Many head and neck cancer patients have surgery followed by radiation therapy. Although it can also be used to shrink tumors before surgery, prevent cancer from recurring, and to treat any tumors that appear in other areas of the body.
It’s possible that you’ll also need other cancer treatments such as chemotherapy in addition to surgery and radiation therapy. This will depend on where the cancer is located, its stage and your overall health.
Research has shown that treating head and neck cancers with a combination of chemotherapy and radiation is more effective than either treatment alone. This includes longer survival rates and a lower rate of cancer recurring.
Our radiation oncologists work closely with Atlanta-area medical oncologists to treat head and neck cancers. They use several types of radiation therapy, including external beam radiation and brachytherapy depending on what’s best for each patient.
Types of External Beam Radiation Used for Head & Neck Cancers
Radiation therapy directs high-energy beams at the tumor and destroys cancer cells.
External beam radiation is the most common type used to treat head and neck cancers. Combining imaging with computer software ensures that the tumor’s location is precisely identified and protects surrounding healthy tissue and organs.
The type of external beam radiation used is based on the patient’s cancer location and type. There are several types used by our radiation oncologists, including:
Intensity-Modulated Radiation Therapy
Intensity-modulated radiation therapy (IMRT) is frequently used to treat head and neck cancers. A computerized tomography (CT) scan creates a three-dimensional picture of both the cancerous cells and healthy tissue. Other scanning methods (PET or MRI) may be used to get an outline of the tumor. These images help deliver radiation to the tumor’s exact location. Variation in the radiation beams’ intensity is also possible with IMRT, which can match the shape of the tumor to minimize damage to healthy tissue.
Volumetric Modulated Arc Therapy
Volumetric modulated arc therapy (VMAT) delivers external beam radiation continuously and in a very short treatment. This is especially useful for head and neck cancers. While the patient lies still, the treatment machine rotates around the body. VMAT is very accurate because the machine shapes the radiation dose to the tumor and delivers treatment with very small and accurate beams of radiation. Because of this, radiation damage to surrounding healthy tissue and organs is minimized.
Stereotactic Body Radiation Therapy
Stereotactic body radiation therapy (SBRT), also known as stereotactic ablative body radiation (SABR), uses radiation beams of varying intensity. The chief use of SBRT/SABR is on small, isolated tumors outside the brain, spinal cord, or in the liver or lungs. It’s also used when the patient cannot undergo surgery. Because of the radiation intensity, treatment with SBRT/SABR is shorter, requiring one to five treatments versus IMRT’s five to eight weeks of treatment. SBRT causes fewer side effects and produces a better outcome than conventional radiation treatment, however it’s not the right type of treatment for all patients.
Stereotactic radiosurgery (SRS) is used when surgery is not an option or would be very difficult due to the cancer’s location. It’s commonly used with tumors in the brain or spine. SRS uses multiple small beams of radiation aimed from different directions. This allows a targeted dose at the exact point where all the beams come together. The individual beams have little effect on the surrounding healthy tissue. The patient is immobilized so the beams can be precisely focused. SRS is usually completed in one treatment but can be given over several days.
Is Internal Radiation Therapy an Option for Head & Neck Cancers?
In some cases, radiation can be inserted into the body with a surgically placed implant. The radiation is then inserted into the implant so it can be delivered inside or immediately near the tumor.
Brachytherapy is most common when a high dose of radiation is needed in a very precise, small area or when external beam radiation would pass through healthy organs to reach the cancer. Brachytherapy greatly reduces the radiation exposure to healthy tissue.
High-Dose Rate Brachytherapy
High-dose-rate (HDR) brachytherapy is the most common for head and neck cancers. The radiation applicator can be inserted into the body or applied externally to the skin. After a few minutes, the applicator is removed. HDR treatment can be administered once or twice a day for two to five days or once a week for two to five weeks.
Low-Dose Rate Brachytherapy
Low-dose rate (LDR) brachytherapy delivers radiation at a slower pace. The implants can be placed temporarily or left in the body. Temporary applications can last from one to seven days. During the application time, the patient is usually hospitalized because they must stay immobile.
Side Effects of Radiation for Head and Neck Cancers
Even though radiation is delivered very precisely there are several organs located near one another in the head and neck area along with your teeth. There can be some effects on other areas nearby. This might include:
Reduced Thyroid Function: If the cancer is being delivered in the neck area, your thyroid could potentially take in some of the radiation therapy. This organ is especially sensitive to radiation and could slow down or stop working. Your cancer care team will watch this closely.
Hoarse Voice: Your voice may become hoarse if radiation is delivered near your voice box. In some cases this could be permanent depending on how much radiation was delivered in this area of the body.
Tooth Decay or Loss: Your cancer care team will work closely with the dentist to determine if there are things that can be done to prevent as much tooth loss as possible.
Dry Mouth: Especially when radiation is delivered in the mouth/oral cavity, the salivary glands can stop working causing the mouth to feel dry. There are mouth rinses available to help with this. Again, depending on how much radiation is delivered in this area, or how many salivary glands had to be removed through surgery, this condition may improve after treatment or could be permanent.
The Right Cancer Treatment Plan for You
If you’re located in the Atlanta area and require radiation therapy as part of the treatment process for a head or neck cancer, our team is available for a consultation about which technologies would be best for you and what you might expect during the treatments as well as afterwards. We’re here to help you throughout your treatment process. Request an appointment at the location that’s closest to you.