"It's important to clarify that most patients will experience and at least some side effects—and often several. So prevention really means reducing severity, complications, and long-term impact rather than avoiding side effects altogether. This process starts before radiation begins and continues throughout the treatment and includes dental evaluation, baseline swallowing assessments, and thorough patient education," ONS member Astrid Amoresano, RN, OCN®, lead oncology nurse specialist at New York Proton Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about side effects of radiation for head and neck cancer.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by February 13, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to radiation side effects in people with head and neck cancer.

Episode Notes

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
• Cancer Symptom Management Basics series
• Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices
• Episode 128: Manage Treatment-Related Radiodermatitis With ONS Guidelines™
• ONS Voice articles:
• Highly Localized, Precision Radiation Therapies Require Nurses to Drive Care Coordination, Patient Education
• IMRT Shows Similar Quality-of-Life Outcomes to Proton Therapy in Head and Neck Cancer
• How to Handle Even the Worst Radiation Therapy Side Effects
• ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition)
• ONS courses:
• ONS/ONCC® Radiation Therapy Certificate™
• ONS Oncology Symptom Management
• Clinical Journal of Oncology Nursing articles:
• The Role of Advanced Practice Providers in Radiation Oncology in 2025
• Systematic Review of Malnutrition Risk Factors to Identify Nutritionally At-Risk Patients With Head and Neck Cancer
• Effects of a Nurse-Initiated Telephone Care Path for Pain Management in Patients With Head and Neck Cancer Receiving Radiation Therapy
• Radiation-Induced Skin Dermatitis: Treatment With CamWell® Herb to Soothe® Cream in Patients With Head and Neck Cancer Receiving Radiation Therapy
• ONS Radiation Learning Library
• ONS Symptom Intervention Resources
• ONCC: Radiation Oncology Certified Nurse (ROCN™)
• American Cancer Society
• CA: A Cancer Journal for Clinicians article: American Cancer Society Head and Neck Cancer Survivorship Care Guideline
• Cancer Survivors Network: Head and neck cancer
• Head and neck cancer resources
• Radiation therapy resources
• American Society of Radiation Oncology
• National Cancer Institute: Common Terminology Criteria for Adverse Events (CTCAE)
• National Comprehensive Cancer Network

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

"Many tumors in the region are very radiosensitive, and radiation can be used either as definitive treatment or after surgery to reduce the risk of reoccurrence, but in many cases, radiation is combined with chemotherapy to improve local control. Because so many vital structures are located in this small complex area, radiation allows us to treat the cancer while minimizing the need for extensive or disfiguring surgery." TS 2:40

"The most common acute side effects of head and neck radiation: effects to the mouth, the throat, the skin, and the energy level. Patients often experience a mucositis, pain or sore throat, difficulty swallowing, dry mouth, or thick saliva, and taste changes. Skin irritation and redness in the treatment field is also common and can progress to dry and moist desquamation. Fatigue is another frequent side effect and tends to build as treatment progresses. Emotional and psychological distress are also very common in this patient population and can have an impact on daily function and quality of life. Side effects usually develop gradually, often beginning in the second and third week of radiation and may be more severe or have an earlier onset in patients receiving concurrent chemotherapy." TS 4:02

"Pain management is essential so patients can continue eating and drinking. Supporting the energy level and maintaining hydration are also key, as fatigue and dehydration can significantly worsen other side effects. Oral care protocols help manage mucositis and nutrition support may include supplements or enteral feeding if needed." TS 11:24

"Sexual health might not be the first thing nurses think of in regard to head and neck radiation. … But even though radiation for head and neck cancer doesn't involve the reproductive organs, it can still have a significant impact on sexual health and intimacy. Like fatigue, pain, dry mouth, changes in speech and visible changes in appearance can all affect body image and relationships." TS 14:52

"One of the common misconceptions is that side effects end when radiation ends. In reality, some effects peak afterward or become long term. Xerostomia, or dry mouth, and taste changes are good examples. While some patients improve, others adjust to a new normal where dry mouth and altered taste are permanent." TS 19:53