Head & Neck Radiation: Side Effects 4

MD Anderson Cancer Center
Date: May 2012

>> Radiation can cause scar tissue to form in the jaw and neck muscles.  This can limit how wide you open your mouth and reduce the movement and flexibility in your neck.  You may begin feeling some tightness during treatment.  Often the tightness or scar tissue develops after treatment and can get worse for several months to years later.  To help prevent or reduce the amount of scar tissue, please refer to the jaw and neck exercises in your packet.  Begin doing these exercises as soon as you start treatment.  Do them every day, seven days a week during your radiation, and when you're done with treatment, continue doing these exercises for at least six months.  If you do develop scar tissue, you may need to continue these exercises for the rest of your life to prevent it from getting worse.

If your sinus or nose is in the treatment area, you'll have sinus congestion and bloody nostrils.  You may begin to have congestion around the second to third week of treatment, and it will get worse throughout treatment.  Your nose may begin to bleed during the third or fourth week.  To help manage congestion and a bloody nose, flush the inside of your nose with an over-the-counter saline rinse several times a day to help loosen the bloody secretions.  Try using an oral decongestant.  It may or may not help.  Don't spray any nasal decongestants in your nose; it will not help, and it will burn the inside of your nose.  Once you're done with treatment, your nose should stop bleeding in about two or three weeks.  The congestion should begin to improve in a few weeks, but may take a few months to feel normal again.  Some patients have long-term thickening of the sinuses that can cause some mild congestion. 

If any part of your voice box or larynx is in the treatment area, you may have some swelling.  This can cause the voice to become hoarse, and you may have some trouble breathing.  To help manage swelling, rest your voice as much as possible.  Straining your voice can make the swelling worse.  Do not use any tobacco products or drink alcohol.  We may prescribe steroids to help reduce the swelling.  If you have swelling that causes serious problems breathing, we make need to insert a trach.  This is small tube inserted in your neck to help you breathe.  The trach is usually temporary and removed when the swelling improves. 

If any part of your ear canal is in a treatment area, you may have a fluid build up in your ears that can cause decreased hearing, ear drainage, ear pain, and infection.  To help with decreased or muffled hearing, we may recommend that you see an ear, nose, and throat doctor, or ENT.  The ENT can irrigate your ear, use instruments to remove wax buildup, or insert a tube to drain the fluid from your ear.  If necessary, you'll be prescribed antibiotics for infection and pain medications for pain.