Radiation therapy for laryngeal cancer

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is usually used to treat laryngeal cancer. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You may also receive other treatments.

Radiation therapy is often combined with chemotherapy to treat laryngeal cancer. This is called chemoradiation. The 2 treatments are given during the same time period.

Radiation therapy is given for different reasons. You may have radiation therapy or chemoradiation:

• as a primary treatment for early stage laryngeal cancer or if you are not healthy enough to have surgery
• as a primary treatment, along with chemotherapy (chemoradiation), to treat large tumours or tumours that have spread to nearby lymph nodes
• to destroy cancer cells left behind after surgery, with or without chemotherapy, to reduce the risk that the cancer will come back (recur) (called adjuvant therapy)
• after surgery if the tumour is hard to remove, can’t be completely removed or has spread to nearby tissues or lymph nodes
• to relieve pain or control the symptoms of advanced laryngeal cancer (called palliative therapy)

It is important to have a dental exam before receiving radiation therapy. A thorough dental exam is done to find any dental work needed and make sure the work is done before the treatment starts. Radiation to the head and neck area can worsen any existing dental problems. The dentist will remove any unhealthy teeth. You and your dentist will also decide on an after-treatment plan for dental care.

People who have radiation therapy to treat laryngeal cancer need an immobilization mask. The mask is worn when planning treatment and during all radiation treatments. It helps you stay in the same position each time radiation is given.

External beam radiation therapy for laryngeal cancer is usually given 5 times a week for about 7 weeks. The following types of external beam radiation therapy are most commonly used to treat laryngeal cancer.

During external beam radiation therapy, a machine directs radiation through the skin to the tumour and some of the tissue around it.

Laryngeal cancer is often treated using a type of external beam radiation therapy called conformal radiation therapy. There are 2 types of conformal radiation therapy.

3-D conformal radiation therapy (3-D CRT) delivers radiation beams of equal strength to the tumour from several different directions. This can decrease the radiation damage to normal tissues and increase the radiation to the tumour.

Intensity-modulated radiation therapy (IMRT) delivers radiation beams of different strengths directed at the tumour from several different directions. This method shapes the treatment beams very precisely and allows the dose of radiation to be adjusted for different parts of the treatment area.

Side effects can happen with any type of treatment for laryngeal cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

During radiation therapy, the healthcare team protects healthy cells in the treatment area as much as possible. But damage to healthy cells can happen and may cause side effects. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after radiation therapy. Sometimes late side effects develop months or years after radiation therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of radiation therapy will depend mainly on the size of the area being treated, the specific area or organs being treated, the total dose of radiation, if chemotherapy is given at the same time (chemoradiation) and the treatment schedule. Side effects of chemoradiation can be more severe than those of radiation therapy alone.

Some common side effects of radiation therapy used for laryngeal cancer are:

• skin problems
• dry mouth
• worsening of hoarseness
• sore throat
• trouble swallowing
• taste changes
• tooth decay
• trouble breathing
• fatigue
• thyroid problems
• trismus
• osteoradionecrosis

Tell your healthcare team if you have these side effects or others you think might be from radiation therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Find out more about radiation therapy and side effects of radiation therapy. To make the decisions that are right for you, ask your healthcare team questions about radiation therapy.