Radiation kills cancer cells by focusing powerful X-rays at the tumor.
Who may need radiation therapy
Your doctor may use radiation for any of these reasons:
To shrink a large tumor before surgery
To kill cancer cells that are left in the area after surgery
For tumors that cannot be removed with surgery
As a primary treatment for smaller tumors, especially with chemotherapy, which can preserve your larynx (voicebox)
If you cannot have surgery for other reasons
For a tumor that grows back after surgery
To help relieve symptoms caused by advanced cancers
Because radiation to the head and neck region can cause problems with tissue healing after dental work, your doctor may suggest you have a complete dental exam before starting radiation. If you have dental problems, the doctor will want you to have an exam done as early as possible before radiation starts. Some or all of the teeth may need to be extracted because radiation can worsen any existing dental problems.
How you may get radiation
There are two ways to get radiation:
External beam radiation treatment (EBRT). This comes from a machine. It is the type most often used to treat laryngeal cancer.
Internal radiation. With this type of radiation, radioactive material is placed inside you. It's put directly into or near the tumor. It's also called brachytherapy. Brachy means near and refers to how close the radiation is to your tumor. It is not used very often for laryngeal cancer.
You may get only 1 of these types of radiation or both of them.
What happens during external radiation
You can receive external radiation treatment as an outpatient. That means you may have it at a hospital or a clinic, but you don't have to stay the night. Usually you have radiation treatments 5 days a week for several weeks in a row. The tumor often gets an extra boost of radiation at the end of that time.
Newer methods of radiation include 3-D conformal radiation therapy (3D-CRT) and intensity modulated radiotherapy (IMRT). These methods use computer modeling to focus the radiation beams more precisely on the tumor. Both of these approaches decrease the dose of radiation to the normal tissues which surround the tumor and decrease side effects.
Radiation to the neck and throat area can cause painful sores in the mouth and throat. These sores can lead to problems with taking in enough food due to an inability to chew and swallow without pain. They typically go away a few days to a few weeks after radiation ends. However, in order to prevent weight loss and malnutrition, your doctor may choose to insert a feeding tube directly into your stomach to help you take in enough food. This tube, known as a percutaneous endoscopic gastrostomy (PEG) tube, is inserted through a small incision in the skin of your abdomen. The PEG tube will be removed when it's no longer necessary.
Other side effects from radiation therapy may include:
Side effects of radiation can be more severe when it's given together with chemotherapy. Rarely, radiation may lead to breakdown of cartilage (called chondronecrosis), which can further damage the larynx or trachea (the windpipe).
Radiation to the neck area might damage the thyroid gland, which could cause you to feel tired, gain weight, feel cold, and have dry skin or hair. If this happens, you might need to take thyroid hormone pills.
Radiation near the salivary glands may cause dry mouth that may persist even after treatment is completed due to lasting damage to the salivary glands. People with dry mouth after radiation must pay close attention to their oral health because dry mouth can cause problems with tooth decay.