Handbook of information to support patients receiving radiation therapy to the head and neck area

The article is professionally consulted by doctors working at Oncology Center - Vinmec Central Park International General Hospital

Radiation therapy is a high-energy X-ray used in the treatment of cancer. The treatment is given once daily, Monday through Friday, usually on an outpatient basis, and you will be directed to the radiation area. A course of treatment can last up to 7 weeks. Chemotherapy may be indicated in combination with radiation therapy.
Before agreeing to radiation therapy, you will be given an explanation of the procedure and possible side effects. This document is designed to provide information in addition to direct advice you have received, but does not replace the consultation process of obtaining consent to treatment through direct discussion with your physician. friend. Please feel free to ask questions if you have any unanswered concerns. Signing a consent form does not mean that you cannot withdraw from treatment, although we do recommend completing the course of treatment according to the discussed and agreed upon protocol.

1. Frequently asked questions about radiation therapy

1.1. Is radiation therapy painful? No . The treatment will keep you pain-free. As radiation therapy accumulates, the area of ​​the body being treated can become inflamed and painful.
1.2. Will I be radioactive during the procedure? No. X-rays are used in radiation therapy, which means you won't get radioactive. You are completely safe to meet friends, family members and children without causing any harm.
1.3. Is radiation therapy really safe? Have. X-rays used in medical treatment are carefully measured and controlled. Your treatment is very well planned. Our aim is to treat cancer and minimize damage to the patient.

2. Cancer treatment process with radiation therapy

Radiation Therapists include Radiation Therapists , Radiation Engineers and Radiotherapy Technicians . Your doctor and Radiation Engineer plan and evaluate your radiation therapy plan in the most meticulous and accurate way. Once approved, the plan will be transferred to the Radiotherapy Technician. Based on the plan, they will position you on the radiotherapy table using the symbols on your mask or markings on your skin.
Once you are in the right position, the radiotherapy technician will leave you alone in the room for the duration of your radiation therapy, but you will be monitored by camera during the procedure. The treatment is quick and painless because most of the healthy tissue is shielded from the radiation beam.

Quy trình điều trị ung thư bằng xạ trị
Điều trị ung thư bằng xạ trị diễn ra rất nhanh chóng và khiến người bệnh không đau

At the beginning of your treatment, you will receive written instructions on how to take care of yourself during treatment, along with a conversation with the Radiation Therapist.

3. Things to avoid during radiation therapy

Smoking Smoking makes reactions worse and significantly increases the risk of late side effects. Smoking also reduces the best chance of successful treatment.
Drinking alcohol Alcohol can aggravate the treatment area and worsen treatment responses. We recommend that you stop drinking alcohol during treatment and for a while after treatment. Low-to-moderate alcohol is acceptable in small quantities. It's best to reduce the amount of alcohol you use, or quit altogether.
Please and feel free to ask about anything that concerns or concerns you at any stage during your treatment.

4. Things to do during radiation therapy

When starting radiation therapy, you should clean your teeth in the morning and evening with a soft toothbrush and mild fluoride toothpaste.
If you use dentures, clean them after every meal. You should use mouthwash at least four times a day during treatment, after each meal and at bedtime.
If your mouth feels sore during treatment, you may need to use the mouthwash more often (every 2-3 hours). Initially, you can use a diluted saline solution (water and salt). As your radiation treatment progresses, you may be able to use mouthwash as an alternative and you will be given these as needed. Note: commercial mouthwashes are usually not of much help.
Candidiasis is a common oral infection during radiation therapy; Medicine will be given if this occurs during treatment.
It is important that you maintain good oral hygiene and hygiene habits throughout your treatment to help reduce your risk of infection.

5. Possible side effects during and after radiation therapy

Side effects may vary for one person or another and depend on the type and location of your tumor/tumor. Any side effects you experience will be regularly monitored by your Radiologist and, if they are present, usually begin to occur two weeks after treatment.
Acute side effects are only temporary. Only the treated area (called the irradiation field) is affected.
Most common side effects:
Your mouth and throat Treatment of the face and neck area can cause mouth and throat pain. You may notice that your voice is hoarse and your lips may feel dry and sore. Your doctor will give you the right medication to help relieve pain, if needed.
It is very likely that you will develop mucositis (inflammation that affects the lining of the mouth and throat). Your radiation therapist can prescribe the right medications for you to ease your symptoms, and you may need to change your oral hygiene habits.
During treatment, your mouth will gradually become more painful and the use of pain relievers (pain relievers) may be prescribed. Your radiation therapist will advise you as needed. This increased soreness is only a temporary reaction and you should be back to normal within a few weeks after finishing treatment.
Dry mouth (Xerostomia) This is a decrease in saliva production, which can occur as a result of radiation therapy. Certain medications, such as pain relievers and prescription medications, can also cause this side effect; In addition, it can also be due to poor nutrition or dehydration.
Treatment may affect your salivary glands and you may feel your saliva become thick and sticky, making your mouth/throat dry. This dry mouth can last for a few months and can also be permanent. Drink water regularly throughout the day to relieve these symptoms and help prevent dehydration. Saliva helps protect your teeth. When your mouth is dry, your teeth are no longer protected by saliva and can make you more susceptible to disease or tooth decay. You may feel that your taste buds also change. Usually this will gradually return to normal after a few months.
Your skin At the beginning of your radiation therapy, you should use a skin ointment or moisturizer. You may also find it helpful to mix the cream with water and use it as soap. During treatment, you may find your skin red and itchy. This is a natural reaction and your radiologist may recommend using a skin cream. The area behind your earlobe can become very painful and sometimes bleed. Please inform the appropriate doctor, specialist staff to advise you on treatment.
At the end of the process and upon completion of the treatment, you may have quite sore and red skin. Your skin may also look flaky, dry, or bleed. This is a normal response to treatment and your radiologist will make sure you are prescribed the right cream to use.
We recommend that you avoid using any razors, makeup tools or perfumes on the treated skin area, only men should use an electric razor instead of a traditional razor. Also, the skin on your neck can become very painful, so it's important to wear loose-fitting, natural-fiber clothing as much as possible, to reduce friction and make you more comfortable.
The treated skin area should be protected from extreme heat or cold. This skin area is often more sensitive to direct sunlight, especially during the first year after treatment. Once the treatment has stabilized, you should use sunscreen on the treated area when outdoors.
Hair loss

Tác dụng phụ khi xạ trị
Trong quá trình xạ trị, tóc sẽ bị rụng và có thể phát triển lại khi kết thúc quá trình

If there is any hair in the treatment area where the radiation enters or exits, the hair will fall out. However, your hair may grow back some time after treatment ends. Male patients may find that beard growth is inhibited if the area is within the radiation treatment area. In some cases, the beard may not grow back, but usually the beard grows back some time after treatment ends.
Throat and larynx If your larynx is in the area of ​​radiation therapy, your voice may become hoarse and less powerful than usual. In some cases, you may temporarily lose your voice completely.
If these happen try to rest your voice as much as possible. Sometimes swelling of the vocal cords remains after treatment, which can make the voice sound hoarse. You may be referred to a speech therapist, who will provide advice on how to care for your voice during radiation therapy and how to help your voice recover from treatment.
During treatment, you may feel uncomfortable eating. This can be due to dry mouth, loss of taste causing pain or discomfort in the mouth or throat but can usually be controlled by adjusting your diet and/or giving you supplements. You may be referred to a dietitian for evaluation and problem-solving advice. Some people may have difficulty with the effects of radiation therapy on movement and muscle coordination in swallowing.
If you are concerned about swallowing, tell your doctor and you may be referred to a speech therapist for evaluation and problem-solving advice.
Trismus If the angle of the jaw is in the area of ​​radiation therapy, you may experience stiffness that limits your ability to open your mouth. This is caused by thickening of the tissues around the jaw. You may be referred to a speech therapist, who will give you specific exercises to prevent or minimize stiffness or reduce movement of your jaw (and other muscles in the head and neck area).
Weight loss When your mouth and throat are sore, it can be difficult to maintain a normal diet. For this reason, you will be referred to a dietitian for help.
If you have been fitted with a feeding tube (nasogastric tube), a dietitian can give advice regarding catheter cleaning and feeding.
Swelling of the chin/ "Double chin" A side effect of radiation therapy is that you may experience fluid accumulation or swelling around the chin. This can create the characteristic "double chin" image. Keep it lightly moist and massage the area to disperse the underlying fluid and reduce side effects. You can do this in a few months.
Cough Some people may experience a cough, causing discomfort during treatment. If this happens, notify the Radiologist and you will be advised or, if appropriate, given cough medicine.
Nausea May occur if radiation therapy is combined with chemotherapy. You will be given antiemetics, if antiemetics are not effective and nausea persists, notify your radiation therapist.
Soreness Most patients will experience some soreness during treatment. You will be given the right pain medication.
Pain relievers are prescribed for each phase of your treatment. If the pain medication you are taking does not work or wears off quickly, please inform the Radiation Oncologist for treatment, you may need a stronger pain reliever. Some strong pain relievers have the side effect of causing constipation. If you begin to have difficulty with bowel movements, please inform the Radiation Oncologist.
Taste Taste may change during your treatment. Changes in taste sensitivity will occur, and some foods can improve your taste buds and stimulate your appetite more than others.
Fatigue During and after treatment, you may become tired and feel lethargic. This is quite normal and may continue for a few weeks after treatment ends. This same fatigue can last longer, even up to a year later.

6. Late/Long-term Side Effects

Tác dụng phụ muộn khi xạ trị
Tuyến giáp hoạt động kém hơn xảy ra vài tháng hoặc vài năm sau khi kết thúc điều trị

Some late or long-term side effects may be experienced after a course of radiation therapy. They can also occur months or years after treatment ends.
Side effects may vary depending on exactly which part of the head and neck area is treated.
Skin changes: Once the skin reaction has subsided, you may notice that the skin in the treatment area is slightly lighter or darker than it was before the treatment. Small blood vessels near the surface of the skin may be more prominent than before.
Permanent dry mouth: The salivary glands may not regain normal function. Your saliva may be thick and sticky making your mouth/throat dry. This dryness can be permanent.
Cavities : If saliva production has been reduced or altered in quality and the jawbone has been treated, your teeth will be more susceptible to decay. If appropriate, your radiologist will arrange for you to see your dentist before radiation therapy begins and any problem teeth must be treated or extracted.
It is important that the remaining teeth have good oral hygiene care and regular checkups. If cavities develop, more serious damage can arise because the jaw receives high doses of radiation (but necessary in your treatment). This means that the jaw bone cannot heal and sometimes the bone can disintegrate beneath the damaged teeth, a process called osteoradionecrosis of the jaw.
Underactive thyroid: Sometimes radiation therapy to the head and neck reduces the normal hormone levels that are produced by the thyroid gland. Symptoms can be increased fatigue, significant weight gain, and dermatitis. If you have any concerns regarding the above, consult your doctor, who can check hormone levels with a blood test. If necessary, hormones may be given to correct this imbalance.
Spinal cord: Your treatment will be tailored specifically for you. As a result of this, every effort is made to keep the dose of radiation reaching the spinal cord to a minimum. Although rare, higher doses may be needed to provide the full dose of radiation to treat cancer. This carries the risk of late damage to the spinal cord, which may arise months or years after radiation therapy. The results of this can be serious, such as paralysis of the limbs and loss of sensation. But it should be emphasized that this happens very rarely. If you recognize this possibility, your doctor will discuss it with you right away.
Secondary malignancy: After a course of radiation therapy, there is a very small risk that radiation exposure may increase the chance of developing secondary cancers to the treated area of ​​the body, which may occur. out many years later.
We hope that all the information you have read above is not alarming, but is intended to provide you with all the information you need to understand the possible developments during and after treatment . Please keep in mind that the side effects listed may be more or less frequent, but they are the result of efforts to control the growth of the cancer and the benefits from treatment far outweigh the risks. potential. The doctors involved in your radiation treatment are available to answer any questions you may have regarding your treatment.
Conclusion: At the completion of radiation therapy
At the end of radiation therapy, the Radiologist will give you advice and a contact phone number for you to consult with any concerns or questions. You may also be referred to your local health facility for check-ups after radiation therapy is completed. A follow-up appointment will be made for you to see the consultant again in the outpatient clinic. Your consultant will decide the best time for this appointment to be made. If you have any further questions or are confused about any of the information you have been provided with, please feel free to speak with us again.

Máy chụp CT mô phỏng
Máy CT mô phỏng tại Đơn vị xạ trị - Trung tâm Ung bướu - Bệnh viện ĐKQT Vinmec Central Park
Máy xạ trị Truebeam
Máy xạ trị Truebeam tại Đơn vị Xạ trị - Trung tâm Ung bướu - Bệnh viện ĐKQT Vinmec Cemtral Park

Oncology Center - Vinmec Central Park International General Hospital is modernly built according to international standards, using a multi-specialty approach model in diagnosis and selection of appropriate treatment regimens for each patient. contribute to comprehensive patient care. Vinmec Central Park Oncology Center has outstanding advantages in cancer treatment such as:
Vinmec Converging experts in radiation, chemotherapy and surgery, equipped with modern facilities. The most modern Truebeam radiotherapy planning system and machine in Southeast Asia, with the outstanding advantage of minimizing the effects of radiation on benign tissues compared to X-rays, reducing irradiation time and the risk of adverse effects. side effects for patients.) helps effectively treat common cancers: Lung, Head, neck, breast.... As the first hospital in Ho Chi Minh City to apply autologous immunotherapy, Vinmec Hospital Central Park can treat cancer with multimodal cancer treatment regimens suitable for each case, bringing high treatment efficiency, providing one more reliable cancer examination and treatment address for people. To learn more about radiation therapy for cancer treatment at Vinmec, you can contact HOTLINE or register online HERE THIS

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