Planning head and neck cancer radiotherapy treatment

To make sure your radiotherapy is as effective as possible, it has to be carefully planned. Planning makes sure the radiotherapy rays are aimed precisely at the cancer and cause the least possible damage to the surrounding healthy tissues. The treatment is planned by a specialist doctor called a clinical oncologist.

Radiotherapy planning is usually done during one visit to the radiotherapy department. It usually takes about 2 hours. Sometimes you may need to make more than one visit.

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

It is important that you lie still, in exactly the same position, for each treatment. To help you do this, you wear a clear plastic mesh mask for each session of radiotherapy. The mask is designed so you can see and breathe normally while wearing it. It is sometimes also called a mould, head shell or cast.

The mask holds your head and neck as still as possible. You have it on for up to about 15 minutes at a time. It fits tightly but should not be uncomfortable. Most people soon get used to it. But it is important to talk to the radiographer, mould room technician or your specialist nurse if you find it difficult to wear the mask. They can suggest things that might help.

You have the radiotherapy mask made after you have met the radiographers. The radiographer or the mask room technician explains the process to you before starting.

Once you have your mask, you will 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. Learn more about the scans.

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

Sometimes, marks might be drawn on your mask. These help the radiographer position you accurately before each treatment.

Tracheostomy tube

Very occasionally, radiotherapy to the mouth or throat can cause swelling in tissues around the airways. This can make breathing difficult. If this is likely to happen, your doctors arrange for you to have a small opening made in your windpipe before you have radiotherapy. This is called a tracheostomy (or stoma) and allows you to breathe comfortably. A tracheostomy is usually temporary.

The radiotherapy team measured and fitted the mask and did scans to work out exactly where they wanted to aim the radiotherapy.


Back to Radiotherapy explained

Possible side effects

You can get side effects during radiotherapy treatment to your head and neck – these usually improve a few weeks after treatment is over.

Making a radiotherapy mask

During radiotherapy to the head and neck a mask is used to help you keep still so that exactly the right area is treated.

Before your radiotherapy

Before you start radiotherapy, your team will explain what your treatment involves and how it may affect you.

Your radiotherapy team

You will meet many different specialists from your radiotherapy team. You may see them before, during and after radiotherapy treatment.