RADIATION THERAPY FOR HEAD AND NECK CANCER
Facts to Help Patients Understand Their Treatment

Diagnosing Head and Neck Cancer

Your physician will examine all the areas of your head and neck for cancer.

• Your doctor will check for lumps on the neck, mouth and throat. He or she may also use a flexible endoscope, a thin, lighted tube that is passed through the nose, to obtain a more comprehensive overview of the head and neck area.
• X-ray, CT, MR and PET scans are often used to show the location and extent of the cancer.
• A biopsy, or the removal of tissue that is then analyzed for cancer, may be done.

Types of Head and Neck Cancers

Head and neck cancers come from the cells that make up the face, mouth and throat. Because cancers in different locations behave differently, treatment will vary by type and extent of the cancer. Some common locations include:

• Nasal cavity/paranasal sinuses.
• Nasopharynx.
• Oral cavity (lips, gums, floor of mouth, oral tongue, cheek mucosa, hard palate, retromolar trigone).
• Oropharynx (base of tongue, tonsils, soft palate, oropharyngeal wall).
• Larynx (vocal cords and supraglottic larynx).
• Hypopharynx (pyriform sinuses, post-cricoid area, posterior pharyngeal wall).
• Salivary glands (parotid, submandibular, sublingual and minor salivary glands).
• Thyroid.

Cancers in the brain or eyes are considered different from head and neck cancers. However, your physician will check those areas to make sure the cancer has not spread.

Treatment for Head and Neck Cancer

Treatment for head and neck cancer depends on the type of cancer, its size and stage, the location, and your overall health.

• Surgery, radiation therapy and chemotherapy are the most common treatments for head and neck cancer.
• It’s often most effective to combine two or three types of treatments. It is important to discuss your care with several cancer specialists, including a surgeon, a radiation oncologist and a medical oncologist.
• A critical concept in treating head and neck cancer is organ preservation. Rather than relying on major surgery, an organ preservation approach begins with radiation and chemotherapy to shrink the tumor. This often results in less extensive surgery and may even allow some patients to avoid surgery altogether.

External Beam Radiation Therapy

External beam radiation therapy is given in a series of daily outpatient treatments to accurately deliver radiation to the cancer.

• Painless radiation therapy treatments are given in a series of daily sessions. Radiation treatments take just a few minutes, but each session takes about half an hour to get checked in, change clothes, get into position and administer the radiation. For some conditions, radiation is given twice a day, with a four to six hour gap between treatments.
• Treatments are usually given Monday through Friday, for five to eight weeks. However, the radiation oncologist may schedule treatments more or less often depending on the cancer.
• 3-dimensional conformal radiotherapy (3D-CRT) combines multiple radiation treatment fields to deliver precise radiation doses to the target area. Tailoring each of the radiation beams to accurately focus on the patient's tumor targets the cancer while avoiding nearby healthy tissue.
• Intensity modulated radiation therapy (IMRT) is a form of 3D-CRT that further fine-tunes the radiation by varying the intensity of each radiation beam. This technique allows a precise adjustment of radiation to the tissue within the target area. IMRT may allow doctors to direct a higher radiation dose to the affected area and keep more radiation away from surrounding healthy tissue.
• To keep patients still during treatment, your doctor may use a plastic head or shoulder mask. These devices are specially fitted for the patient and are painless to use.

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