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External radiotherapy for mouth cancer

Men and women discussing mouth cancer

This page has information about treating mouth and oropharyngeal cancers with external radiotherapy. You can find information about

 

A quick guide to what's on this page

External radiotherapy for mouth cancer

This treatment aims an accurately targeted dose of radiation to the area of the tumour. You usually have a type of radiotherapy called intensity modulated radiotherapy for mouth or oropharyngeal cancer. 

You have the treatment in the hospital radiotherapy department. You go for treatment once a day, from Monday to Friday, with a break at the weekends. The length of the course of treatment varies but is usually between 4 to 7 weeks.

Radiotherapy masks

During each treatment session, you usually need to wear a treatment mask, also called a mould or shell. This keeps your head and neck very still during your treatment. The mask fits over all or part of your face and neck. The radiographer attaches the mask to the radiotherapy couch. Your mask is made during your first planning appointment. It should feel comfortable and secure when you wear it.

Planning your treatment

Your radiotherapy treatment team carefully plan the treatment. During your planning appointment, you have scans from a specialised CT scanning machine. Your treatment team uses the scans to work out exactly where to give the treatment.
 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating mouth cancer section.

 

 

What external radiotherapy is

For external radiotherapy a machine aims a precisely targeted dose of radiation to the area of the tumour. You usually have a type of radiotherapy called intensity modulated radiotherapy for mouth or oropharyngeal cancer. 

You have the treatment in the hospital radiotherapy department. You go to the hospital for treatment once a day, from Monday to Friday, with a break at the weekends. 

The length of the course of treatment varies, depending on the type and size of the cancer and the aim of the treatment. But it is usually for between 4 to 7 weeks.

Your doctor makes sure that the whole area with cancer is treated, as well as a small area around it. This is to make sure the radiation doesn't miss any stray cancer cells. Doctors call these stray cells microscopic spread. A scan can't pick up these cells because they are so small. But if they are left, they could grow and your cancer could come back.

 

Planning your radiotherapy treatment

Before you begin your treatment, the radiotherapy team carefully plan your external beam radiotherapy. This means working out how much radiation you need to treat the cancer and exactly where you need it. 

Your planning appointment may take from 15 minutes up to a couple of hours. You will have a planning CT scan. The scan shows the cancer and the structures around it.

CT scanner

You lie on the scanner couch with the treatment area exposed. The radiographers put some markers on your skin. You need to lie very still. Once you are in position the radiographers move the couch up and through the scanner. The scanner is a doughnut shape. 

The radiographers leave the room and the scan starts. It takes up to 5 minutes. You won't feel anything. The radiographers watch from the next door room.

Before the planning appointment you may also have other scans, such as MRI scans. Your treatment team can feed the other scans into the planning scanner.

Moulds or masks

If you have radiotherapy to any area of your face and neck, you usually need to wear a treatment mask, also called a mould or shell. The mask keeps your head and neck very still during your treatment. The mask fits over all or part of your face and neck. The radiographer attaches it to the radiotherapy couch each time you have treatment.

You have your mask made during your first planning appointment. The staff will explain what is going to happen. The radiographers lie you down on the CT scanner and they put you in the position you need to be in for the treatment. They then make your mask individually for you. Having the mask made won't hurt. But it may feel a bit strange to have someone working so near to your face.

You may have an impression of your teeth made with gel. The technician will put the gel into your mouth and take an imprint of your teeth. This takes between 5 and 10 minutes. The whole visit usually takes about 30 minutes.

Masks are made from either a thin sheet of clear plastic or various materials which mould into shape easily when they are heated up. The technician will cut holes in the mask for your nose and mouth so that you can breathe comfortably.

Mesh plastic mask used for radiotherapy for the head and neck area

After your planning session

You may have to wait a few days or up to 2 weeks before you start treatment. During this time the physicists and your radiotherapy doctor decide the final details of your plan. 

Your doctor plans the areas that need treatment and outline areas to limit the dose to or avoid completely. They call this contouring. Then the physicists and staff called dosimetrists plan the treatment very precisely using advanced computers.

 

Having your radiotherapy treatment

Radiotherapy machines are very big. The machine may be fixed in one position or able to rotate around your body to give treatment from different directions. Before your first treatment your radiographers explain what you will see and hear. The treatment rooms usually have docks for you to plug in music players. So you can listen to your own music.

You can't feel radiotherapy when you actually have the treatment. It is important to lie in the same position each time, so the radiographers may take a little while to get you ready. They place the mask on you for every treatment.

A photo of a linear accelerator, which gives radiotherapy

Once you are in the right position the staff leave you alone in the room for up to 30 minutes. They watch you carefully on a closed circuit television screen. 

External radiotherapy doesn't make you radioactive. It is perfectly safe to be with other people, including children, throughout your course of treatment.

This video shows you how you have radiotherapy for head and neck cancer:

View a transcript of the video showing radiotherapy for head and neck cancer. The transcript opens in a new window.

 

More about mouth cancer radiotherapy

Find out about

External radiotherapy

Intensity Modulated Radiotherapy (IMRT)

Radiotherapy moulds and masks

Side effects of radiotherapy to the mouth or oropharynx

Cancer tests and scans

Coping with cancer - Fear, anxiety and panic

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IMRT side effects radiotherapy

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Updated: 30 September 2014