Masks for radiotherapy

Most types of radiotherapy to the brain, head, or neck involve wearing a mask to help you remain still.                                               

What is a radiotherapy mask?

During most types of radiotherapy to the head, neck, or brain, you wear a mask. This is sometimes called a mould, headshell, or cast.

It is designed to keep your head and neck still and in exactly the right position. This helps your treatment be as accurate and effective as possible. The mask should fit snugly but not be uncomfortable. While wearing it, you can breathe normally.

Learn more about radiotherapy for head and neck cancer. We have more information about radiotherapy for brain tumours, including stereotactic radiotherapy for brain tumours.       

Before the radiotherapy mask is made

made, the mask can only be adjusted slightly after it is made. In order to ensure that your mask fits properly, you may be asked to do the following:

  • Dental work
    Your mouth and teeth may need to be examined by a dentist before a radiotherapy mask can be made. Some of your teeth may need to be removed or repaired if they are unhealthy. Dental work can alter the shape of your mouth and face. It is crucial that this is done before the mask is made.
  • Mouth bites
    Some people are given a mouth bite to wear inside their mouth during radiotherapy. By holding your mouth and jaw in place, you can treat the right area. Side effects can also be reduced. Your radiotherapy team will advise you if you need a mouth bite. You will also have to wear it while your mask is being made.
  • Hair
    Normally, you don’t need to cut your hair before the mask is made. If you have a beard, you should trim or shave it. If you are undergoing treatment, don’t make big changes to your hairstyle or let your facial hair grow back. It will affect how well the mask fits. Wet shaving can irritate the skin. If you need to shave, use an electric shaver.           

How a radiotherapy mask is made

The mask is usually made by a technician or radiographer in the radiotherapy department. The mask-making process varies depending on the hospital, but it usually takes about 30 minutes. While it is being made, you may need to remove some of your clothes and wear a hospital gown. If you usually wear a wig or headscarf, you should also take them off.

Masks are usually made with a mesh material. It is molded to fit the shape of your head and neck. Wet plaster bandages are used less frequently to make a mould, which is then used to make a clear plastic mask.

Radiotherapy masks come in two types:

  • This type of mask is made from a type of plastic mesh that becomes soft when heated in hot water (thermoplastic).
  • The Perspex® mask is made from a clear plastic called Perspex®.                                

Making a mesh plastic mask                       

Stage 1

Lie on a couch, similar to that used for treatment. Rest your head on the plastic headrest. Radiographers or technicians try to make you as comfortable as possible. The plastic mesh is heated and pressed onto your face, so it gently moulds to fit your head and neck perfectly.

It feels a bit like a hot towel. There is no harm in it, and it cools down very quickly. Plastic mesh has lots of holes, so you can breathe easily.

The first photo shows a man’s face being covered with plastic mesh. In the next photo, you can see how the mesh has been gently molded around his face and around the sides and top of his head.

Stage 2

The plastic mesh hardens and cools down while you lie still for up to 15 minutes.   

Stage 3

Remove the mask and put it on.

Below is a photo showing a mask being lifted off a man’s face.

Making a Perspex® mask                           

involves two steps. Initially, the technician or radiographer makes a plaster mould of your head and neck. Your treatment mask is then made from the clear plastic (Perspex®) mould.

They spread a cool cream or gel on your face before making the plaster mould. They also give you a swimming cap or another covering to protect your hair from the plaster mixture. Wet plaster of Paris bandages are then applied. Holes are left around your nose and mouth to allow you to breathe.

As it sets, the plaster of Paris gets warm. Normal and does not harm your skin, but it may feel uncomfortable. The mould takes about five minutes to set.

A Perspex® mask is then made from the mould.   

Radiotherapy masks and treatment 

can then be planned. The next appointment may be right after the mask is made, or you may need to come back for another appointment.

With treatment planning, the radiation is targeted precisely at the cancer. You may need to remove some clothing and wear a hospital gown. You should also remove your wig or head scarf if you usually wear them.

The radiotherapy team helps you get in the same position as when your mask was made. Your face is gently covered with the mask, and your head and neck are fixed to the treatment couch. The mask should be snug, but not uncomfortable. Tell the staff if it is uncomfortable so they can adjust it.

Wearing the mask may make you feel very nervous, or claustrophobic. You may want to bring some relaxing music or a relaxation podcast to listen to during your appointments. Usually, patients cope well with the support of the radiotherapy team. Tell them if you are worried or uncomfortable so they can help you. Before your treatment, your doctor may prescribe medication to help you relax. However, this is not always necessary.

The doctor or radiographer may mark the mask with ink during treatment planning. A permanent mark may also be made on your chest. In this procedure, a small scratch is made in the skin with a needle and some ink, similar to how a tattoo is made. Let your radiographer know if you are concerned about permanent marks. Other options may be available to you. It is easier to get you into the same position for treatment every time you come in.

A treatment planning appointment usually lasts 30 to 60 minutes. You are not required to wear the mask throughout the appointment.

When you receive radiotherapy treatment, you lie on a couch below a radiotherapy machine in exactly the same position. The mask is gently placed over your head and neck and attached to the couch. The procedure takes 10 to 30 minutes and is not painful. Again, the team can see, hear, and speak with you and is always available if you need them.

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