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Mouth cancer radiotherapy side effects

Radiotherapy to the mouth, oropharynx or neck area causes side effects. The effects are usually at their worst at the end of your course of treatment. Over the 2 to 3 weeks following your treatment they slowly get better. Getting over a long course of treatment completely can take several months.

Generally, radiotherapy causes tiredness and sore, red skin in the area being treated. Don’t put any lotions, powders or creams on the treated skin without checking first with your radiotherapy department.

Other side effects

Other side effects with mouth or oropharyngeal cancer radiotherapy can include

  • A sore throat and pain on swallowing – your mouth and throat may become increasingly sore and you may have mouth ulcers. You may need strong painkillers and a liquid diet or liquid food through a tube
  • A dry mouth – radiotherapy to the head and neck area can damage the glands that make saliva so you may have a permanently dry mouth. Your doctor can prescribe artificial lubricating agents and stimulants for your salivary glands
  • Changes to your sense of taste and smell
  • A hoarse or lost voice – your voice will come back but may sound different after treatment
  • Some people may feel sick at times

If you need help with side effects, speak to your radiographer or nurse at the radiotherapy department. They can help you manage the effects.

 

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

 

 

When you get side effects

Radiotherapy to the mouth, oropharynx and neck area causes side effects. The effects usually come on gradually during your course of treatment. They will usually be at their worst at the end of your radiotherapy course. Over the 2 to 3 weeks following your treatment they will slowly get better. It may take up to 6 weeks before the mouth or throat soreness has completely gone. Getting over a long course of treatment completely can take several months.

 

General radiotherapy side effects

Generally, radiotherapy causes tiredness and sore, red skin in the area being treated. This is a bit like sunburn.

Remember not to put any lotions, powders or creams on the skin in the treatment area without checking first with staff in your radiotherapy department. If you have any soreness, the creams or lotions may make things worse, not better. If you need it, ask at the radiotherapy department for something to soothe your skin.

Some people may feel sick at times. Your doctor or specialist nurse can prescribe anti sickness medicines if you need them.

Radiotherapy to the neck can damage the thyroid gland. If this happens, you will need to take pills to replace thyroid hormones.

 

Sore mouth and throat

Your mouth and throat may become increasingly sore and you may have mouth ulcers as you go through your treatment. If it is very sore, you may need  painkillers such as morphine. Your doctor may also prescribe a mouth gel. This gel forms a protective barrier over the inside of the mouth, a bit like a dressing. The barrier can make your mouth less painful and can make it easier to eat and drink.

Mouth care is very important with this type of treatment. Your nurse or radiographer can give you mouthwashes to use and will talk you through how to use them. It is important to do this as often as you are asked to. Otherwise there is a risk of getting an infection, which can be very painful.

 

Pain on swallowing

Towards the end of the radiotherapy course, you may have a lot of difficulty swallowing. You can have a liquid diet if you need to. Make sure you tell the staff in the radiotherapy department about any problems that you have. The staff can arrange for you to see a dietician and to have liquid feeds on prescription. If you can still swallow you can drink the liquid feeds. If you are finding it too painful to swallow, your doctor or nurse can put in a tube called a nasogastric tube (NG tube). The nasogastric tube goes up your nose and down into your stomach. You can then have the feeds through the tube. 

Many people find they need to have tube feeding, just to keep their calorie intake up. Some people have a tube that goes through the skin into their stomach. This is called a PEG tube

If you have an NG tube or a PEG tube, your nurse will show you and your relatives how to use it and look after it and how to give the feeds.

 

Dry mouth

Radiotherapy to the head or neck area can cause damage to the salivary glands. Salivary glands make spit (saliva) and keep your mouth and throat moist. Saliva provides minerals that help to keep your teeth healthy. It also helps to make swallowing and digestion of food easier and helps your sense of taste.

After the treatment, you may have a permanently dry mouth, which can make eating and talking uncomfortable. If you have trouble with a dry mouth, your doctor can prescribe artificial lubricating agents and stimulants for your salivary glands. These will help to keep your mouth moist and will make you more comfortable. Moistening the mouth also helps to reduce the chance of mouth infections or tooth decay. You will need to have regular check ups with your dentist. 

There is some evidence to suggest that treatment with acupuncture can help to reduce a dry mouth after radiotherapy to the head and neck area. There is detailed information about coping with a dry mouth in the living with mouth and oropharyngeal cancer section.

 

Taste changes

Radiotherapy to the head or neck often affects taste. You may lose your sense of taste, or have strange tastes or dulled taste. People often describe a metallic taste in their mouth with radiotherapy and some chemotherapy drugs. A loss of taste can also affect your appetite, which can make things difficult if you are finding it hard to eat anyway. Although your sense of taste may recover, some people may find that it is permanently dulled. There is information about coping with taste changes in the living with mouth and oropharyngeal cancer section.

 

Hoarse voice

Your voice may become hoarse as you go through your radiotherapy. Depending on the area being treated your voice may disappear altogether. It will come back, but may sound different afterwards.

 

Changes to your sense of smell

Radiotherapy for mouth and oropharyngeal cancer can affect your sense of smell. This is because radiotherapy causes dryness of the mouth and nose. If your nose is very dry you will not be able to smell things normally for a while.

 

Difficulty opening your mouth

Radiotherapy can damage the nerve which controls the muscles that move your mouth. This can make it difficult for you to open your mouth. This problem is called trismus. If this happens, your doctor or nurse will give you exercises to do to help relieve the problem.

 

Where to find more information

There is information about the general side effects of radiotherapy to the head and neck in the main radiotherapy section.

If you need help with side effects, speak to your radiographer or nurse at the radiotherapy department where you have treatment. The staff can help you manage the side effects. They can speak to your doctor if necessary. If the side effects are particularly severe your doctor will stop the treatment for a while to allow you to recover.

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Updated: 26 March 2013