What is radiotherapy?

Radiotherapy uses high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells. How and when radiotherapy is used to treat laryngeal cancer depends on the stage of the cancer.

Radiotherapy for early-stage laryngeal cancer

You may have radiotherapy on its own if you have an early-stage laryngeal cancer. Your cancer doctor may advise you to have radiotherapy if surgery is likely to affect your speech or swallowing.

The aim of radiotherapy for early cancer of the larynx is to cure the cancer. This is called radical radiotherapy.

Radiotherapy for locally advanced laryngeal cancer

If the cancer is larger, or spreads to lymph nodes or tissues nearby (locally advanced), radiotherapy is usually combined with other treatments. You may have radiotherapy:

  • after surgery to destroy any remaining cancer cells, and reduce the risk of it coming back
  • after surgery, combined with chemotherapy (chemoradiation)
  • instead of surgery, combined with chemotherapy (chemoradiation)
  • combined with a targeted therapy drug.

The aim of radiotherapy for locally advanced laryngeal cancer is to cure the cancer (radical radiotherapy).

Radiotherapy for advanced laryngeal cancer

Sometimes it is not possible to cure the cancer. In this case, the main aim of treatment is to help reduce symptoms. This is called palliative radiotherapy.

You may have radiotherapy:

  • to shrink a tumour that is causing problems with swallowing or breathing
  • to help improve symptoms if the cancer has spread to other areas of the body.

 

How radiotherapy is given

Radiotherapy is usually given from outside the body. This is called external beam radiotherapy. High-energy x-rays are directed at the cancer from a radiotherapy machine. Radiotherapy is not painful, but you do have to lie still for a few minutes while the treatment is being given.

You may have radiotherapy:

  • Monday to Friday, with a rest at the weekend (this is the most common method)
  • more than once a day (hyperfractionation).

Treatment may take 3 to 7 weeks. This is called a course of treatment. Your cancer doctor or specialist nurse will discuss the treatment with you. If you are having radiotherapy to help with symptoms, you may only need a short course or a single treatment session.

Intensity-modulated radiotherapy (IMRT)

Intensity-modulated radiotherapy (IMRT) is the main type of external beam radiotherapy used to treat laryngeal cancer. It shapes the radiotherapy beams and allows different doses of radiotherapy to be given to different parts of the treatment area. This means lower doses of radiotherapy are given to the healthy tissue surrounding the tumour.

This can help reduce the risk of side effects and late effects. It may also allow higher doses of radiotherapy to be given to the tumour.

Research has shown that having IMRT may reduce some long-term side effects, including having a dry mouth. This is because radiotherapy given in this way avoids the salivary glands, where saliva (spit) is produced.

Some people may have regular scans during their treatment. This is to make sure the radiotherapy is targeting the treatment area.

Sometimes the treatment may need adjusting, for example, if you lose weight during treatment.

Conformal radiotherapy (CRT)

Many types of external beam radiotherapy are conformal. This means the beams are specially shaped to fit the treatment area. It may be used to give lower doses of radiotherapy.

Planning your radiotherapy

To make sure your radiotherapy is as effective as possible, it must be carefully planned. Planning makes sure the radiotherapy is aimed directly at the cancer. This means it causes the least possible damage to surrounding healthy tissues. The treatment is planned by your cancer doctor.

Radiotherapy planning is usually done during one visit to the radiotherapy department. Sometimes you may need to make more than one visit. Planning can take up to 2 hours. Your team will let you know how long it is likely to take for you.

To start with, you meet the radiographers (experts in giving radiotherapy). They can answer any questions you have.

Radiotherapy masks

It is important that you lie still and in the correct position during each treatment. To help you stay still, you wear a plastic mesh mask for each radiotherapy session. The radiographer, or mask room technician, will explain more about masks for radiotherapy.

Planning a CT scan

After your mask is made, you have a CT scan of the area to be treated. The radiographers take measurements to plan the treatment specifically for you. Some people also have an MRI scan as part of their radiotherapy planning.

The radiographer enters the measurements and the information from the scans into the radiotherapy planning computer. Your doctors then use this to plan your treatment precisely.

Radiotherapy treatment sessions

At the beginning of each session, the radiographers will make sure you are in the correct position. They will tell you how long your treatment will take. They then carefully fit you with your mask and make sure you are comfortable.

When everything is ready, they leave the room and the treatment starts. The radiotherapy itself is not painful. It does not make you radioactive. You will not be a risk to anyone during your treatment.

The radiographers can see and hear you from outside the room. There is usually an intercom, so you can talk to them if you need to during your treatment.

In some treatment rooms, you can listen to music to help you relax. Ask your radiographers if it is possible to listen to music.

Sometimes the radiotherapy machine may stop and move into a new position. This is so you can have radiotherapy from different directions. Some radiotherapy machines make a small beeping noise. This is just so that you know when the treatment is starting and when it has finished.

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