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Studies have shown that people who are treated at centers that treat a lot of head and neck cancers with radiation, tend to live longer. And because of the complicated types of surgeries, along with the need for coordination between cancer specialists to make a complete treatment plan, it’s very important to have a cancer center and radiation oncologist who has experience treating these cancers.
Radiation therapy uses high-energy x-rays or particles to kill cancer cells. It can be used in many ways to treat laryngeal and hypopharyngeal cancers:
Many times, for advanced laryngeal and hypopharyngeal cancers, chemotherapy is given at the same time as the radiation. This combination, called chemoradiation, often works better than radiation alone, but it also has more side effects.
Radiation to this part of your body can cause problems to your teeth and gums, so it's important to see a dentist before starting treatment. A dentist can make sure your mouth is healthy before treatment. They might recommend that certain bad teeth be removed before you start radiation because this can increase your chance of infection during treatment. During and after treatment your dentist can help check for and treat any problems that may come up, such as infection or tooth and bone damage.
If you smoke, you should quit. Your cancer might not shrink as well if you smoke during radiation treatment, you might have more side effects, and your benefit from radiation treatment might be less (which can raise your risk of the cancer coming back). Smoking after treatment can also increase the chance of getting another new cancer. Quitting smoking for good (before treatment starts, if possible) is the best way to improve your chances of survival. It is never too late to quit. For help, see How To Quit Using Tobacco.
The types of radiation therapy that might be used to treat laryngeal and hypopharyngeal cancer are:
The main type of radiation therapy used to treat laryngeal and hypopharyngeal cancer is external beam radiation therapy. External beam radiation therapy (EBRT) focuses radiation from a source outside the body on the cancer.
Before your treatments start, the radiation team will use a CT scan to take careful measurements to determine the correct angles for aiming the radiation beams and the proper dose of radiation. A flexible, but sturdy, head and neck mask made from a plastic mesh might be made to hold your head, neck, and shoulders in the exact same position for each treatment. Some people might feel a bit confined while this mask is on and might need to ask for medicine to help them relax during the treatment. Sometimes, the mask can be adjusted so that it is not too constricting. Your radiation oncologist can discuss the options with you.
Radiation therapy is much like getting an x-ray, but the radiation is much stronger. The procedure itself doesn't hurt. Each treatment lasts only a few minutes, but the setup time – getting you into place for treatment – usually takes longer.
Standard EBRT for laryngeal and hypopharyngeal cancer is usually given in daily fractions (doses), 5 days a week, for about 7 weeks. Other schedules for radiation that might be used to treat laryngeal or hypopharyngeal cancer include:
There are also more advanced EBRT techniques that help doctors focus the radiation more precisely:
Internal radiation therapy, also known as brachytherapy, puts radioactive material right into or near the cancer. It's rarely used to treat laryngeal and hypopharyngeal cancer as first treatment, but might be used if the cancer recurs (comes back).
If you are going to get radiation therapy, it’s important to ask your doctor about the possible side effects, so you know what to expect.
Common side effects depend on where the radiation is aimed and can include:
Most of these side effects slowly go away when treatment is over. Side effects of radiation tend to be worse if chemotherapy is given at the same time. Tell your doctor about any side effects you have because there are often ways to help.
Many people treated with radiation to the neck and throat area have painful sores in the mouth and throat that can make it very hard to eat and drink. This can lead to weight loss and malnutrition. The sores heal with time after the radiation ends, but some people might continue to have problems swallowing long after treatment ends.
Ask your speech pathologist about swallowing exercises you can do to help keep those muscles working and increase your chance of eating normally after treatment.
Radiation aimed at the head and neck might damage the salivary glands, leading to dry mouth that doesn't get better with time. This can cause discomfort and problems swallowing, and can also lead to tooth decay and damage to the jaw bone. People treated with radiation to the neck and throat must pay close attention to their oral health and see a dentist regularly.
Radiation might damage your thyroid gland. Your doctor will order regular blood tests to see how well your thyroid is working. You may need treatment if it's been damaged and not working well.
Some people treated with radiation therapy might be at risk of developing lymphedema in the head and neck areas that were radiated. These areas can become swollen and firm. This can be worse if the person also had surgery. Sometimes, medicines, physical therapy, or massage therapy might be helpful.
A person who has had radiation to the neck area might have an increased risk of stroke many years after treatment. This might be because of health problems that were already present before radiation such as narrowing of the artery or an increase in plaque both of which can decrease blood flow . People who smoke are also at risk. Because of this some doctors might schedule regular ultrasounds for you after treatment, to keep an eye on your arteries.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
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Last Revised: January 21, 2021
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