Radiotherapy for head and neck cancer
Our world-class head and neck cancer service is led by a team of expert specialists to provide everything you need throughout your treatment.
Leading the way
Our world-class head and neck cancer service is led by a team of expert oncologists as well as head and neck surgeons, radiographers, clinical nurse specialists, specialised dietitians, speech and language therapists and pharmacists to provide everything you need throughout your treatment.
At GenesisCare we use volumetric modulated arc therapy (VMAT) and surface-guided radiotherapy (SGRT) as standard to treat head and neck cancers.
Volumetric modulated arc therapy (VMAT) is an advanced radiotherapy technique that describes the continuous delivery of radiation dose as the treatment machine rotates. This technique enables accurate shaping of the radiation to the tumour, whilst minimising dose to the surrounding structures. It also reduces treatment times when compared to conventional radiotherapies.
Surface-guided radiotherapy (SGRT) is a technique that uses 3D camera technology to track and monitor thousands of points on the surface of your skin. This enables us to precisely target the radiation by tracking your position during treatment so if you move out of place we can pause the radiotherapy. Unlike some other forms of radiotherapy, SGRT means that you don’t need to have any permanent markings (tattoos) to help track treatment.
Together, VMAT radiotherapy and SGRT help improve the accuracy, safety, speed and comfort of treatment.
- Highly accurate
- Avoids surrounding healthy tissue
- Reduced side effects
- Shorter treatment times
- 3D camera technology
- Highly accurate
- No permanent markings (tattoos) needed
Is head and neck radiotherapy for me?
Your consultant is highly experienced in VMAT radiotherapy and other treatment techniques. They’ll discuss your head and neck cancer, treatments to date and overall health with you in detail before advising if this is right for you.
Radiotherapy is just one of the many treatments that GenesisCare offers for head and neck cancer, including surgery, chemotherapy, immunotherapy and targeted therapy. Depending on the type of head and neck cancer you have, you may be offered these options alongside your radiotherapy sessions.
What is head and neck cancer?
Head and neck cancer is a broad term given to various cancers that occur in the head and neck region. The treatment you may need will depend on which type of cancer you have. We treat all types of head and neck cancer at our centres. There are many types of head and neck cancer, and the most common locations are:
- Throat (pharynx or back of the tongue and tonsils)
- Voice box (larynx)
- Nose and sinuses
- Salivary glands
- Middle ear
- Back of the nose and mouth (nasopharynx)
Despite their location, cancers of the oesophagus, brain and eye aren’t generally classified as a head and neck cancer.
Your head and neck treatment team
Our multidisciplinary team
During your treatment at GenesisCare, you’ll be looked after by a multidisciplinary team of specialists in head and neck cancers and cancer care. Each one is dedicated to a different part of your care, yet they work closely together to make sure that everything you need is here when you arrive at the centre so your treatment runs smoothly and without delay.
Consultant clinical oncologist
Your consultant clinical oncologist will lead your radiotherapy treatment. Their role is to work with and supervise the team, including other specialist doctors and radiographers.
Consultant head and neck surgeon
If you need surgery, this will be carried out at one of our partner hospitals. Your surgeon may be a specialist consultant ear, nose and throat (ENT) surgeon or an oral and maxillofacial (jaw and face) surgeon.
Your radiographer is involved in your planning scans, treatment
planning and delivery of radiotherapy. They’ll
make sure you safely receive the correct dose of radiotherapy
and monitor you during your radiotherapy sessions.
Our pharmacists will work closely with your treatment team, ensuring you have fast access to any medication you may need during your treatment. You may experience a range of symptoms, and our pharmacists are on-site to organise any relief quickly and ensure prescriptions are ready for you, as well as to answer any questions.
Clinical nurse specialist
Our clinical nurse specialists have additional training in head and neck cancers to help treat and manage cancer-specific symptoms or treatment side effects that you might experience. They’re dedicated to your care and wellbeing and will get to know you, your preferences and your concerns so they can support you throughout your treatment journey.
Our dietitians are specialised in the assessment and treatment of nutritional and dietary concerns related to cancer. They’ll create a dietary plan personalised to you and any side effects you might be experiencing to ensure that your weight and nutritional needs are carefully managed throughout treatment.
Specialist speech and language therapist
Our specialist speech and language therapist will work with you closely during your recovery. They’ll assess your needs and give advice and support for any changes to your ability to swallow, as well as your voice or speech.
We also recommend that you see a specialist dentist before your VMAT radiotherapy treatment begins. They can assess whether they can help avoid, reduce or minimise any concerns that might occur after treatment with your teeth or jaw, such as a tooth infection. Your consultant will discuss with you the possible impact of radiotherapy and may suggest preventative dental work beforehand.
What will happen at my appointments?
Before your first appointment, your care team will contact you, explain any preparation instructions in advance of your appointments, and answer any questions you may have.
Here is an overview of what to expect before, during and after your head and neck VMAT treatment.
You’ll need to have a special mask created for your radiotherapy. These are important to keep you in the correct position throughout your treatment. Your consultant will explain this to you and show you an example mask. You’ll have plenty of time and opportunities to ask questions too. Your mask will be unique to you. We’ll create this at your initial radiotherapy planning session.
At GenesisCare, we use two types of masks, an open mask and a closed mask, depending on the area of your head and neck you need treated.
Masks are made of a perforated sheet of thermoplastic. During treatment, any marks needed to guide the radiographers can be drawn on the plastic instead of on your skin. To create your mask, a plastic mesh is warmed and softened and then your radiographer will place it gently over your face and head and the mask is moulded to fit. This can take up to 30 minutes to create and set. Once ready, it’s removed and placed over your head again before your planning scan and treatment.
You might feel nervous about wearing the mask or feel claustrophobic. This is completely natural, and your treatment team understand this. They’ll help you work through any concerns you may have, provide relaxation techniques and can answer any questions too. We can also share experiences and tips from other patients who have been through this treatment before.
Before starting VMAT radiotherapy, your team will contact you to organise a contrast enhanced CT scan. This means that your radiographer will give you a contrast dye injection just before the scan. This will help improve the quality of your scan and show specific areas in more detail.
Your CT scan will help us determine your tumour’s exact size, shape, and position to accurately plan your treatment. We use it to calculate the best radiation dose and precisely where to direct the radiation beam during your procedure. Your appointment will take between 45 to 90 minutes.
Your radiographer will explain the process and ask you some questions to complete their CT checklist before carrying out the CT scan. You’ll be asked to lie in a specific position for your CT scan. When you’re in the correct place, your radiographer will leave the room, but you’ll be able to speak to them through an intercom system.
The scan will take about 20 minutes, and you must stay as still as possible. Once finished, you may also have an MRI scan as part of your treatment planning. After your scan, you’ll need to wait for 30 minutes before leaving the centre.
Over the next seven to ten days, your care team will work together to create a detailed radiotherapy treatment plan tailored to you using the images from your CT scan and advanced computer technology.
Each treatment appointment lasts around 15 minutes. Before your treatment begins, your care team will explain what will happen. Then, when you’re ready, you’ll get onto the treatment bed and your radiographer will help you get into the correct position using our surface guidance software and your planning CT scan. Once you’re set-up, your radiographer will leave the room. You can speak to them through the intercom system and listen to music throughout your treatment.
Before your treatment starts, a “Cone Beam” CT scan will be taken on the radiotherapy machine. This is so your radiographers can ensure you’re in the correct position so that the radiotherapy is targeting the exact position mapped by your consultant. Your treatment should last between two and four minutes. You’ll see the linac moving around you, but it won’t touch you, and you won’t feel anything from the treatment.
When the treatment has finished, your radiographer will come back into the room and help you off the treatment bed. After that, you’ll be able to leave as soon as you feel ready, or we can arrange some refreshments so you can relax quietly for a while. We’ll give you the contact details for your care team if you have any further questions.
After your treatment course has finished, you’ll have regular follow-up appointments with your care team. Seven to ten days later, a member of your care team will call to see how you’re feeling and answer any questions you may have. Four to six weeks later, you’ll have a review with your GenesisCare consultant to discuss your side effects and response to the treatment.
In the longer term, your care team will continue to follow up on your recovery and wellbeing through appointments, phone calls and emails. To help with your follow-up, we have developed a bespoke app to collect patient-reported outcome measures (PROMs), so we can monitor the long-term side effects of your treatment. We encourage you to download the app; you’ll be prompted to record your responses at designated intervals from the start of your treatment. Your care team can provide you with support on how to access the app.
It’s important that you can attend your follow-up appointments, so we can provide support and advice on the best way to deal with any side effects you may experience.
Radiotherapy to the head and neck can cause temporary side effects, such as a sore mouth or throat and difficulty swallowing. The side effects you may experience will depend on the size of the area being treated and the length of treatment. Your consultant will explain any side effects that are specific to the location of your cancer.
Side effects usually begin to develop after two weeks of radiotherapy. They may continue to increase for seven to ten days after your treatment ends before slowly improving. Most people notice an improvement in their side effects six to eight weeks after radiotherapy has finished.
Our care team have specialist experience in managing side effects, and they’ll be able to give you advice and support during your treatment about the best ways to manage them.
- Difficulty swallowing
- Temporary hair loss
- Pain in the mouth, throat or food pipe (oesophagus)
- Sore and ulcerated lining in the mouth
- Dry mouth
- Difficulty opening the mouth
- Low mood
- Difficulty swallowing and change in sense of taste
- Dry mouth and dental decay
- Changes in skin colour and texture in the area treated
- Weight loss
- Swelling in some areas (lymphoedema)
- Brittle jawbon
- Risk of stroke
- Other cancers
If you find you’re having trouble chewing or swallowing food, we’ll support your nutritional needs, either with oral supplements or if needed, with a feeding tube also known as a percutaneous endoscopic gastrostomy (PEG) tube.
Sometimes it’s necessary to have a small feeding tube, called a PEG, inserted through your skin and into your stomach. This helps ensure you’re getting all the nutrients and fluids you need. If you do require a PEG, you’ll start on liquid food while you’re recovering. Our dietitian will then work with you to slowly build up your calorie intake.
Our clinical nurse specialist and dietitian will monitor your progress, along with your speech and language therapist, who will check how you’re swallowing. When you’re able to swallow, and your calorie intake is back to normal, you’ll be able to have your PEG tube removed.
Managing nutrition related side effects
It’s common for head and neck cancer to affect your ability to eat normally, and weight loss or lack of nutrients can be a cancer symptom as well as a treatment side effect. Our dietitian will work closely with you and with your speech and language therapist to understand your needs and preferences at every step. They’ll help create a personalised dietary plan for you, focused on your specific side effects.
Why choose GenesisCare
We provide an integrative cancer care programme alongside your treatment, to support your emotional and physical wellbeing.
We offer exercise medicine as part of your personalised treatment plan. Exercise medicine effectively improves treatment tolerance, builds muscle mass, and reduces cancer-related fatigue, among many other health-related benefits.
We have also partnered with the charity Penny Brohn UK to offer personalised wellbeing therapies at many of our centres to help support you through this challenging time. These therapies, such as acupuncture, massage, and counselling are proven to help ease cancer-related concerns and reduce stress.
These services are both offered at no extra cost to you or your insurer. After all, we’re treating you – not just your cancer.
Frequently asked questions
We have a dedicated section on our website of patients stories and experiences. We’re constantly updating with new experiences to help you find a story that relates to you. To find these stories, please visit our patient stories.
VMAT radiotherapy doesn’t make you radioactive. So it’s perfectly safe for you to be with other people, including children and pregnant women, throughout your treatment.
If you’re currently in work, you should be able to continue working for at least part of your radiotherapy course. Although each treatment takes place Monday to Friday, the appointments are short, with minimal waiting times. You can ask your care team for a convenient appointment time, and we’ll do our best to accommodate you.
People experience side effects differently, so you should speak to your employer about making changes to help if you feel unwell or tired. It’s reasonable to take time off work for cancer treatment if needed. Your care team can give you advice too.
Most people receiving radiotherapy can continue driving throughout their treatment. However, you should be aware that radiotherapy can make you tired, so it’s not advisable to drive if you’re feeling fatigued. If you’re unable to drive, you should arrange for someone to take you to and from your appointments or use public transport. Alternatively, we’ll help our patients with transport depending on treatment and locations – speak to a member of our care team for more information.
Your consultant can give you more advice about driving.
If you have a pacemaker, we’ll need to contact your cardiology team before the CT planning scan to know what type of pacemaker you have and your latest test results.
Depending on the treatment site, it is possible to experience temporary hearing changes. This is rarely a persistent problem and your care team will advise on management where necessary.