using the tube as soon as it is safe.

It is important to follow the advice of your healthcare team when you have a feeding tube in.

Radiotherapy can change the consistency of your saliva. It may become thicker, stringy and sticky, like mucus. The mucus does not flow as well as normal saliva, so it may build up in the mouth and throat.

You might need to spit often to get rid of the mucus, so it is a good idea to always have tissues with you. Rinsing your mouth and drinking water regularly can also help.

If you have a build-up of mucus, your cancer doctor or specialist nurse may suggest you use a nebuliser. This is a small machine that changes liquid medicine into a fine mist of fluid, which you inhale. It can help to loosen the mucus.

If your sleep is disturbed by coughing, using a nebuliser before bed may help. A nebuliser may also help if you have problems swallowing, or a dry mouth and throat.

Changes in your saliva may get better within about 8 weeks of radiotherapy ending. But sometimes they continue for several months or more. Tell your doctor or nurse if this happens. They may be able to prescribe medicines to help.

You may not feel like eating if your mouth is sore. The soreness may be worse towards the end of radiotherapy and in the first 2 weeks after treatment has finished. 

It is important to try to eat, even if you do not feel like it. Try taking smaller meals more often. 

If your mouth is very sore, it can help to take painkillers before you eat. 

You can also see a dietitian. They may suggest you have some high-calorie or nutritious drinks until your appetite returns.

We have some tips for managing appetite loss.

Radiotherapy may cause some temporary hair loss over the back of your head. If you have any facial hair, it may fall out. Sometimes, this can be permanent.

We have more information on dealing with hair loss.