External radiotherapy for nasopharyngeal cancer
This page is about treating nasopharyngeal cancers with external radiotherapy. You can find the following information
Having radiotherapy for nasopharyngeal cancer
You go to the hospital for treatment once a day, from Monday to Friday, with a break at the weekends. A course of treatment usually lasts for between 4 and 7 weeks.
If you have radiotherapy to any area of your face and neck, you need to wear a treatment mask. This keeps your head and neck very still during your treatment. The mask fits over your lower jaw 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.
Planning your treatment
Radiotherapy treatment is carefully planned. During your planning appointment, you lie under a large specialised CT scanning machine. The machine helps the doctors work out exactly where to give the treatment.
It may take around 15 minutes to have the treatment. You cannot feel the radiation. External radiotherapy does not make you radioactive.
You can view and print the quick guides for all the pages in the treating nasopharyngeal cancer section.
External beam radiotherapy uses high energy rays to kill cancer cells. You usually have a type of radiotherapy called intensity modulated radiotherapy (IMRT) for nasopharyngeal cancer. IMRT directs a precisely targeted dose of radiation to the area of the tumour from outside the body.
You have your treatment in the hospital radiotherapy department. This means going 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 and 7 weeks.
Your doctor makes sure that the whole of the area with cancer is treated, as well as about 1 centimetre around it. This is to make sure they don’t miss any stray cancer cells. Doctors call these stray cells microscopic spread. A scan is unable to pick them up because they are so small. But if they are left, they could cause your cancer to come back.
If you smoke your doctor will advise you to give up. Radiotherapy may not work as well and you may have more side effects if you continue to smoke. Stopping smoking can be very difficult, especially when you are going through a stressful time. So do talk to your doctor or nurse about support to help you stop smoking.
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 may have more than one appointment.
You will have a planning CT scan. The scan shows the cancer and the structures around it.
You lie on the scanner couch. 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 or PET scans. Your treatment team can feed the other scans into the planning scanner.
During your first planning appointment, the radiographer makes a mask of your head and neck. The mask is also called a mould or shell. This keeps your head and neck very still during your treatment, and makes sure that you are in the same position every time you have radiotherapy.
This helps to make sure that the radiation only goes to the exact area that needs treating. Below is a picture of a mask.
The staff explain what is going to happen. 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 a dental impression made with gel. The technician puts the gel into your mouth, and take an impression of your teeth. This takes between 5 and 10 minutes. The whole visit takes about 30 minutes.
Masks are usually made from a special plastic mesh which moulds into shape easily when it is heated up.
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.
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 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 the radiotherapy when you actually have the treatment. It may take up to 15 minutes or more. It is important to lie in the same position each time, so the radiographers may take a little while to position you on the couch and attach your mask to the couch. They make sure your mask feels comfortable.
Once you are in the right position the staff leave you alone in the room. 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.
The video below shows how you have radiotherapy for head and neck cancer:
View a transcript of the video showing radiotherapy for head and neck cancer (opens in new window).
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