Head and neck cancer

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.

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.

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.

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.

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.

• 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
• Nausea
• Tiredness
• 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

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.