Head and Neck Radiation Treatment Guide

Thank you for choosing MD Anderson Cancer Center at Cooper for your radiation treatment. The

following information will help you understand your treatment process as we work together toward

your recovery.

Radiation Treatment

Your Health Care Team

Many different specialists will participate in planning and monitoring your radiation treatment. Your

health care team may include doctors, nurses, therapists, dosimetrists, physicists and others.

If the process seems overwhelming, please talk with your health care team about your concerns.

They are available to help and support you and your caregiver during your treatment.

Consult Visit

You will have a consult visit before you receive radiation. You will meet with your nurse and doctor

to discuss your individual treatment plan. Your nurse may give you educational materials and you

Simulation

Before you receive radiation, you will undergo a simulation, which is used to map out the

treatment. The simulation allows your radiation doctor to locate the exact area to be treated, to

take measurements and to create shielding that protects normal tissue. This treatment planning

session usually takes about 45 minutes to one hour to complete.

During the Simulation

You will be positioned on a treatment table. Your radiation therapist will make a custom head and

neck mask made out of plastic mesh. The mask helps to keep you very still and to ensure correct

positioning during treatment.

RVSD 9/8/2015

If you need something during the simulation, speak normally and your therapists will hear you over

the intercom. If necessary, they can turn off the machine and come into the room immediately.

Marks may be made on your skin to ensure the radiation is aimed at the same area during each

treatment. Under your clothing, wear a soft undershirt or a cotton t-shirt to absorb any stains from

the marking fluid. The stains may be permanent. If the treatment area (the area of your body that is

Port Film

Prior to starting the actual radiation it is important to make sure that everything sets up correctly.

You will come back for a special session to take port films, which double check to make certain the

radiation set-up is accurate. You will not receive any actual radiation on this day. If adjustments are

needed, this allows your doctor to safely make changes prior to the radiation.

Treatment Schedule

Radiation treatments are usually scheduled every weekday, Monday through Friday, allowing you

to rest on Saturday and Sunday. You will receive all of your treatments as an outpatient over a

for any schedule changes. The therapists or front desk can print an updated schedule for you.

Treatment Guidelines

Always check in at the reception desk in the radiation treatment lobby as soon as you arrive. After

you check in, go to your assigned waiting area. Wait here until the radiation therapist calls your

name. You may be asked to put on a gown or remove some clothing to show the marks.

The treatment itself is short, lasting only a few minutes, but it may take 15 to 45 minutes in the

treatment room before you are finished. A staff person will help you on and off the treatment table.

normally. You should not feel pain.

Once you are positioned, do not move until the therapist tells you the treatment is finished. You will

be in the same position every day for your treatment.

When you are positioned on the table, the therapist will leave the room, close the door and monitor

you by closed-circuit television. If you need something during treatment, you can speak to your

therapist over the intercom in the room. If necessary, the therapist can turn off the machine and

come into the room immediately. The radiation will stop when the machine is turned off.

Your radiation doctor may want to change the treatment area and marks as the treatment

Weekly Management Visits

radiation physician’s schedule. Refer to your radiation schedule for these appointments.

When you arrive, check in at the reception desk. Please be patient as there are many reasons the

clinic may run behind. Tell the patient access service specialist (PASS) if you have waited for more

than 30 minutes.

Schedule Changes

these changes happen suddenly, so check your schedule daily.

you are unable to keep your appointment due to flooding or mandatory evacuation in your area,

please call this telephone number. We will add the missed treatment to the end of your schedule.

We want to make sure you take your medicines safely. Please bring a list of all your current

prescription and non-prescription medicines, vitamins, nutritional supplements, herbal products

and over-the-counter drugs to every doctor’s appointment.

Side effects will depend on the part of the body being treated and the stage of the tumor. Most side

your doctor or nurse about medicines to help relieve the itching. Use only the products that your

doctor or nurse has approved.

You may feel more tired than usual. Get plenty of rest and do not overexert yourself. However,

some patients find it helpful to do light activity, such as walking for 15 to 20 minutes, two to three

times per day. If you feel tired, stop and rest.

You may lose hair in the area being treated. This hair loss may be permanent. You may also lose

hair if you also receive chemotherapy.

You may have changes in taste and may not feel like eating or drinking. You may also have

nausea. It helps to eat small meals or snacks throughout the day, instead of three big meals. A

dietitian will give you more eating tips. If you are unable to eat, your doctor will talk to you about

If any part of your mouth or neck is in the treatment field, you may have painful and difficult

swallowing, mouth sores and blood in your saliva (spit). If this happens, you may need to eat soft

foods or liquids until your mouth feels better. Your doctor will prescribe pain medicine.

Your saliva may get thick and sticky. Drink fluids as directed to help thin the saliva. Rinse your

mouth with a baking soda solution (see instructions below). Your saliva will improve two to four

months after treatment has ended. You may have dry mouth for the rest of your life or the salivary

If your sinus (nose) area is in the treatment field, your nose may feel stuffy and you may have

It is very important that you take in enough food and fluid to stay well hydrated and to maintain

dietician will talk with you about your food and fluid needs. If you are unable to drink enough fluid

or eat enough food to maintain your weight, please tell your clinic nurse.

Dental visits and good mouth care are important during and after treatment. If needed, you may

have an appointment with a dentist. The dentist will discuss brushing and flossing, and may decide

that fluoride therapy is needed to prevent cavities. The dentist also may teach you daily mouth

 Mix two teaspoons of baking soda in one quart of warm water.

 Rinse and gargle before and after meals (four to six times a day).

 If your saliva is very thick or sticky and makes you gag, try adding ½ teaspoon of salt to the

baking soda mixture. This will help break up the saliva.

 Start using the baking soda rinses when you begin your first treatment and continue rinsing

daily, seven days a week. Once your treatment is completed, continue using the baking

soda mixture for at least six months.

If you have thick, “rope-like” saliva, use a bedside humidifier during the night. Some patients find it

helpful to sleep with the head of their bed elevated to at least 30 degrees. Talk to your radiation

team about other measures to help manage this.

Avoid things that can irritate the tissues of your mouth and throat, such as:

 Tobacco.

 Alcohol.

 Carbonated beverages.

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Ask your nurse for a copy of Mouth Care for Radiation Therapy Patients.

Skin Care

Your radiation oncology nurse will give you instructions for skin care. These include avoiding

swimming pools and hot tubs and using a skin cream or ointment on irritated skin.

To prevent infection, it is important to wash your hands thoroughly before and after doing any type

of skin care.

Wash your skin with mild soap and pay it dry. Do not rub the skin.

Begin applying skin ointment or cream to your skin in the treated area the first day of treatment as

instructed by your doctor or nurse. Only a small amount is needed. Apply the ointment or cream

three times per day. However, only apply the product four to five hours before receiving radiation

treatment.

Bathe or shower in warm water using a mild soap such as Ivory

or Dove

. Avoid deodorant soaps

that may irritate the skin. Use your hands, not a washcloth, on the treated skin. Do not soak the

treated area in a bathtub for any period of time until your skin has fully healed and/or your doctor

has told you that it is okay. Be careful not to wash off the ink markings around your treatment area.

Ask your nurse for a copy of Exercises After Neck Dissection While Receiving Radiation. These

exercises are designed to improve the range of motion (flexibility) of your neck and jaw. Begin

these exercises when you start your course of radiation treatment.

Radiation causes tightness of the tissue in the treated area. It is important that you perform these

exercises daily and for an extended period of time after completing radiation treatment.

Perform the exercises slowly, allowing your muscles to stretch. Hold the stretch for five seconds.

The side effects of radiation may stabilize or become worse 10 to 14 days after the last treatment.

They will slowly begin to improve over several weeks. To help you recover, it is very important that

Do the following: