Planning radiotherapy for mouth and oropharyngeal cancer

Radiotherapy shell (mould)

Your treatment team might make a mask for you if you are having radiotherapy to your head and neck area. They are also called radiotherapy shells.

Your treatment team will make one for you to wear during your treatment sessions. It will help you to keep very still when you have radiotherapy.

The radiographers make marks on the mask and use the marks to line up the radiotherapy machine for each treatment.

The process of making the shell can vary slightly between hospitals. It usually takes around 30 minutes.

Before making the mask

You need to wear clothes that you can easily take off from your neck and chest. You also need to take off any jewellery from that area.

Facial hair, long hair or dreadlocks can make it difficult to mould the shell. The radiotherapy staff will tell you if you need to shave or to tie your hair back.

Making the mask

A technician uses a special kind of plastic that they heat in warm water. This makes it soft and pliable. They put the plastic on to your face, neck and chest so that it moulds exactly. 

After a few minutes the plastic gets hard. The technician takes the mask off and it is ready to use.

The planning CT scan

You usually have a planning CT scan in the radiotherapy department.

The scan shows the cancer and the area around it. You might have other types of scans or x-rays to help your treatment team plan your radiotherapy. The plan they create is just for you.

Your radiographers tell you what is going to happen. They help you into position on the scan couch. You might have a type of firm cushion called a vacbag to help you keep still. You wear your radiotherapy mask during the scan.

The CT scanner couch is the same type of bed that you lie on for your treatment sessions. You need to lie very still. Tell your radiographers if you aren't comfortable.

Injection of dye

You might need an injection of contrast into a vein in your hand. This is a dye that helps body tissues show up more clearly on the scan.

Before you have the contrast, your radiographer asks you about any medical conditions or allergies. Some people are allergic to the contrast.

Having the scan

Once you are in position your radiographers put some markers on your skin or mask. They move the couch up and through the scanner. They then leave the room and the scan starts.

The scan takes about 5 minutes. You won't feel anything. Your radiographers can see and hear you from the CT control area where they operate the scanner. 

You need to keep your head still during the CT scan.

Watch our video about radiotherapy planning. It is just under 3 minutes long.

After your planning session

You might have to wait a few days or up to 3 weeks before you start treatment.

During this time the physicists and your radiotherapy doctor (clinical oncologist) decide the final details of your radiotherapy plan. They make sure that the area of the cancer will receive a high dose and nearby areas receive a low dose. This reduces the side effects you might get during and after treatment.

Removing teeth and putting in dental implants

You may need to have some or all of your teeth removed before your radiotherapy treatment. You might also need to have dental implants put in after your radiotherapy. 

Your restorative dentist will talk this through with you before your radiotherapy. They will be happy to answer your questions. They will be aware that you may be very worried and upset about having your teeth removed. Don't be afraid to find out all you need to. You might find it easier to cope if you understand exactly what is going to happen. 

Having radiotherapy