Cancer - Head or Neck - Radiation

This form of treatment involves the use of various types of radiation to kill cancer cells in a specific area of the body.

This form of treatment involves the use of various types of radiation to kill cancer cells in a specific area of the body.

Head or neck cancer refers to the growth of abnormal (malignant or cancerous) cells in the tissues of the head or neck. These cancers frequently start in the squamous cells that are located in the moist membranes (also called mucous membranes) that line the surface of the nose, mouth and throat. They are often called squamous cell carcinomas of the head and neck. The following cancers are included in the group of head and neck cancers.

  • Cancers of the mouth (oral cavity) - This includes the front of the tongue, the gums, the lining of the cheeks and lips and the bottom and top of the mouth.
  • Cancers of the throat (pharynx) - This tube that begins behind the nose and extends to the food pipe.
  • Cancers of the voicebox (larynx) - This short tube is located at the bottom of the pharynx.
  • Cancers of the sinuses and nasal cavity - These are hollow spaces inside the head and nose.
  • Cancer of the salivary glands - These are the glands in the floor of the mouth that produce saliva. Cancer of the salivary glands is uncommon.

After the diagnosis of a cancer in the head or neck, healthcare providers will look for spread of the head or neck cancer to the lymph nodes in the neck or tissues in other areas of the body. This process is called “staging.” Metastatic head or neck cancer is cancer that started in the mucous membranes of the head or neck and has spread to the lymph nodes or other organs and tissues. Your healthcare provider will need the following clinical information to decide what type of treatment is right for you.

  • What does the cancer look like under the microscope? Where is it located?
  • How large is the primary cancer?
  • Has the cancer spread to lymph glands or anywhere else in the body?
  • What is the overall condition of your health?

Radiation therapy involves the use of various forms of radiation, or high-energy x-ray beams, to kill cancer cells in a specific area of the body. Radiation therapy can be used:

  • Before surgery to make a tumor smaller
  • To cure a cancer that cannot be removed by surgery
  • After surgery to prevent a cancer from returning
  • As an alternative to surgery
  • To decrease symptoms that are related to a tumor or aggressive cancer
  • With chemotherapy

Radiation therapy can be given in various ways, depending on what type of cancer you have and where it is located in your body.

  • Radiation therapy to treat various head and cancers is usually given externally by a machine that is located outside the body. The x-ray beams can kill the cancer cells and shrink a tumor or even make it disappear.
  • The x-ray beams must pass through normal tissue on their way to the cancer and out of the body. The radiation that passes through normal organs can cause damage, which can be temporary or permanent.
  • Radiation oncologists plan treatments to minimize exposure to normal organs.
  • The treatments must be given daily over several weeks.

Some types of radiation therapy include:

  • Three-dimensional (3D) conformal radiation is tailored to adapt to the size and shape of a tumor. The patient's position is changed so the beam goes through the tumor from two or three different angles. The approach is planned to allow the maximum exposure of radiation to the tumor.
  • In IMRT the intensity of the beam is varied to conform to the shape of the tumor. The aim is to limit damage to surrounding healthy tissues, while effectively treating the cancer. IMRT is a valuable technique for treating a small percentage of cancerous tumors, but adds little value in the treatment of others. IMRT may not be covered by your health plan unless certain criteria are met.
  • The decision to administer radiation therapy will depend on the individual circumstances.

Head or neck cancers can develop at any age. However, they are more common in men over 50 years of age. The risk factors for cancers of the head and neck include:

  • Tobacco and alcohol use (cause about 75% of cancers of the head or neck)
  • History of certain viruses, such as Human Papillomavirus (HPV) or Epstein-Barr (EB) infection
  • Prior radiation therapy to the head or neck area
  • Use of betel quid (a type of chewing tobacco) or mate (a type of tea)
  • Poor oral health
  • Exposure to certain particles or chemicals in the workplace (wood dust, asbestos)
  • Asian ancestry

The primary ways to prevent cancers of the head and neck are by not using tobacco and limiting alcohol intake. Good oral hygiene is also very helpful. In addition, being aware of your risk factors can improve your prognosis by leading to early diagnosis and treatment.

The symptoms of head and throat cancers vary depending on the location of the cancer. These symptoms can be similar to those of other less serious conditions, so medical evaluation is necessary. Some of the symptoms include:

  • A sore or lump that does not heal
  • A constant sore throat
  • Frequent headaches
  • Swallowing and eating difficulty
  • Changes or hoarseness in voice
  • Pain when speaking or swallowing
  • Pain in the ears or teeth
  • Chronic sinus infections that do not respond to treatment
  • Swelling of the jawline or under the chin

Contact your healthcare provider if you have any of the above symptoms. He or she will review your symptoms and do a physical examination. They may also recommend one of the following tests:

  • A laryngoscopy, an examination of your mouth and throat using a special instrument
  • Removal of abnormal tissue for examination under a microscope (biopsy)

A biopsy is needed to determine if an abnormality is cancer. If your biopsy indicates you do have cancer, additional testing may be needed.

The treatment for head or neck cancer is based on many factors, including:

  • Your age and overall health
  • The type and stage of the cancer
  • Other tests that determine the specific characteristics of the cancer

Treatments for head or neck cancer are either local (only affects the area of the cancer) or systemic (affects all areas of the body). Local treatments include:

  • Surgery to remove the cancer
  • External radiation to kill the cancer cells

The systemic treatments include:

  • Chemotherapy to kill the cancer cells
  • Targeted or biologic therapy to interfere with the changes in cells that help the cancer grow

Treatment for head and neck cancer may involve a combination of local and systemic treatments, especially if the cancer has gone to other parts of your body. You may also have more than one type of treatment at a time.

To get a full range of opinions and perspectives, you may want to consider input from a variety of doctors. This group may include:

  • Your primary care physician
  • A medical oncologist (a doctor who specializes in the treatment of cancer)
  • A surgeon with experience in head or neck cancer
  • A radiation oncologist (a doctor who specializes in treating cancer with radiation therapy)
  • A plastic surgeon

It is important to remember that the total cost of this care path does not include all possible medications, lab work, or imaging studies. Those charges can add up. If your healthcare provider recommends any lab work or imaging studies, you may need to search for their costs separately.

Contact your healthcare provider if you have symptoms of head or neck cancer. Be prepared to discuss your symptoms and how long you've had them.

  • Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
  • Make a list of your medications (including over-the-counter).
  • Write down any questions, symptoms or concerns you want to talk about.
  • If your healthcare provider prescribes a medication for you, ask for a generic version. If your doctor thinks that a generic version is not right for you, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).

What should I ask my healthcare provider before having radiation therapy?

  • How will radiation improve my prognosis?
  • What specific precautions do I need to take after receiving radiation therapy?
  • What are the possible complications?
  • How will I feel after radiation therapy? Will I have to modify my activity?
  • What type of radiation will I receive? What symptoms should I report to my healthcare provider before my next appointment?
  • Is there a reason you are recommending one form of radiation therapy over another?
  • Will I be receiving other treatments along with the radiation therapy?

It is important you understand all home care instructions (including medications and side effects) and follow-up plans.

Don't forget to make arrangements for help at home.


Also known as:

Throat Cancer
Radio Therapy
Mouth Cancer
Head Cancer
Cancer of the Neck
Cancer of the Mouth
Cancer of Head
Cancer - Head or Neck - Radiation
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