Having your laryngeal cancer radiotherapy

You have radiotherapy 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 on the aim of the treatment.

If you have radiotherapy treatment to any area of your head and neck you will usually need to wear a treatment mask. The mask is also called a cast, mould or shell. This keeps your head and neck very still during your treatment. Keeping your head very still helps to make sure that the radiation only goes to the exact area that needs treating. 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. The staff will explain what is going to happen before anything is done. The mould room technician will make your mask individually for you. It should feel comfortable and secure when you wear it. Having the mask made won't hurt. But it may feel a bit strange to have someone working so closely on your head and neck. The whole visit takes about 30 minutes.

Masks are made from either a thin sheet of clear plastic or newer thermoplastic materials that are more like netting. Thermoplastic means you can shape them when they are heated. The technician will cut a hole in the mask for your mouth and for your nose, if your mask comes up that far. There is a picture of a mask below.

Once your mask is ready, your specialist plans your radiotherapy treatment very carefully. During your second planning appointment, you lie under a scanner or a large machine called a simulator. The radiographer will fix your mask in place so that you can't move your head. This is important, to make sure the treatment is given very exactly. The scanner or simulator takes scans or X-rays. The doctor uses these to work out where to give the treatment to

• Include any remaining cancer cells
• Miss as much of the surrounding healthy body tissue as possible

Your specialist works out the total radiation dose you need and how that should be split up into your daily treatments. This is a complicated process, but if you would like to know more, there is more information about planning radiotherapy in the main radiotherapy section of CancerHelp UK.

Each treatment only takes a few minutes. The radiographer will help position you on the couch and make sure your mask feels as comfortable as it can. You will be left alone for the minute or two the radiotherapy machine is switched on. The staff will be able to hear you through an intercom, so you can call if you need them. The treatment does not hurt – you will not be able to feel it at all. You will need to lie very still for the few minutes it takes to treat you. There is a picture of a radiotherapy machine below.

Having external radiotherapy does not make you radioactive. It is perfectly safe to be with other people, including children, throughout your treatment course.

Radiotherapy side effects usually come on gradually during your course of treatment. Most people have some side effects with radiotherapy to the head and neck. They are usually at their worst at the end of your course of treatment. Over the 2 to 3 weeks following your treatment the side effects will slowly get better. It may take up to 6 weeks before the soreness has completely gone. Getting over a long course of treatment completely can take quite a few months. If you had chemotherapy at the same time as radiotherapy, it can take 3 or 4 months for the soreness to settle.

Generally, radiotherapy causes tiredness and sore, red skin in the area being treated. Radiotherapy to the neck can cause

• A sore throat
• Pain on swallowing
• A dry mouth
• A hoarse voice

Your throat may become more sore as you go through your treatment. If it is very sore, you may need strong painkillers, such as morphine. Towards the end of a 4 or 6 week course, you may find it very difficult to swallow. You can have a liquid diet if you need to. Make sure you tell the staff in the radiotherapy department about any problems you have. They can arrange for you to see a dietician and to have liquid food on prescription.

If your mouth is very dry, your doctor can prescribe artificial saliva to keep it moist. This is not just to make you more comfortable. You are less likely to get an infection if your mouth is moist.

Your voice is likely to get more hoarse as you go through your treatment. It may go altogether. It will come back, but may sound different to you afterwards. Radiotherapy to the voice box can change the sound of your voice permanently.

If you need help with side effects, speak to the radiographer or nurse at your radiotherapy department. They can help you manage the side effects and speak to your doctor if necessary. Very rarely, side effects are particularly severe. If this happens, your doctor will stop the treatment for a time to allow you to recover.

Remember to check with your radiotherapy department before putting any lotions, powders or creams on the skin in your radiotherapy treatment area. If your skin is sore, lotions or creams may make things worse not better. If you need it, ask staff at the radiotherapy department for something to soothe your skin.

There is more about general head and neck radiotherapy side effects in the main radiotherapy section of CancerHelp UK.