Radiation therapy for head and neck cancer

Head and neck cancer includes tumors that develop in any kind of tissue in the head and neck area. Common types of head and neck cancer are: the tongue, the base of the tongue, the roof of the mouth, the throat cavity and the vocal cords.

Various radiation treatment options

Radiotherapy aimed at the head and neck area usually consists of 35 treatment sessions over a period of 6 to 7 weeks. In some cases we combine the radioherapy with chemotherapy or immunotherapy. We call this chemoradiation or bioradiation. This treatment uses drugs called Cisplatin or Cetuximab. Cisplatin kills the cancer cells and halts cell division. It can make cancer cells more sensitive to radiation treatment, which will increase the effectiveness of the treatment. You will receive 35 radiation sessions, combined with 3 chemotherapy sessions. Cetuximab is a drug that activates the immune response against the cancer cells. The cancer cells will be more sensitive to the radiation treatment, which can increase its effects. You will receive 35 radiation sessions and will be given 7 doses of immunotherapy.

If we suspect that some tumor cells remained after your surgery, we will deliver radiation after your surgery. The total amount of sessions you will have depends on the results of your pathological tests and can vary between 23 and 35.

Radiation can be given as a palliative treatment to alleviate the symptoms when the cancer has developed or spread, or if the tumor causes a lot of discomfort. This will shrink it and halt tumor growth, but the treatment cannot cure you. The number of sessions you will receive depends on your personal situation and can vary between 1 and 16.

The latest techniques and advanced technology

Our Radiation Oncology department is constantly working on the development of new techniques using the most advanced technology currently available - both in diagnostic imaging, preparation, and radiation itself. This allows us to deliver the most effective treatment possible to you, while sparing as much healthy tissue as possible.

Consultation with your radiation oncologist

You will meet with your radiation oncologist to discuss your situation and the treatment that best fits you, its goal, expected outcome preparation, execution, and side effects.

Multidisciplinary team meeting

Your situation, test results and medical history will be discussed in a multidisciplinary team meeting consisting of specialists such as gastroenterologists, surgeons, and radiation oncologists, in order to find the treatment that best fits you. Your radiation oncologist will discuss the results with you.

Studies

We are constantly working to improve and develop radiation treatment through research. if your radiation oncologist knows of a trial that you may qualify for, he or she will let you know. You will receive more information to make an informed decision. Your participation is voluntary. if you decide not to participate, you will be treated according to the latest protocols and developments.

Preparation

For treatment of cancer in the head and neck region we will prepare by making a mask, which will ensure that you cannot move during the treatment. We will make the mask out of pliable plastic at our moulage room. The plastic will be heated and placed on your face so the mask will have the same contours as your face. It will then be attached to the table. There are plenty of holes in the mask to allow you to breathe, hear, and see.

You will get a CT scan to prepare for your treatment. You will be wearing the mask during the scan. We will project laser lines on the mask and draw this field on the mask to ensure that you will be in an identical position during all treatment sessions. You may receive a contrast solution during the scan.

You may need an MRI or PET scan while wearing the mask to improve accuracy of the radiation field. If this is the case for you, you will receive more information about this procedure.

We will provide information about the treatment during your preparatory consultation. There will be plenty of time to ask questions.

Radiation treatment planning

Your radiation oncologist will draw the placement of the radiation field on these CT and/or MRI scans. He or she will calculate the optimal external beam radiation using special software: the treatment planning. It is important to ensure that the field receives the correct dose and that the surrounding tissue is spared as much as possible.

Radiation

Radiotherapy lab technicians ensure that you are positioned correctly on the table and are wearing your mask. The beams on will overlap with the lines on your mask.

We will often check whether your position is still correct by using a CT scanner attached to the machine. This allows us to make small adjustments to your position in order to ensure that the radiation matches the tumor shape as closely as possible. The lab technicians will follow the treatment on monitors.

The radiation machine can revolve around you to find the right angle for the treatment.

The delivery of the radiation itself will take a few minutes. The total time of the treatment will be approximately 15 minutes. The beams won’t hurt, although you will start to notice the effects of the radiation.

Check-ups with your radiation oncologist or physician assistant

During your treatment you will regularly meet with your radiation oncologist to discuss the progress and ask any questions you may have. Your radiation oncologist will offer advice on how to deal with the side effects you are experiencing and prescribe medication if needed. You will also hear about the next step after your treatment.

Side effects

The side effects you will experience depend on your personal situation, overall shape and health, and the area that is receiving the treatment as well as the dose. Your practicing physician will discuss the side effects you can expect with you. You may notice the acute side effects after two or three weeks of treatment. These will increase in severity over the course of your treatment and may linger for months after its end. Some side effects may be permanent. Your practicing physician will discuss which side effects you can expect.

Radiation to the head and neck area may cuse a dry mouth, thicker mucus, loss of taste, trouble swallowing (pain and difficulty) and skin issues. You may also experience fatigue. There will be time to discuss these problems during your consultations. You will also be referred to a dietician and oral hygienist.

What you can do

If your symptoms, situation, and overall health allow, we recommend daily exercise to improve your recovery. You could consider walking or biking, or exercise under the supervision of a physical therapist. We also recommend continuing your day to day activities as much as possible.

General nutritional guidelines apply during treatment.

Please consult your practicing physician if you wish to continue taking additional vitamins or supplements during your treatment.

Radiation therapy for head and neck cancer

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Our working methods