Radiation Therapy for Throat Cancer
Overview
Radiation therapy works by using high-energy X-rays to kill cancer cells. MSK offers precise radiation therapy that kills throat cancer cells with fewer side effects from radiation. This keeps the healthy tissue safe.
The 2 main treatments for throat cancer are radiation or surgery. If radiation is your main treatment, you also may have chemotherapy. Radiation is often also used after surgery to keep the cancer from coming back.
Radiation therapy is also called radiotherapy. Your doctor may use it to treat different types of throat cancer, such as:
- Oropharyngeal cancer.
- Tonsil cancer.
- Laryngeal cancer.
- Hypopharyngeal cancer.
To understand how throat cancer radiation therapy fits into your treatment, this is a good place to start.
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How is radiation therapy used to treat throat cancer?
Radiation therapy uses very precise, powerful, high-energy beams to kill cancer cells.
Radiation therapy is a common treatment for throat cancer. Your doctor may recommend radiation therapy:
- After surgery for throat cancer, to lower the chance that the cancer will come back.
- To treat throat cancers that cannot be removed by surgery,
- To treat throat cancers that come back after surgery.
Your doctor may recommend chemotherapy as part of your radiation therapy. This is called chemoradiation. It may help the tumor respond better to treatment.
Radiation oncologists are cancer doctors with special training in using radiation to treat cancer. MSK’s radiation therapy experts deliver radiation to the tumor while keeping nearby healthy tissue safe. Radiation therapy aims to kill off throat cancer cells with as few side effects as possible.
Throat cancer may not respond to surgery or chemotherapy. If so, we use radiation therapy to relieve symptoms and improve your quality of life.
Types of radiation therapy for throat cancer
There are 2 basic kinds of radiation therapy, external and internal.
External radiation therapy is delivered from outside your body. This kind of therapy uses high-energy rays to harm cancer cells so they can no longer grow.
External beam radiation therapy (EBRT) uses a treatment machine called a linear accelerator to aim beams of radiation right at the tumor.
The beams pass through your body and harm cancer cells in their path. You will not see or feel the radiation.
Most energy rays used for EBRT are photons (X-rays or gamma rays). Another type of EBRT is proton therapy, which uses proton rays.
EBRT is the type of radiation used to treat throat cancer.
Doctors at MSK are national experts in all methods of radiation therapy. They’ll recommend which is best for you, based on the cancer and your preferences.
External beam radiation therapy
Intensity-modulated radiation therapy (IMRT) lets us change the radiation beams’ power during treatment using a special computer program. We make a dose plan that can deliver high doses of radiation more precisely to the tumor area.
IMRT can have fewer side effects for some people because it’s so accurate.
You’ll have a CT scan before IMRT to make a 3D map of the tumor. Most treatment sessions take 10 to 30 minutes. You’ll have them 5 days a week for a few weeks.
The total number of treatments depends on things like the tumor’s size and location. You also may have chemotherapy to make radiation work better.
Image-guided radiation therapy, or IGRT, can treat tumors with even more accuracy than regular radiation therapy. This method gives a very precise dose of radiation right to the tumor.
Image-guided means we take images to help guide the radiation beams. Imaging can include PET, MRI, and CT scans to locate the tumor before and during radiation therapy.
Most often, you’ll have IGRT 5 days a week for 6 to 7 weeks. You’ll have more imaging scans during IGRT to track changes in the tumor’s size or shape.
MSK is one of only a few hospitals to offer the most advanced proton therapy in New York City. We use proton therapy, also called proton beam therapy, for some cases of throat cancers. Proton therapy is often used for throat cancer that comes back after treatment.
Proton therapy uses charged particles called protons to kill cancer cells. A device called a cyclotron sends tiny, high-energy beams of protons to the tumor.
With proton therapy, the beams do not go past the tumor. It can cause fewer side effects because healthy tissue near the tumor is more likely to be safe.
Chemotherapy with radiation (chemoradiation) for throat cancer
Chemoradiation is when chemotherapy is given together with radiation. It’s also called chemoradiotherapy.
Radiation alone can work very well on some cancers, but chemotherapy can help the radiation work better.
Chemoradiation works by using chemotherapy to first weaken cancer cells. Chemo makes the tumor more sensitive to radiation treatment, so radiation harms the tumor more easily.
Chemotherapy also can treat very tiny cancer cells that may have spread outside the area where the cancer started.
Quitting tobacco can help throat cancer radiation therapy work better. Our Tobacco Treatment Program offers treatment options to help you quit, such as counseling and medicine. It’s open to people who never had cancer or a disease linked to tobacco. Learn why it’s never too late to quit using tobacco.
Side effects of throat cancer radiation therapy
What are the short-term side effects of throat cancer radiation therapy?
Radiation treatments are very precise and cause little harm to healthy tissues. Radiation treatment does not cause hair loss, and many people report few lasting side effects.
In general, you can keep doing your daily activities. You may be able to keep working during radiotherapy treatment. If you’re getting chemoradiotherapy, you may need to take time off from work during treatment.
Radiation therapy for throat cancer can affect how well you can swallow. Having trouble swallowing is called dysphagia (dis-FAY-jee-uh).
It can weaken the muscles and structures that help you swallow, making it harder to eat and drink. Whether this happens depends on the tumor’s size and location.
Some people do have side effects during or shortly after throat cancer radiation. These symptoms often start 1 to 2 weeks after your first radiation therapy session. They may get worse during treatment. Most symptoms start to get better about 2 to 4 weeks after your treatment ends.
Short-term side effects of throat cancer radiation include:
- Pain, sores, or redness in the mouth.
- Trouble swallowing.
- Changes in taste.
- Weight loss.
- Changes in your skin that look like a sunburn.
- A hoarse (low, raspy) voice.
- Fatigue (feeling very tired).
What are the long-term side effects of throat cancer radiation therapy?
Side effects can start months or years after radiation treatment ends. These are called long-term or late effects. Late effects of throat cancer radiation are not common, but they can include:
- Dry mouth.
- Hypothyroidism.
- Weak teeth (tooth decay and dental problems).
- Trismus, also known as lockjaw, which is when you have trouble opening your mouth all the way. Trismus can happen anytime during, right after, or even years after head and neck radiation therapy.
It’s important to get enough nutrition before, during, and after head and neck cancer treatment. We have information about how to manage side effects during radiation therapy and chemotherapy. Watch this video to learn how to get enough nutrition during radiation treatment for head and neck cancer.
Radiation therapy for throat cancer can also cause fibrosis (fy-BROH-sis), which is tissue scarring that’s permanent (does not go away). The effects of radiation scarring depend on the throat area that was treated, and include:
- Trismus, or lockjaw, which is when you have trouble opening your mouth all the way.
- The muscles in your tongue and the back of your throat may not move as well. This can make it harder to eat and drink.
- The muscles that help protect your airway when you swallow may weaken. They may not be strong enough to keep foods or liquids from going down your airway. You have a higher risk for chocking.
- Your esophagus (food pipe) may narrow (get smaller). This can cause food to get stuck in the back of your throat.
MSK experts will help you manage problems with swallowing after radiation therapy.
How do we limit exposure to radiation during treatment?
MSK radiation experts do everything possible to lower the chances of radiation harming your body and causing side effects. They use the most precise ways to deliver radiation to treat the tumors and not nearby healthy tissue.
For safety, we can take images each day to see the bones or tumor and keep healthy tissue safe. These methods limit healthy tissue’s exposure to radiation.
More than 3 out of every 10 people get xerostomia (dry mouth) after radiation for throat cancers. Dry mouth, or cotton mouth, can hurt. But it also can lead to infections, cavities, tooth decay, and poor nutrition. Learn about dry mouth symptoms and natural treatments for dry mouth.
We manage side effects to help you recover fast from throat cancer radiation therapy.
Our Integrative Medicine and Wellness Service offers acupuncture, meditation, massage therapy, yoga, and exercise. Integrative medicine is also called complementary, natural, or holistic therapies. Without using prescription drugs, integrative therapies can help improve and control side effects of cancer treatment.
Our dental and rehabilitation experts can also help manage side effects. They can keep your throat working as it should, for eating, swallowing, and speaking.
During and after treatment, you’ll have exercises to prevent side effects. We’ll watch for any problems with swallowing. And we’ll make sure you keep the range of motion in your tongue, jaw, and neck.
Common questions
Before you start radiation therapy for throat cancer, you’ll have a treatment planning procedure called a simulation. A radiation simulation is done to make sure that:
- Your treatment site is mapped so the radiation is precise and targeted.
- You get the right dose (amount) of radiation.
- Nearby tissue gets the lowest amount of radiation possible.
Your radiation simulation will take about 4 to 6 hours. You’ll have imaging scans, including a PET-CT scan, an MRI, or both.
Your skin will be marked with little tattoo dots that tell us which area to treat. These tattoos are permanent (do not come off).
You’ll be lying in one position for a long time.
Your radiation oncologist and care team will carefully plan and check the angles and shapes of the radiation beams.
Radiation treatments take place Monday through Friday, for about 7 weeks.
Your radiation therapy team will tell you what to expect for your treatment schedules. You may have chemotherapy and radiation on the same day.
You must come to every appointment. Treatment may not work as well if you skip or miss appointments. If you need to change your schedule, talk with your radiation therapist.
Learn more about the set-up procedure and treatments
Before your appointment, it’s helpful to write down questions you want to ask. Here are some examples. Write down the answers during your appointment so you can review them later.
- How will radiation make my throat feel?
- What kind of radiation therapy will I get?
- How many radiation treatments will I get?
- What side effects should I expect during radiation therapy?
- Will these side effects go away after I finish radiation therapy?
- What kind of late side effects should I expect after my radiation therapy?
- What kind of follow-up care will I need after radiation therapy ends?
Palliative (PA-lee-uh-tiv) radiation therapy is a way to control symptoms from cancer. It’s similar to radiation therapy that treats cancer. But radiation therapy to control throat cancer symptoms is:
- Less intense
- Lasts a shorter time
- Has fewer side effects
Radiation therapy can shrink the throat cancer tumor, which helps with pain, and makes it easier to swallow or breathe.