The most common radiation therapy approach for nasopharyngeal cancer is called external beam radiation. This type of radiation therapy applies radiation from outside the body.
Intensity modulated radiation therapy (IMRT) or Volumetric arc therapy (VMAT) or Tomotherapy, which use different ways to deliver radiation very precisely, minimising the radiation that gets to healthy parts of the body surrounding the cancer.
Stereotactic radiation therapy, which delivers a large and precise dose of radiation in one or a few visits. It can be used as part of radiation therapy to increase the dose of radiation to the nasopharynx cancer. It is sometimes used to treat cancer that has come back.
You might need to have some of your teeth taken out, this will depend on the area being treated and the dose of radiation therapy. It is important to take out any broken or infected teeth before radiation therapy. Taking out unhealthy teeth after radiation therapy can cause problems with the jaw bone.
Your cancer and its treatment can make it hard to eat and drink. Your doctor will recommend you see a dietitian to maximise your nutrition during treatment as well as while you are recovering. Sometime feeding tubes may be recommended depending on the area being treated and the dose of radiation therapy. There are two common types of feeding tubes:
Gastrostomy tube (sometimes called a PEG tube): this type of tube is inserted through your abdominal wall into your stomach, with part of the tube staying outside the stomach. A syringe can be attached to the tube to give you food this way if needed. The tube is inserted using a camera through the mouth into the stomach (gastroscopy) or using a CT scanner to guide insertion directly through the skin. If a PEG tube is needed, your doctor will organise this before starting your radiation therapy
Nasogastric tube: this type of tube goes through the nose down into the stomach and is usually used for short periods (days or weeks). A nasogastric tube can be inserted at any time (before, during or after treatment).
There are many other aspects of supportive care that are available, ask your doctor if you have any specific needs.
The side-effects of radiation therapy start around two weeks into treatment and progress through treatment to peak in the last week or just after treatment ends. The side effects start to improve 2-3 weeks after the end of treatment.
the dose of radiation therapy
the area being treated
whether or not chemotherapy is added to the radiation.
tiredness
skin irritation in the treated area e.g. redness, dryness and itching, weeping skin, scaling or sometimes skin breakdown (sores)
nasal irritation, blockage and crusting
ulcers in the mouth and throat that make it painful or difficult to chew or swallow
sticky or thick saliva
altered taste, which is usually a loss of taste or, sometimes, an unpleasant taste in the mouth
blocked ears from inflammation within ear canals.
Most side effects are short lived and may go away within 4–6 weeks of finishing radiation therapy. Some side effects may last for months after you finish radiation therapy and some may be permanent.
Long-term side effects of radiation therapy include:
dry mouth (called xerostomia) and difficulty eating dry food such as bread/biscuits due to lack of saliva. With modern radiation techniques, some recovery of saliva may be expected up to two years after radiation therapy
inability to eat certain foods, in particular sensitivity to spicy or acidic foods
gum and tooth problems from lack of saliva
crusty nasal discharge
worse hearing or deafness may occur, although with modern radiation therapy techniques the risk of this side effect can be greatly reduced
underactive thyroid gland
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