Radiation therapy for salivary gland cancer

Radiation therapy is treatment with high energy x-rays to kill cancer cells or shrink tumors. External beam radiation is most often used to treat salivary gland cancers. It is much like getting a regular x-ray, but it lasts longer. Each daily treatment lasts only a few minutes, but the setup time -- the time to get you into place for treatment -- usually takes a bit longer. Treatment most likely will be given 5 days a week for 6 or 7 weeks. Or it might be given twice a day over a shorter length of time. Radiation treatment does not hurt.

Doctors can now use 3-D (3-dimensional) pictures from CT or MRI scans and computers to figure out how best to aim radiation at the cancer while limiting the radiation to nearby normal tissues. This may limit side effects.

Radiation is sometimes used as the main treatment for salivary gland cancer, especially for patients who aren’t well enough for surgery, or for people whose cancers are too large to be removed by surgery. Radiation can also be used after surgery to kill cancer cells that may have been left behind because they could not be seen during the operation.

Radiation can be used to ease symptoms such as pain, bleeding, and trouble swallowing caused by the spread of cancer.

Side effects of radiation treatment

There can be side effects from radiation. Common effects could include skin changes (like sunburn), nausea, vomiting, and tiredness. Many people treated for salivary gland cancer also have problems with sore throat, hoarseness, trouble swallowing, loss of taste, bone pain, bone damage, and tooth problems. A common long term effect of radiation to treat salivary gland cancer is dry mouth. This can causes problems with eating and swallowing and can lead to tooth decay.

Often radiation is only needed on one side of the head. If so, it may be possible to avoid long-lasting side effects such as dry mouth and thyroid gland injury, which can happen if both sides of the head must be treated.

Because radiation can make dental problems worse, you will need a dental exam before treatment begins. It may be necessary to remove some of your teeth. This depends on the area to be treated and the condition of your teeth. It can be done by either the head and neck surgeon or by an oral surgeon.

Radiation treatment might also damage your thyroid gland. It can take months or even years before the radiation treatment causes thyroid hormone levels to drop. Tests of thyroid function will be done during follow up (after treatment is complete). If thyroid hormone levels get low, you will need to take pills to replace thyroid hormone.

It's a good idea to discuss the possible side effects of radiation treatment with your doctor before starting treatment. Talk to your doctor about what can be done to try to limit side effects. If you do have side effects, there are ways to relieve many of them, so it is important to tell your doctor about any problems you have. To find out more about radiation therapy, see our document called Understanding Radiation Therapy: A Guide for Patients and Families.