Radiation therapy:

A method of destroying cancer cells.


External Beam Therapy

A method of delivering a beam of high energy x-rays to a tumor. www.radiologyinfo.org

Intensity Modulated Radiation Therapy IMRT

An advanced mode of highly precise radiotherapy that uses computer controlled x-ray accelerators to deliver precise radiation to a tumor or specific areas within the tumor while minimizing exposure to surrounding normal tissue.
www.radiologyinfo.org

TomoTherapy(r)

This is a form of CT Guided Intensity Modulated Radiation Therapy. The primary advantage of delivering radiation in a CT like fashion from 360 degrees is the ability to precisely deliver radiation to a cancerous tumor while sparing the normal healthy tissue around it. A daily CT is used to precisely place the radiation beam and allows the operator to modify the treatment should the patients anatomy change due to weight loss or tumor shrinkage. Any cancerous lesion that is treated with external beam radiation can be treated with TomoTherapy.
www.tomotherapy.com

Proton Therapy

 Proton beam therapy is a medical procedure, a type of particle therapy that uses a beam of protons to irradiate diseased tissue, most often in the treatment of cancer. Proton therapy’s chief advantage over other types of external beam radiotherapy is that as a charged particle the dose is deposited over a narrow range and there is minimal exit dose.. More information can be found at the following links:

http://whsc.emory.edu/home/publications/winship-cancer/winship-magazine/summer2013/power-of-the-proton-beam.html

https://en.wikipedia.org/wiki/Proton_therapy

https://www.procure.com/Head-Neck-Tumors

Does proton therapy have side effects for head and neck cancer patients? | MD Anderson Cancer Center

MY EXPERIENCE DURING RADIATION

Prior to radiation, I received a consultation from the Oncologist. He advised me of possible side effects, and set out a schedule of 33 treatments, to be done every business day until complete. They are lenient regarding vacations or any time off one desires. The next appointment consisted of a simulation, where they took several x-rays and fitted me with a mesh mask. They also drew pictures on my neck and chest so they would be able to get the radiation in exactly the places they wanted. This involved lying in the supine position for an extended period, so it is best not to eat or drink anything for several hours before your appointment. I had not been advised of this and was very uncomfortable. Following the simulation I was given a schedule for my treatments and then received a CT Scan. The first thirty of my treatments took about 15 minutes a day from the time arrived until the time I left. The last three treatments will be superficial treatments of the stoma area itself without the mask, but since they feel the stoma area is quite red, they have given me a week off before the treatments. Since I have no feeling in most of the area they are treating, I was unaware of the skin burns which they noticed and treated with Aquaphor. Fortunately, I have not experienced any difficulty swallowing or pain, but have noticed fatigue. I still have edema in my neck which may be prolonged due to the radiation. Sometimes this impedes the ability to use my Servox and my sweet spot changes from day to day due to the swelling.
Roger Scharmen

WHAT TO DO ABOUT RADIATION BURNS

When I got radiation after my surgery at MD Anderson in Houston, a nurse in radiation recommended RadiaCare Gel, for which I needed a prescription. But a nurse or other non-MD health professional can prescribe it. The manufacturer is Carrington Laboratories, Irving TX. Phone 1-800-358-5205 or 1-800-527-5216; the first is on the package, the second on the web site. Not all pharmacies stock it, but they should be able to tell you where and how to get it. I found it helpful in taking some of the sting out of radiation burns and in keeping the skin from drying out completely. It is a water-based gel, NOT petroleum based like Vaseline, which is not a good idea for burns. You have to wash it off before radiation sessions. Your skin should be free of goop before each treatment. But it feels pretty good afterwards.
Paul Sampson

Seems like I was given a different med each week by the Oncology dept where I had my radiation.. I also found that aloe lotion from Crabtree and Evelyn (which my granddaughter gave me for Christmas and it smelled good) was as effective as any. I remember being told by the technicians to have the skin clean and clear of any lotion or medication at time of treatment. The Home Health Nurse had told me to put on some cream around the stoma to keep it soft but I found out that was a definite no-no! Kay Wolff

I began using Aquaphor before the radiation burns began just to keep my skin moist. Of course, it had to be washed off before the treatments. I found that it helped reduce the effects. I still had signs of skin darkening, but I had no discomfort.
Helene Stinneford

I’ve used Aquaphor around the stoma area when needed, the nurse has free samples. So ask.
Greg Sidwell

Many of us have found the Aloe plant very effective against radiation burns. You can cut off a leaf, slit it open to get the gel and smear it on the skin. It is almost instant relief for a burn of any kind and is well known as the “Burn Plant” that many of us keep in the kitchen window for fast use on a burn when cooking. Be careful of lotions that “contain” aloe since the other ingredients may not be good for your skin. You can find 100% aloe juice at the health food store in bottles. Some people swear by swallowing a spoonful to coat and soothe the burn inside the throat and it is made for oral consumption.
Pat Wertz Sanders

I am a firm believer in aloe vera—from a health food store, in dark brown glass bottles. My favorite brand is Lily of the Desert. Aloe Vera is proven, in the real scientific meaning of the word, to boost the immune system. It is also proven to help wounds heal without scarring and decrease swelling.

You can get Aloe Vera in gel form or in juice form but don’t use it internally unless it is approved for that. I like the gel because it can be put on the neck and stay there easier than juice and I have the mental image of it sticking to the inside of my throat better. I would take two ounces morning, noon, and night—from a shot glass, I would just ‘shoot’ the first one, and then let the second one dribble down my throat and ‘coat’ it. It will cause diarrhea is you take too much. I also would put some on the outside of my neck when I got back from my radiation—it kept the burn and swelling down quite a bit. I have great belief in the benefits of Aloe Vera, and the long term effects of green tea. but tea is another post.
Paul Galioni

RADIATION SIDE EFFECTS

The side effects of radiation may cause difficulty in swallowing, dry mouth, loss of taste or taste changes that make previously pleasurable tastes unpleasant. These are very different problems and several may occur at the same time. If you are looking for effective advice in treating these side effects be as specific as possible in describing your symptoms. Since some of these symptoms may be results of other treatments, please look under section called Side Effects.

You should see your dentist prior to radiation to see if you have any dental work that may be needed. Also talk to your dentist about care of you teeth during radiation. He may recommend a fluoride tray to help protect your teeth during treatment.

MedShadow has good information on head and neck radiation treatments. It includes the process and side effects. Patients are often not told about the side effects so it is good to do some research.
https://medshadow.org/features/the-troubling-side-effects-of-head-neck-radiation/

Posted: 09/23/2018

HBO – HYPERBARIC OXYGEN THERAPY

Hyperbaric Oxygen Therapy (HBO) is a medical treatment by which oxygen is administered at greater than normal pressure to a patient in order to treat specific medical indications. Long established as the primary therapy in the treatment of medical disorders such as carbon monoxide poisoning and gas gangrene, hyperbaric oxygen therapy is now increasingly being used on an adjunctive basis in the management of a variety of disorders refractory to standard medical and surgical care. HBO has been shown to be particularly effective in treating problem wounds, chronic bone infections and radiation injury. In HBO therapy, the patient is placed in a specially designed chamber, the pressure in the chamber is increased, and 100% oxygen is breathed. Alveolar oxygen pressure is increased, causing a rise in plasma oxygen content which results in enhanced tissue oxygen delivery. The amount of pressure increase and the length of time under pressure are determined by the condition being treated. Treatment pressures are usually between 2 and 3 times atmospheric. Treatments usually last from 1 to 2 hours at full pressure.
Hyperbolic Oxygen Therapy

The reason doctors want you to have the HBO treatments is to help the wound heal faster and to help lessen the chance of infection.. I’ve had about 60 treatments over the years.. I’ve had about 15 teeth removed since 1977. I had the treatments because my jaw deteriorated and broke from the radiation treatments I got in 1978. I went to Miami in 1999 to see the best Oral surgeon in the country .. He recommended the HBO treatments after I had my left jaw replaced with a metal plate. There is a large HBO chamber for 6 people I think at Jackson Memorial Hosp in Miami, but I went to a small one in Atlanta near my home. An infection in the jaw is very serious, the HBO treatments help the wound to heal faster because you are saturated in oxygen for a period of time.
Rich Mycoskie

There is a large HBO chamber in Philadelphia at the University of Pennsylvania. It can hold up to 10 patients, looks much like a submarine with a movie for the patients, if they wish. Some patients bring books or magazines to read. The dives take about 2 hours give or take a little. A paramedic or nurse is on board. There is testing beforehand to make sure the pressure is not too much for your ears. If it is, they insert tubes, which takes care of that problem. Healing is the target of these treatments, and, they are quite effective. 
Carole Rabin

MOUTHWASHES

RINSES

For Patients Receiving Chemotherapy and Radiation Therapy

The following are general guidelines to be individualized by your doctor

1.Rinse with a warm, dilute solution of sodium bicarbonate (baking soda) or salt & bicarbonate (also commercially available as Sage Salt & Soda Rinse) every two hours to bathe the tissues and control oral acidity. Two teaspoons of bicarbonate (or one teaspoon of table salt plus one teaspoon of bicarbonate) per quart solution is recommended.

2.If you are experiencing pain, rinse with one teaspoonful of elixir of Benadryl before each meal. Be careful when eating while your mouth is numb to avoid choking.

3.If your mouth is dry, sip cool water frequently (every ten minutes) all day long. Allowing ice chips to melt in the mouth is comforting. Artificial salivas, eg, Sage Moist Plus spray, Moi-Stir, Salivart, Xero-Lube, Orex, can be used as frequently as needed to make the mouth moist and slick. A mouth moisturizing gel, ie Sage Mouth Moisturizer or OralBalance gel may be helpful when applied to the gums. Keep the lips lubricated with petrolatum or a lanolin- containing lip preparation. Commercial mouth rinses with alcohol bases, coffee, tea and colas with caffeine should be avoided as they tend to dry the mouth.

4.If oral yeast infection develops, antifungal medications can be prescribed.
a. Nystatin pastilles*; let one dissolve in the mouth five times a day, or
b. Let a 10 mg clotrimazole (Mycelex)* troche dissolve in the mouth five times a day,
c. Swish with Nystatin oral suspension for two minutes timed by a clock. Either spit out or swallow, as directed by your dentist or physician.

(This is from the Patient Information Sheet recommended by the American Academy of Oral Medicine and it has been copied verbatum from ” Clinician’s Guide to Treatment of Common Oral Conditions The American Academy of Oral Medicine, Fall 1993.”)

ALOE GARGLE

To stop the throat and mouth burn from radiation, three times a day I sipped 1 oz of 99% pure Aloe Vera gel to 2 oz of water and the burn went away after one and a half days, never to return. If you are able to gargle do that and swallow the rest. Do not spit it out. You can also try 50%-50%, but the taste was a little strong for me.
Craig Smith

MIRACLE MOUTHWASH

This is by prescription but this is the recipe:
Benylin 1120cc
Cortef 15cc
Nystatin Syrup 15cc
Tetracycline liquid 30cc
You shake it well. The dose is 10-15cc You swish and hold the swallow.
Patty Jones

REFERENCES ON-LINE

Macmillan Cancer Support: charity in England, Wales, Scotland and the Isle of Man
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Larynx/Treatinglaryngealcancer/Radiotherapy.aspx

MedicineNet: Excellent Larynx Cancer Forum, page 7 of 13 is on Radiation
http://www.medicinenet.com/larynx_cancer/page7.htm