Another way to deliver radiation is by placing radioactive materials right into or near the cancer. This is called internal radiation, interstitial radiation, or brachytherapy. The radiation travels only a very short distance, which limits its effects on nearby normal tissues.

Brachytherapy is not used often to treat oral cavity or oropharyngeal cancers because newer external radiation approaches, such as IMRT, are now very precise. When brachytherapy is used, it’s most often combined with external radiation to treat early lip or mouth cancers.

Different types of brachytherapy may be used. In one form, hollow catheters (thin tubes) are placed into or around the tumor during Surgery. They are left in place for several days while the patient stays in the hospital. Radioactive materials are put into the tubes for a short time each day.

In another form, small radioactive pellets (about the size and shape of a grain of rice) are put right into the tumor. The pellets give off low levels of radioactivity for several weeks and, over time, lose their strength. The pellets themselves are just left in place and rarely cause any problems.

Possible side effects of radiation therapy

Radiation of the mouth and throat area can cause several short-term side effects, including:

• Skin changes like a sunburn or suntan in the treated area that slowly fades away
• Hoarseness
• Loss of sense of taste
• Redness and soreness or even Pain in the mouth and throat

Sometimes open sores develop in the mouth and throat, making it hard to eat and drink during treatment. Liquid feeding through a tube placed into the stomach may be needed.

Radiation therapy may also cause long-lasting or permanent side effects:

Damage to the salivary glands: Permanent damage to the salivary (spit) glands can cause a Dry mouth. This can lead to problems eating and swallowing.

The lack of saliva can also lead to tooth decay (cavities). People treated with radiation to the mouth or neck need to practice careful oral hygiene to help prevent this problem. Fluoride treatments may also help.

Newer Radiation therapy techniques such as IMRT may help reduce this side effect. A drug called amifostine (Ethyol^®) can also help reduce this side effect by limiting radiation damage to normal tissues. It is given into a vein over 15 minutes just before each radiation treatment. Amifostine has side effects, such as low blood pressure, nausea, and vomiting, that can make it hard to tolerate.

Damage to the jawbone: This problem, known as osteoradionecrosis of the jaw, can be a serious side effect of radiation treatment. This is more common after tooth infection, extraction, or trauma, and it can be hard to treat. The main symptom is Pain in the jaw. In some cases, the bone actually breaks. Sometimes the fractured bone heals by itself, but often the damaged bone will have to be repaired with Surgery.

To help prevent this problem, people getting radiation to the mouth or throat area need to see a dentist to have any problems with their teeth treated before radiation is started. In some cases, teeth may need to be removed.

Damage to the pituitary or thyroid gland: If the pituitary or thyroid gland is exposed to radiation, their production of hormones may decrease over time. This can lead to problems with metabolism that may need to be corrected with medicine.

Side effects tend to be worse if Chemotherapy is given at the same time as radiation (chemoradiation). Both the radiation and the Chemotherapy side effects are worse, which can make this treatment hard to tolerate. For this reason, it’s important that anyone getting chemoradiation be in relatively good health before starting treatment, that they understand the possibility of serious side effects, and that they’re treated at a medical canter with a lot of experience with this approach.