Having radiotherapy for laryngeal cancer
Radiotherapy uses high energy x-rays to treat laryngeal cancer cells. You have the treatment in the hospital radiotherapy department.
You usually have treatment once a day, Monday to Friday with a break at the weekends. The length of the course of treatment varies depending on the type and stage of laryngeal cancer. It might be between 3 to 7 weeks.
Your doctor works out the total dose of radiotherapy you need. This is divided into a number of smaller doses (called fractions). This allows healthy cells to recover between treatments.
You might have a type of external beam radiotherapy called intensity modulated radiotherapy (IMRT).
When you might have radiotherapy
You might have radiotherapy for laryngeal cancer:
- on its own
- after surgery
- with chemotherapy (chemoradiotherapy)
- with targeted cancer drugs
- to relieve symptoms
Radiotherapy on its own
Radiotherapy on its own is a common treatment for early stage laryngeal cancer. Your doctors might suggest radiotherapy or transoral endoscopic surgery. Transoral surgery means having surgery through your mouth. Both treatments work well. Doctors aim to treat the cancer and try not to affect your voice.
Whether radiotherapy is suitable for you depends on:
• the size of your cancer
• how far it has grown
• where it is
Radiotherapy after surgery
Radiotherapy after surgery is called adjuvant therapy. It helps to stop your cancer from coming back. Doctors use radiotherapy after surgery for a number of different reasons. You may have it if your doctor thinks the cancer is likely to come back because:
- the cancer was difficult to remove
- there may be cancer cells left behind
- the cancer had grown through the larynx wall
- cancer cells were found in your lymph nodes or breaking through the outer wall of the lymph nodes
You might also have chemotherapy added in some of the above situations. This depends on where the cancer is. Your doctor will tell you if you need this.
Radiotherapy with chemotherapy (chemoradiotherapy)
You might have chemotherapy with radiotherapy. This is called chemoradiotherapy. These treatments often work better when you have them together. You usually have it for
or laryngeal cancer. But people with early stage laryngeal cancer might have chemoradiotherapy in certain situations.
This treatment can help to shrink or control the cancer.
Your doctor might recommend chemotherapy on its own followed by radiotherapy. Or chemotherapy on its own followed by chemoradiation.
Radiotherapy with targeted cancer drugs
Targeted cancer drugs work by ‘targeting’ those differences that help a cancer cell to survive and grow. For locally advanced laryngeal cancer you might have a targeted cancer drug added to your radiotherapy treatment. The aim is to help to shrink or control the cancer.
Your doctor will give you more information about this treatment if you have it.
Radiotherapy to relieve symptoms
Radiotherapy can relieve symptoms of advanced cancer of the larynx. This is called palliative radiotherapy. For example, advanced laryngeal cancer can cause you to have difficulty with swallowing. Radiotherapy can shrink the cancer or slow its growth for a time and relieve your symptoms.
To control symptoms, you are most likely to have a short course of radiotherapy, over a few days.
The radiotherapy room
Radiotherapy machines are very big and could make you feel nervous when you see them for the first time. The machine might be fixed in one position. Or it might rotate around your body to give treatment from different directions. The machine doesn't touch you at any point.
Before your first treatment, your will explain what you will see and hear. In some departments, the treatment rooms have docks for you to plug in music players. So you can listen to your own music while you have treatment.
It is important to lie in the same position each time. Your radiographers may take a little while to position you on the couch and attach your mask to the couch. They make sure your mask feels comfortable.
Once you are in the right position the staff leave you alone in the room.
During the treatment
You need to lie very still. Your radiographers might take images (x-rays or scans) before your treatment to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.
Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.
The treatment can take between 15 to 30 minutes.
Daniel (radiographer): Before your treatment starts your doctor will need to work out exactly where the treatment needs to go and also which parts need to be avoided by the treatment.
To have radiotherapy you lie in the same position as you did for your planning scans.
To stop you moving and to make sure your treatment is directed at the cancer you wear a custom mask over your face which is attached to the couch.
We line up the machine using marks on your mask and then leave the room. We control the machine from a separate room this is so we aren’t exposed to radiation.
Treatment takes a few minutes and you’ll be able to talk to us using an intercom. We can see you and hear you while you’re having treatment and we will check that you’re OK.
When your treatment starts you won’t feel anything. You may hear the machine as it moves around you giving the treatment from different angles.
Because we’re aiming to give the same treatment to the same part of the body every day the treatment process is exactly the same everyday so you shouldn’t really notice any difference.
You’ll see someone from the team caring for you once a week while you’re having treatment. They’ll ask how you are and ask about any side effects.
You won't be radioactive
This type of radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.
Travelling to radiotherapy appointments
You might have to travel a long way each day for your radiotherapy. This depends on where your nearest cancer centre is. This can make you very tired, especially if you have side effects from the treatment.
You can ask your radiographers for an appointment time to suit you. They will do their best, but some departments might be very busy. Some radiotherapy departments are open from 7 am till 9 pm.
Car parking can be difficult at hospitals. Ask the radiotherapy staff if you are able to get free parking or discounted parking. They may be able to give you tips on free places to park nearby.
Hospital transport may be available if you have no other way to get to the hospital. But it might not always be at convenient times. It is usually for people who struggle to use public transport or have any other illnesses or disabilities. You might need to arrange hospital transport yourself.
Some people are able to claim back a refund for healthcare travel costs. This is based on the type of appointment and whether you claim certain benefits. Ask the radiotherapy staff for more information about this and hospital transport.
Some hospitals have their own drivers and local charities might offer hospital transport. So do ask if any help is available in your area.
Side effects
Radiotherapy for laryngeal cancer can make you feel tired. Other side effects of radiotherapy include a dry mouth and a sore throat.
