Laryngeal Cancer: Radiation Therapy
Radiation therapy kills cancer cells by focusing powerful rays of energy at the tumor.
You will see a radiation oncologist for treatment. This is a healthcare provider who
specializes in radiation therapy, to treat cancer. A healthcare team will work with
you during your treatment. Your team will include a radiation therapist, radiation
nurse, and dietitian.
When might radiation therapy be used for laryngeal cancer?
Radiation therapy might be used for any of these reasons:
To kill cancer cells that might be left after surgery and lower the chance that the
cancer will come back
For tumors that can't be removed with surgery
As the main treatment for some tumors that aren't too advanced. This may help your
voice stay much the same. Surgery usually involves removing the voice box (larynx).
If you can't have surgery for other reasons. This might be because you're too sick
or have other major health problems.
For a tumor that comes back after treatment
To help ease symptoms caused by advanced cancers, like pain or trouble swallowing
Radiation to the head and neck area can affect your teeth and gums. It can also cause
problems with tissue healing after dental work. Because of this, it's important to
have a full dental exam before starting radiation. Some or all of your teeth may need
to be removed because radiation can make any existing dental problems worse if you
have damaged teeth.
How is radiation therapy given for laryngeal cancer?
There are two main types of radiation therapy. One is external beam radiation treatment
(EBRT). The other is internal radiation. This is also called brachytherapy.
External beam radiation treatment (EBRT)
This type of therapy uses a large machine to focus the radiation beams on the tumor.
The machine doesn't touch you, and radiation treatment doesn't hurt. EBRT is the type
of radiation therapy most often used to treat laryngeal cancer. The treatment plan
will be made to fit your cancer. It will usually include a specific number of treatments
given over a set period of time.
Some of the types of EBRT that may be used include:
Standard. Standard EBRT aims radiation at your tumor from one direction. Treatment is a lot
like getting an X-ray, but it lasts longer.
3-D conformal radiation therapy (3-D CRT). This form of EBRT uses a computer to shape the radiation beams and aim them at your
tumor from many directions. This can decrease the dose of radiation to nearby healthy
tissue and help lessen side effects.
Intensity-modulated radiotherapy (IMRT). IMRT uses a computer to control the direction, shape, and strength or intensity of
the radiation beams. This allows a high dose to reach the tumor. It decreases the
dose of radiation to nearby healthy tissue to help reduce side effects. IMRT is the
most common type of radiation used for laryngeal cancer.
Internal radiation or brachytherapy
Internal radiation therapy is done by putting radioactive material right into or near
the tumor. It may be done along with EBRT. But it's seldom used for laryngeal cancer.
What are common side effects of radiation therapy?
Radiation therapy affects normal cells as well as cancer cells. The side effects of
radiation depend on the amount and the type of radiation you get, as well as the part
of the body being treated. It also depends on whether you're getting chemotherapy
along with the radiation. Side effects may start 2 to 3 weeks after starting EBRT
Radiation to the neck and throat often causes painful sores in the mouth and throat.
This can make it hard for you to chew and swallow. Because of this, you may not eat
or drink enough. The sores tend to go away a few weeks after radiation ends. But to
help prevent weight loss and malnutrition, your healthcare provider may advise putting
a feeding tube into your stomach. This tube is called a percutaneous endoscopic gastrostomy
(PEG) tube. It's put into your stomach through a small cut (incision) on your belly.
The PEG tube is temporary. It is taken out when it's no longer needed. A dietitian
can work with you to help you get enough nutrition to stay at your normal weight.
Other side effects from radiation therapy may include:
Skin in the treated area turns red and may peel or blister
Thick, sticky saliva
Difficulty opening the mouth
Decreased sense of taste
Loss of appetite
Trouble breathing because of swelling. This could require a temporary breathing tube.
Swelling or scarring
Side effects of radiation are worse when it's given along with chemotherapy. You most
likely will feel better 4 to 6 weeks after the end of radiation therapy.
In rare cases, radiation may lead to a breakdown of cartilage that can further damage
your larynx. Or it may damage your windpipe or trachea.
Radiation to the neck might damage the thyroid gland. This may make you feel tired,
gain weight, feel cold, and have dry skin or hair. If this happens, you may need to
take thyroid hormone pills.
Radiation near the salivary glands may cause dry mouth. This may continue even after
treatment ends because of lasting damage to the salivary glands. People with dry mouth
after radiation must pay close attention to their oral and dental health. Dry mouth
can cause tooth decay and tooth loss. This is why it's important to see the dentist
before starting radiation so teeth in the radiation field can be removed.
Most side effects go away after treatment. Talk to your healthcare provider about
what radiation side effects you should watch for and when to notify them. Ask what
you can do to manage or even prevent side effects.