Anyone have head/neck radiation on HALF only?

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kellydx
kellydx Member Posts: 3
My husband's doc may be recommending radiation on only one side of his head/neck. He has had a neck dissection, tonsillectomy and parotidectomy on one side, and now radiation is being recommended on that side only. I hope that means half the bad side effects. Comments, anyone??

Comments

  • osmotar
    osmotar Member Posts: 1,006
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    No half here
    Hi kellydx,

    My right tonsil was the primary source and went to 1 lymph node on the right side of my neck. ENT only removed the rt tonsil as the left was healthy, I was unnder the impression that the radiation treament would only be to the rt side, but the onco rad doc is doing both sides. I'll have a total of 39 treatments , # 3 was today, with 1 day if cisplatin for every week of chemo. No neck disection is required , since the intial chemo treatments shrunk the tumor on the right side of neck to the point neither of my onco docs can feel it. It was all gone by the 2nd round of chemo.

    Blessings and light for your husband continued treatment.

    Linda
  • Hal61
    Hal61 Member Posts: 655
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    one side
    Hi Kelly, weclome to the board. From my year and a half here on the board, it's not the usual approach. I had radiation, chemo, and last a left side dissection. My initial diagnosis was BOT, SCC with mets to the left side lymph nodes. Most often, the oncs will do both sides as a precausion to treat cancer cells that might not have been picked up by PET?CT scams. Your husbands course has been a bit different as he has had 3 surgical procedures.

    But, to answer your question, I would think that rads to one side would have less effect on a system, generally, than radiating both.

    Just try and be sure the docs are certain that a chance of cellular spread can be counted out for the other side.

    best to both of you,

    Hal
  • longtermsurvivor
    longtermsurvivor Member Posts: 1,842 Member
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    I'm not sure how you do this
    Until a better answer comes along, consider that radiation passes through-and-through. Therefore, if you radiate froma lateral port on the left, let's say, you get radiation all the way through to exit on the right. Similarly, if you radiate from the front, you get radiation all the way to the back. This even applies to tomotherapy, where the ports can be shrunk, but still there is exit exposure.

    Best
  • mixleader
    mixleader Member Posts: 267 Member
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    Neck Rads
    Yes, I had radiation treatments (30) to the right side of my face and neck for a right parotid cancer. This happened after surgery to remove the parotid salivary gland and part of the facial nerve. From the onset, my radiation oncologist thought that this would give me manageable side effects and he was right. It was tough, of course, but I did not need a feeding tube and I did not need heavy duty pain killers. My face and neck got quite red and I lost hair, but I managed it. It made me feel like I was choking sometimes, but I never got to the point where I could not swallow. I had to take anti-anxiety meds to keep the choking feeling at bay, but I managed. I kept on working until the last two weeks of rads when heavy fatigue finally made me take some time off. Unfortunately, my cancer was very aggressive and survived this radiation and recurred again on the same side of my neck and then spread to my lungs/spine. Should there have been more rads initially? I have asked some of my Docs about how this survived and nobody seems to know. Cancer is just not understood well enough, I guess.
  • Hondo
    Hondo Member Posts: 6,636 Member
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    Hi Kelly

    Radiation is radiation no matter how much or how little, the good news is that there is only one side of his neck or face that will be affected by the beam.

    PS: Also welcome to the family here on CSN


    Take care
    ╠╣ONDO
  • ratface
    ratface Member Posts: 1,337 Member
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    Hondo said:

    Hi Kelly

    Radiation is radiation no matter how much or how little, the good news is that there is only one side of his neck or face that will be affected by the beam.

    PS: Also welcome to the family here on CSN


    Take care
    ╠╣ONDO

    Not that unusual to tailor the intensity
    It's common practice to radiate at different intensities from different sides. The main radiation field may concentrate on one side and then they typically hit the other side on a mop up mission of sorts but at less intensity. If you read my radiation report they used 70 grey on the tumor side and 50 grey on the other side. It was apparent during my last week of rads that the machine was on a different trajectory and the time span and rotation had changed. I inquired of the technicians and they said the fields had been changed to get any stray cells on the other side. Are you certain that zero radiation is the plan for the opposite side?

    Many of us have unknown primary sites and it would make sense to radiate both sides in these cases. Conversely your husband's cancer locations appear to be well identified so why not just do concentrated radiation. I have read where some are recommending less radiation for HPV derived cases citing less damage but the same overall result. You raise a valid and interesting question that I'm sure your doctor can answer. Why don't you let us know?

    I'm guessing 30 Rad sessions are going to affect him in a fairly standard fashion but the long term damage may be less.
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
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    Ratface - Ding Ding Ding DIng
    We have a winner....

    Like most that have posted, my Dx and Tx was very similar. STGIII Tonsils and a Lymphnode. Many weeks of chemo and seven of those with IMRT..to both sides.

    How Ratface explained is how my radiation wwas delivered. I did have both tonsils removed also.

    But my rads were heavier on the right side (infected tonsil and lymphnode side). Not by a lot, but who know what a lot is... If I remember I had something like 7000 rads on the right and 6000 rads on the left.

    Main reasoning and thought for treatment to both sides was to prevent or minimize any cells passing to the other side.

    Welcome to the forum...

    Best,
    John
  • RogerRN43
    RogerRN43 Member Posts: 185
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    2 sides for me
    I'm a L tonsil primary with L lymphs involved, I'm getting IMRT 3D concentrated on the area, spanning less intense down the neck. On my right side is a lighter rad, sparing the R parotid.

    From what I've researched, when it has spread beyond the primary, usually people get chemo+rad on both sides because CT/MRI/PETs are not 100%. However, if new research suggests the percentages are low for cross-side involvement, maybe that's why only one side is being done.

    The benefit is he will have full salivation on the non-rad side which will compensate across and is a big plus to prevent cavities for all teeth. And most likely, less rad side effects overall.

    The downside maybe, is if it returns on the non-rad side, he will need to do another 35 rads and blanket the area to cure, maybe not being able to save any salivary glands. But don't take my word on it, ask your rad doc about the options and what ifs.

    The decision may be tough, the key is to eradicate and no recurrence.
    I was happy to see a prominent U.S. Head and Neck specialist in a May'10 youtube video talking about short and longterm side effects begin by saying H&N cancers overall these days even at Stage4 are 80-85% curable, not referring to HPV+ which already has that rough stat.
    http://www.youtube.com/watch?v=3yQeLaM7e6I

    Hoping your family the best.
  • ratface
    ratface Member Posts: 1,337 Member
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    RogerRN43 said:

    2 sides for me
    I'm a L tonsil primary with L lymphs involved, I'm getting IMRT 3D concentrated on the area, spanning less intense down the neck. On my right side is a lighter rad, sparing the R parotid.

    From what I've researched, when it has spread beyond the primary, usually people get chemo+rad on both sides because CT/MRI/PETs are not 100%. However, if new research suggests the percentages are low for cross-side involvement, maybe that's why only one side is being done.

    The benefit is he will have full salivation on the non-rad side which will compensate across and is a big plus to prevent cavities for all teeth. And most likely, less rad side effects overall.

    The downside maybe, is if it returns on the non-rad side, he will need to do another 35 rads and blanket the area to cure, maybe not being able to save any salivary glands. But don't take my word on it, ask your rad doc about the options and what ifs.

    The decision may be tough, the key is to eradicate and no recurrence.
    I was happy to see a prominent U.S. Head and Neck specialist in a May'10 youtube video talking about short and longterm side effects begin by saying H&N cancers overall these days even at Stage4 are 80-85% curable, not referring to HPV+ which already has that rough stat.
    http://www.youtube.com/watch?v=3yQeLaM7e6I

    Hoping your family the best.

    heart disease
    The most uplifting part of that interview was that the prognosis for head and neck patients concerned itself with the possibility of patients developing heart disease. Now, go out and have some ice cream! Thanks for making my day Roger.
  • Hal61
    Hal61 Member Posts: 655
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    ratface said:

    Not that unusual to tailor the intensity
    It's common practice to radiate at different intensities from different sides. The main radiation field may concentrate on one side and then they typically hit the other side on a mop up mission of sorts but at less intensity. If you read my radiation report they used 70 grey on the tumor side and 50 grey on the other side. It was apparent during my last week of rads that the machine was on a different trajectory and the time span and rotation had changed. I inquired of the technicians and they said the fields had been changed to get any stray cells on the other side. Are you certain that zero radiation is the plan for the opposite side?

    Many of us have unknown primary sites and it would make sense to radiate both sides in these cases. Conversely your husband's cancer locations appear to be well identified so why not just do concentrated radiation. I have read where some are recommending less radiation for HPV derived cases citing less damage but the same overall result. You raise a valid and interesting question that I'm sure your doctor can answer. Why don't you let us know?

    I'm guessing 30 Rad sessions are going to affect him in a fairly standard fashion but the long term damage may be less.

    Exactly
    Good explanation, that's what I meant to say. Ha. My rad onc told me that radiation docs vary the concentration in two ways. Some choose to concentrate the dosage more on one side in every session, and others will, as you said, change the routine for x days at the end of treatment. Mine varied my sectors and time each visit, so my machine wheezed and rotated in the same manner each session.


    best, Hal
  • MidgeMary
    MidgeMary Member Posts: 2
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    mixleader said:

    Neck Rads
    Yes, I had radiation treatments (30) to the right side of my face and neck for a right parotid cancer. This happened after surgery to remove the parotid salivary gland and part of the facial nerve. From the onset, my radiation oncologist thought that this would give me manageable side effects and he was right. It was tough, of course, but I did not need a feeding tube and I did not need heavy duty pain killers. My face and neck got quite red and I lost hair, but I managed it. It made me feel like I was choking sometimes, but I never got to the point where I could not swallow. I had to take anti-anxiety meds to keep the choking feeling at bay, but I managed. I kept on working until the last two weeks of rads when heavy fatigue finally made me take some time off. Unfortunately, my cancer was very aggressive and survived this radiation and recurred again on the same side of my neck and then spread to my lungs/spine. Should there have been more rads initially? I have asked some of my Docs about how this survived and nobody seems to know. Cancer is just not understood well enough, I guess.

    Neck Radiation - information please
    Hi,
    I had surgery for basal cell adenocarcinoma of the salivary gland - very rare I am told - as well as removal of the facial nerve as the tumour was embedded in the facial nerve - right side of my face. I am left with an eye that does not blink or close properly and my mouth droops. I continue to put drops in my eye to keep it moist and have to cover it each night to be sure it is closed tight. I am now in the process of preparing for radiation treatment - 30 sessions. Face mask etc. I am having a very hard time dealing with this. I live in Ireland and research with the Irish Cancer Society has resulted in nobody with this type of cancer to the best of their knowledge. I am desperate for information. Thanks to anyone who has information on this type of cancer.

    All the best,
    Midge
  • ratface
    ratface Member Posts: 1,337 Member
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    MidgeMary said:

    Neck Radiation - information please
    Hi,
    I had surgery for basal cell adenocarcinoma of the salivary gland - very rare I am told - as well as removal of the facial nerve as the tumour was embedded in the facial nerve - right side of my face. I am left with an eye that does not blink or close properly and my mouth droops. I continue to put drops in my eye to keep it moist and have to cover it each night to be sure it is closed tight. I am now in the process of preparing for radiation treatment - 30 sessions. Face mask etc. I am having a very hard time dealing with this. I live in Ireland and research with the Irish Cancer Society has resulted in nobody with this type of cancer to the best of their knowledge. I am desperate for information. Thanks to anyone who has information on this type of cancer.

    All the best,
    Midge

    Midge
    Seems you are looking for someone with surgery to the facial nerve? Why don't you start a new thread for this which may get you a better answer. Regards and welcome from down under.
  • mixleader
    mixleader Member Posts: 267 Member
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    MidgeMary said:

    Neck Radiation - information please
    Hi,
    I had surgery for basal cell adenocarcinoma of the salivary gland - very rare I am told - as well as removal of the facial nerve as the tumour was embedded in the facial nerve - right side of my face. I am left with an eye that does not blink or close properly and my mouth droops. I continue to put drops in my eye to keep it moist and have to cover it each night to be sure it is closed tight. I am now in the process of preparing for radiation treatment - 30 sessions. Face mask etc. I am having a very hard time dealing with this. I live in Ireland and research with the Irish Cancer Society has resulted in nobody with this type of cancer to the best of their knowledge. I am desperate for information. Thanks to anyone who has information on this type of cancer.

    All the best,
    Midge

    Neck Rads
    Hi, Midge. I also have cancer of the right side parotid salivary gland. Mine was different in that it is a ductal cell adenocarcinoma. I also had nerve involvement and the lower part of my facial nerve was removed along with the parotid gland. About 6 weeks later, the entire right side of my face was paralyzed. I also have the droopy face and the right eyelid will not blink on it's own. I have learned to live with this for the last year and a half. Like yours, my cancer is also very rare and not much research has been done on it. I also had 30 rad treatments with the mask. It was tough, but I got through it and so can you. Hang tough and fight this thing. It is very scary, but lots of people on this site have been through radiation and there is a wealth of information here about that. I wish you good luck on your battle and I think it is a good thing you have found this site to offer support and advice.

    Roger
  • buzz99
    buzz99 Member Posts: 404
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    1/2
    Buzz had neck dissection, tonsillectomy and radiation to one side 10 years ago. That seems to be standard treatment. BTW, he had minimal side effects, no difficult swallowing, and actually gained weight during treatment! (Tho that is not typical). Regards, Karen
  • seadogdw1964
    seadogdw1964 Member Posts: 3 *
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    I am new to this, but I have head and neck since 2020, they took my left tonsil out and I had radiation treatments on that side only plus seven chemo, they thought they had it but last Friday they did a bioscope on my chest and it spread to lymph nodes in my chest area, now I'm waiting to start treatments on that. Not sure if that helps.

  • wbcgaruss
    wbcgaruss Member Posts: 2,374 Member
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    Hello, seadog, and welcome to the CSN H&N discussion board. I am sorry your cancer has come back. I have read some of the posts on this and it looks like there are different applications of radiation based on a case-by-case basis. I had radiation for throat cancer in 2013. I understand that no matter how sure your care team is of their approach there is still a possibility of cancer coming back either from a previous cancer or a new one. Reading the posts above I think provides all the info you need. The main thing is your doctors decided on a radiation plan based on your case and your scans so I am assuming they felt confident it would get rid of your cancer and any errant cancer cells. With H&N or any cancer, the main thing is to get it as a "One Shot Deal". You definitely want to do treatment only once if possible. Does your care team feel for sure it came from your previous cancer or is this a new cancer? You do have the option to get a second opinion on this as another option. I know how it is a bummer having cancer come back, I have had it 3 times. Hang in there you will get through this. What treatments are you getting this time?

    Wishing You the Best

    Take Care, God Bless-Russ