Side effects of radiotherapy for salivary gland cancer

The side effects of radiotherapy usually come on gradually during your course of treatment. Most people have some side effects from radiotherapy to the salivary gland area. They are usually at their worst at the end of your course. Over the 2 to 3 weeks following your treatment they will slowly get better. It may take up to 6 weeks before the soreness has entirely gone. Getting over a long course of treatment completely can take quite a few months.

Generally, radiotherapy causes tiredness and sore, red skin in the treatment area. This is a bit like sunburn. You may also feel sick for a while after the treatment.

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

The salivary glands make saliva, which keeps your mouth and throat moist and your teeth healthy. It also helps make swallowing and digestion of food easier and helps your sense of taste. Radiotherapy to the salivary glands stops them making saliva. You will see a restorative dentistry consultant before you start treatment.

Usually only the glands on the treated side of your face are affected. This means that glands on the other side should still make saliva. Rarely, some people have a permanently dry mouth after the treatment. This can make eating and talking uncomfortable.

If you have trouble with a dry mouth, the team caring for you can prescribe artificial lubricating agents and stimulants for your salivary glands. These help to keep your mouth moist and make you more comfortable. They also reduce the chance of infections or tooth decay. You will need to have regular check ups from your dentist.

Most people start making saliva again within 4 to 8 weeks of finishing treatment. The saliva is likely to be quite thick and may taste unpleasant at first.

There is information about coping with a dry mouth in our eating after salivary gland cancer section.

Your mouth and throat may get increasingly sore with mouth ulcers as you go through your treatment. If they are very sore, you may need strong painkillers such as morphine. Your doctor may also prescribe a mouth gel such as Gelclair. This gel forms a protective barrier over the inside of the mouth, a bit like a dressing. This can make your mouth less painful. You will then find it easier to eat and drink.

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 after radiotherapy and some types of chemotherapy. Loss of taste can reduce your appetite. This doesn’t help when you are finding it difficult to eat anyway. Although you can recover your sense of taste, some people may find it is permanently dulled. There is detailed information about coping with taste changes in the living with salivary gland cancer section.

Standard radiotherapy for parotid gland cancer may cause damage to the inner ear and hearing loss. The COSTAR trial aims to find out if giving radiotherapy in a different way can reduce the risk of hearing loss.

Radiotherapy to your mouth can make you more likely to get tooth decay. You will need to go for check ups at the dentist more often. Fluoride treatment may help to protect your teeth. You can have this as a mouthwash to use twice a day. Sometimes you might have to have some teeth taken out before you start treatment. Your specialist may refer you for a dental examination before your radiotherapy.

Remember to tell your dentist that you have had radiotherapy to your salivary glands before you have any dental work. Your dentist may have to change the way they treat you and may need to talk to your radiotherapy doctor before giving you any treatment. There is a clinical trial looking at how to reduce the risk of bone damage after radiotherapy to the jawbone.