Having radiotherapy for nasal and paranasal sinus cancer
Radiotherapy uses high energy x-rays to treat nasal and parnasal sinus cancer cells. You have the treatment in the hospital radiotherapy department.
When you might have radiotherapy
Radiotherapy on its own
Radiotherapy may be the first choice of treatment for some types of nasal cavity and paranasal sinus cancers. It can cure many people with early stage cancers. Whether this type of treatment is suitable for you will depend on:
- which type of cancer you have
- the size of the cancer
- how far it has grown into the surrounding tissues
- exactly where the cancer is
Radiotherapy with chemotherapy
You may have radiotherapy and chemotherapy together (chemoradiotherapy). This might be for some types of nasal cavity and paranasal sinus cancers.
Radiotherapy after surgery
Radiotherapy after surgery is called adjuvant therapy. It helps to stop your cancer from coming back. Doctors use radiotherapy after surgery for several reasons. You may have it because:
- the tumour was difficult to remove
- your surgeon thinks there may be cancer cells left behind
- the tumour had spread locally into nearby structures
- cancer cells were found in your lymph nodes
You usually have treatment every day, Monday to Friday, for between 4 and 7 weeks. You have up to 35 separate treatments called fractions. Breaking the treatment down into a series of smaller treatments helps to keep side effects under control.
If you add up all the radiation doses you have in the fractions, the total will be the complete dose of radiation your specialist has prescribed for you.
Radiotherapy to relieve symptoms
Radiotherapy can relieve symptoms in advanced nasal cavity and paranasal sinus cancers. This is also called palliative radiotherapy.
Your cancer may be causing difficulty in swallowing or breathing. Some nasal cavity and paranasal sinus cancers are close to the brain, so they can grow and put pressure on the brain. Radiotherapy can help to relieve this pressure.
The treatment relieves symptoms by shrinking the cancer. The cancer may grow back, but it could take a while to do so. No one can say how long, but the radiotherapy could relieve your symptoms for some time.
Radiotherapy can also help to relieve pain and control any bleeding. To control symptoms, you are most likely to have a short course of treatment over a few days.
Types of radiotherapy
Intensity modulated radiotherapy (IMRT)
There are different types of external radiotherapy. You usually have a type of radiotherapy called intensity modulated radiotherapy (IMRT) for nasal or paranasal cancer. This treatment directs a precisely targeted dose of radiation to the area of the tumour from outside the body.
Proton beam radiotherapy
Proton beam radiotherapy is sometimes used for:
- very rare sinus cancers
- treatment to an area called the skull base
Your specialist doctor will refer you for this specialised type of radiotherapy if they think it is the best treatment for you.
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.
This video shows what happens during the treatment. The video lasts 1:17 minutes.
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 everyday 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 radiotherapy
Radiotherapy for nasal and paranasal sinus cancer causes tiredness and sore, red skin in the area being treated. It can also cause other effects.
