Having external radiotherapy for mouth and oropharyngeal cancer
External radiotherapy uses a machine outside the body to direct radiation beams at the cancer. It uses high energy rays similar to x-rays to kill cancer cells.
You usually have a type of external radiotherapy called intensity modulated radiotherapy (IMRT) for mouth or oropharyngeal cancer.
Intensity modulated radiotherapy (IMRT) is a type of conformal radiotherapy. This means shaping the radiation beams to closely fit the area of cancer.
When you might have it
You may have external radiotherapy:
- on its own as your main treatment
- after surgery
- with chemotherapy (chemoradiotherapy)
- with targeted drugs
- to control symptoms of advanced cancer
How you have radiotherapy
You have your treatment in the hospital radiotherapy department. You usually have it Monday to Friday with a break at the weekend. The treatment can be over 4 to 7 weeks. This depends on the:
- size of your cancer
- type of cancer
- hospital treating you
You need to travel to the hospital each time you have treatment. Some hospitals have rooms nearby where you can stay if you have a long way to travel.
You go to the radiotherapy department from your ward if you are staying in the hospital.
Radiotherapy as your main treatment
You might have radiotherapy on its own with no other treatment. This is usually if you have a small, early stage cancer or if you cannot have surgery.
Radiotherapy after surgery
This is called adjuvant therapy. It aims to kill any remaining cancer cells after surgery and It helps to stop your cancer from coming back.
You may have it because:
- your tumour was difficult to remove
- your surgeon thinks there may be cancer cells left behind
- the tumour had spread locally into nearby structures
- your doctor found cancer cells in your lymph nodes
You have adjuvant radiotherapy on its own or together with chemotherapy.
Radiotherapy with chemotherapy
You might have radiotherapy and chemotherapy together (chemoradiotherapy). You may have this as your main treatment if your cancer has spread into surrounding tissue or lymph nodes, and if surgery is not suitable. Or you might have this after surgery.
Research has shown that in some situations these treatments work better together than on their own.
Radiotherapy with targeted drugs
You may have a targeted drug with radiotherapy, for example, cetuximab. Targeted cancer drugs work by ‘targeting’ those differences that help a cancer cell to grow and survive.
To treat symptoms of advanced cancer
Radiotherapy can help relieve symptoms of advanced cancer. You may hear this called palliative radiotherapy. The treatment can relieve symptoms such as bone pain, caused by cancer spreading to the bones.
The radiotherapy room
Radiotherapy machines are very big and could make you feel nervous when you see them for the first time. The machine might be fixed in one position. Or it might rotate around your body to give treatment from different directions. The machine doesn't touch you at any point.
Before your first treatment, your 
will explain what you will see and hear. In some departments, the treatment rooms have docks for you to plug in music players. So, you can listen to your own music while you have treatment.
During the treatment
You need to lie very still. Your radiographers might take images (x-rays or scans) before your treatment to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.
Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.
Daniel (radiographer): Before your treatment starts your doctor will need to work out exactly where the treatment needs to go and also which parts need to be avoided by the treatment.
To have radiotherapy you lie in the same position as you did for your planning scans.
To stop you moving and to make sure your treatment is directed at the cancer you wear a custom mask over your face which is attached to the couch.
We line up the machine using marks on your mask and then leave the room. We control the machine from a separate room this is so we aren’t exposed to radiation.
Treatment takes a few minutes and you’ll be able to talk to us using an intercom. We can see you and hear you while you’re having treatment and we will check that you’re OK.
When your treatment starts you won’t feel anything. You may hear the machine as it moves around you giving the treatment from different angles.
Because we’re aiming to give the same treatment to the same part of the body every day the treatment process is exactly the same every day so you shouldn’t really notice any difference.
You’ll see someone from the team caring for you once a week while you’re having treatment. They’ll ask how you are and ask about any side effects.
You won't be radioactive
This type of radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.
Travelling to radiotherapy appointments
You might have to travel a long way each day for your radiotherapy. This depends on where your nearest cancer centre is. This can make you very tired, especially if you have side effects from the treatment.
You can ask the for an appointment time to suit you. They will do their best, but some departments might be very busy. Some radiotherapy departments are open from 7 am till 9 pm.
Car parking can be difficult at hospitals. Ask the radiotherapy staff if you are able to get free parking or discounted parking. They may be able to give you tips on free places to park nearby.
Hospital transport may be available if you have no other way to get to the hospital. But it might not always be at convenient times. It is usually for people who struggle to use public transport or have any other illnesses or disabilities. You might need to arrange hospital transport yourself.
Some people are able to claim back a refund for healthcare travel costs. This is based on the type of appointment and whether you claim certain benefits. Ask the radiotherapy staff for more information about this and hospital transport.
Some hospitals have their own drivers and local charities might offer hospital transport. So do ask if any help is available in your area.
Side effects of treatment
Radiotherapy for mouth or oropharyngeal cancer can give you:
- red or sore skin around the area
- dry and sore mouth
- taste and smell changes
- voice changes
- nausea (feeling sick)
