Radiotherapy for head and neck cancer

Radiotherapy uses high-energy rays to destroy cancer cells, while causing as little damage as possible to healthy tissue. Radiotherapy can be used on its own if the cancer is small.

If the cancer is larger, radiotherapy is often given with other treatments. It may be used:

  • after surgery, with or without chemotherapy
  • in combination with chemotherapy (called chemoradiation), without surgery
  • in combination with the targeted therapy drug cetuximab.

Treatment for head and neck cancers is usually with external beam radiotherapy. You will have treatment in a hospital radiotherapy department, usually as a series of short daily sessions from Monday to Friday. Treatment may take 4 to 7 weeks, depending on your situation.

Your radiotherapy doctor (clinical oncologist) or specialist nurse will tell you more about your treatment and what to expect.

Radiotherapy

Radiotherapy uses high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells. It is an important treatment for head and neck cancers. Radiotherapy can be used on its own, but is often given in combination with chemotherapy. This is called chemoradiation.


Radiotherapy for early-stage cancers

Radiotherapy can be used on its own to treat cancers that are small and have not spread. It is often used for cancers in harder-to-reach areas, such as the back of the mouth or throat. Radiotherapy may also be used when surgery could seriously affect important functions, such as speech and swallowing.


Radiotherapy for locally advanced cancers

If a cancer is bigger, or is affecting other tissues nearby (locally advanced cancer), radiotherapy is usually combined with other treatments. It may be given:

  • after surgery (with or without chemotherapy) to destroy any remaining cancer cells and reduce the risk of cancer coming back
  • in combination with chemotherapy (chemoradiation), without surgery
  • in combination with the targeted therapy drug cetuximab
  • to reduce symptoms (palliative radiotherapy).


Radiotherapy after surgery (adjuvant radiotherapy)

If you have surgery for advanced cancer, you are usually given radiotherapy afterwards. This is to reduce the risk of the cancer coming back. It is called adjuvant radiotherapy. Sometimes chemotherapy and radiotherapy are given together after surgery. This called adjuvant chemoradiation.

If you need adjuvant treatment, your specialist team will decide whether radiotherapy or chemoradiation is best for your situation.


Chemoradiation

Chemoradiation is often the main treatment for advanced head and neck cancers. It may be used:

  • to treat cancers that cannot be removed with surgery
  • to treat cancers in harder-to-reach areas, such as the nasopharynx or throat
  • when surgery could cause severe changes to speech or swallowing.


Radiotherapy and cetuximab

Combining chemotherapy and radiotherapy (chemoradiation) is a very effective treatment for head and neck cancers, but it can also cause severe side effects. Some people cannot have chemoradiation because they:

  • are not well enough to cope with these side effects
  • have other health problems that could be made worse by chemotherapy.

Instead, they may be given radiotherapy in combination with a targeted therapy drug called cetuximab.


Palliative radiotherapy

Sometimes it is not possible to cure a cancer, and the main aim of treatment is to relieve symptoms. This is called palliative treatment.

Palliative radiotherapy may be used to:

  • stop bleeding from a tumour
  • shrink a tumour that is causing swallowing or breathing difficulties
  • relieve symptoms if the cancer has spread to other parts of the body, such as the lungs or bones.


How radiotherapy is given

Radiotherapy is usually given from outside the body as external-beam radiotherapy. A beam of x-rays is directed at the cancer from a large machine called a linear accelerator.

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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.