The majority of head and neck cancers are squamous cell carcinomas, originating from the mucosal surfaces in this region. A significant subset of oropharyngeal cancers (affecting the tonsils and base of the tongue) are caused by human-papilloma virus (HPV). These cancers have a better prognosis and response to treatment compared to HPV-negative head and neck cancers.

Symptoms of head and neck cancers are diverse and depend on the tumor’s location but may include a persistent sore throat, difficulty swallowing, changes in voice, a lump in the neck, and unexplained weight loss. Symptoms often reflect the tumor’s impact on local structures and functions within the head and neck region.

Treatment strategies for head and neck cancers vary widely based on the cancer’s stage, location, and HPV status, and may include surgery, radiation therapy, chemotherapy, or a combination of these modalities.

Advanced Radiation Centers utilizes cutting-edge radiation therapy technologies to treat head and neck cancers effectively while minimizing side effects. These include:

• Intensity-Modulated Radiation Therapy (IMRT): Delivers precise radiation doses to the tumor while sparing surrounding healthy tissue, reducing the risk of side effects.
• Image-Guided Radiation Therapy (IGRT): Uses detailed imaging to guide the delivery of radiation therapy, enhancing accuracy and allowing for adjustments based on tumor movement or changes during treatment.
• Stereotactic Body Radiation Therapy (SBRT): A highly focused radiation therapy that can be used for small or well-defined tumors in the head and neck region, delivering high doses of radiation in fewer sessions.

Radiation therapy for head and neck cancers can lead to side effects such as dry mouth, difficulty swallowing, changes in taste or smell, and skin irritation in the treatment area – many of which are only temporary. Our team provides comprehensive support to manage these side effects, including nutritional counseling, speech and swallowing therapy, and pain management.

Radiation treatment demands meticulous preparation by a dedicated team, ensuring precision and patient safety throughout the process.  Each step of the radiation treatment process is designed with precision, safety, and your well-being in mind, ensuring that you receive the most effective and personalized care possible.

Consultation

The initial step involves you and your family meeting with an ARC radiation oncologist to discuss your diagnosis, review your medical history, and consider the most effective radiation treatment options tailored to your specific case. Expectations of therapy, side effects and treatment alternatives will be discussed.

Simulation

Once a course of radiation is agreed upon a simulation, or treatment planning session is performed over a 45-60 minute period.  During the simulation, the positioning of the body is set, often used a thermoplastic “mask” which is customized to the head/face area, and ensures daily reproducibility in positioning on a day-to-day basis, aiding in pre-treatment alignment.  An imaging scan is performed to pinpoint the exact location of the cancer or areas at risk relative to the geometric position of the body and treatment room. This step is crucial for designing a treatment plan that maximizes the radiation dose to the cancer while sparing surrounding healthy tissue.

The Planning Process (Behind the Scenes)

For a week or two following the simulation, a multi-disciplinary team composed of the radiation oncologist, medical physicists and dosimetrists, collaborate behind the scenes using advanced software to 3-dimenionally reconstruct the anatomic areas of consideration and map out the precise treatment plan, calculating the optimal radiation dose distribution.  This dosimetry plan is a “blueprint” that will be used to ensure accuracy in the treatment delivery.

Daily Radiation Treatments

Radiation therapy typically involves daily treatments over several weeks using a machine that generates high energy photons called a linear accelerator. The treatment room is large and is not claustrophobic.  Each session typically takes place in a 10-15 minute appointment slot, with most of this time used in positioning and alignment, while the actual beams of radiation are on for only a few minutes.  The radiation is invisible and not felt.  Patients can drive themselves to and from the appointments, continue to work or exercise and maintain their normal daily activities. Specific restrictions if any can be discussed with your radiation oncologist at consultation and during the weekly on-treatment visits.

Weekly On-Treatment Physician Review

Regular meetings with patients undergoing radiation are conducted with the radiation oncologist throughout your treatment course. These check-ins allow the doctor to monitor your progress, briefly exam the area under treatment for any possible side effects, provide any medications or treatment adjustments, and discuss any questions or concerns that may arise during therapy.

Completion of Therapy and Follow-Ups

Upon finishing the radiation treatment course, a final conversation with your radiation oncologist will discuss the next steps, expectations for resolution of side effects, and any further treatment or monitoring needed.  Regular follow-up appointments are crucial after completing radiation therapy, and allow the radiation team to monitor your recovery, manage any late side effects, and check for signs of cancer recurrence.