Radiation Oncology
Managing
Side Effects in Head and Neck Region
What
Side Effects Occur With Radiation Therapy to the Head and Neck
Area?
Some
people who are having radiation to the head and neck have redness
and irritation in the mouth, a dry mouth, difficulty in swallowing,
changes in taste, or nausea. Try not to let these symptoms keep
you from eating.
Other
problems that may occur during treatment to the head and neck
are a loss of your sense of taste, earaches (caused by hardening
of ear wax), and swelling or drooping of skin under the chin.
There may be changes in your skin texture. You also may notice
that your jaw feels stiff and that you cannot open your mouth
as wide as before your treatment. Jaw exercises may help this
problem. Report any side effects to your doctor or nurse and
ask what you should do about them.
If
you are receiving radiation therapy to the head or neck, you
need to take especially good care of your teeth, gums, mouth,
and throat. Side effects from treatment to these areas most often
involve the mouth, which may be sore and dry.
Here
are a few tips that may help you manage mouth problems:
-
Avoid
spices and coarse foods such as raw vegetables, dry crackers,
and nuts.
-
Don't
smoke, chew tobacco, or drink alcohol.
-
Stay
away from sugary snacks that promote tooth decay.
-
Clean
your mouth and teeth often, using the method your dentist
or doctor recommends.
-
Do
not use a commercial mouthwash; the alcohol content has a
drying effect on mouth tissues
Dental
Care
Radiation
treatment for head and neck cancer can increase your chances
of getting cavities. Mouth care designed to prevent problems
will be a very important part of your treatment. Before starting
radiation therapy, notify your dentist and arrange for a complete
dental/oral checkup. Ask your dentist to consult with your
radiation oncologist about any dental work you need before
your radiation treatments begin.
Your
dentist can give you very detailed instructions about caring
for your mouth and teeth to reduce the risk of tooth decay
and will help you deal with possible problems such as soreness
of the tissues in your mouth. It is important to your total
well-being that you follow the dentist's advice while you're
receiving radiation therapy. Most likely, you will be advised
to:
-
Clean
teeth and gums thoroughly with a soft brush after meals and
at least once more each day.
-
Use
a fluoride toothpaste that contains no
abrasives.
-
Floss
gently between teeth daily, especially if you flossed regularly
before your illness.
-
Use
a disclosing solution or tablet after brushing to reveal
plaque that you've missed.
-
Rinse
your mouth well with a salt and baking soda solution after
you brush. Use 1/2 teaspoon of salt and 1/2 teaspoon of baking
soda in 1 quart of water.
-
Apply
fluoride regularly as prescribed by your dentist.
Your
dentist can explain how to use disclosing tablets, how to mix
the salt and baking soda mouthwash, and how to use the fluoride
treatment method that best suits your needs. Most likely you
can get printed instructions for proper dental care at the
dentist's office.
Handling
Mouth or Throat Problems
Soreness
in your mouth or throat may appear in the second or third week
of external radiation therapy. It is likely to decrease from
the fifth week on and end a month or so after your treatment
ends. You may have trouble swallowing during this time because
your mouth feels dry. Your doctor or dentist can prescribe
medicine for mouth discomfort and advise you about methods
to relieve other mouth problems.
If
you wear dentures you may notice that they no longer fit well.
This may happen if the radiation causes swelling in your gums.
It's important not to let your dentures cause gum sores that
may become infected. You may need to stop wearing your dentures
until your radiation therapy is over.
Your
glands may produce less saliva than usual, making your mouth
feel dry. It's helpful to sip cool drinks often throughout
the day. Water probably is your best choice. In the morning,
fill up a large cup or glass with ice, add water, and carry
it with you so you have something to drink during the day.
Keep a glass of cool water at your bedside at night, too. Many
radiation therapy patients say that drinking carbonated beverages
helps relieve dry mouth. Sugar-free candy or gum also may help.
Avoid tobacco and alcoholic drinks because they will dry and
irritate your mouth tissues even more. Moisten food with gravies
and sauces to make eating easier. If these measures are not
enough, ask your dentist about artificial saliva. Dry mouth'
may continue to be a problem even after treatment is over.
Tips
on Eating
If
you are having radiation therapy to the chest, you may find
swallowing difficult or painful. Some patients say that it
feels like something is stuck in their throat.
Soreness
or dryness in your mouth or throat can make it hard to eat.
However, there are several ways to ease your discomfort:
-
Choose
foods that taste good to you and are easy to eat.
-
Try
changing the consistency of foods by adding fluids and using
sauces and gravies to make them softer.
-
Avoid
highly spiced foods and textures that are dry and rough,
such as crackers.
-
Eat
small meals, and eat more frequently than usual.
-
Cut
your food into small, bite-sized pieces.
-
Ask
your doctor for special liquid medicines that can help you
eat and swallow more easily by reducing the pain in your
throat.
-
Ask
your doctor about liquid food supplements. These can help
you meet your energy needs.
-
If
you are being treated for lung cancer, and you get your doctor's
okay, try to drink extra fluids. This will help keep mucus
and other secretions thin and manageable.
-
If
your sense of taste changes during radiation therapy, try
different methods of food preparation.
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