Chemotherapy for oral cancer

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. It is sometimes used to treat oral cancer. Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of chemotherapy. You may also receive other treatments.

Chemotherapy is often combined with radiation therapy to treat oral cancer. This is called chemoradiation. The 2 treatments are given during the same time period.

Chemotherapy is given for different reasons. It may be used along with radiation therapy to treat oral cancer after surgery or when surgery is not possible. It may be used, with or without radiation therapy, to relieve pain or control the symptoms of advanced oral cancer (called palliative therapy).

Chemotherapy is usually a systemic therapy. This means that the drugs travel through the bloodstream to reach and destroy cancer cells all over the body, including those that may have broken away from the primary tumour in the mouth.

Chemotherapy drugs used to treat oral cancer are:

• cisplatin
• 5-fluorouracil (Adrucil, 5-FU)
• methotrexate
• carboplatin (Paraplatin, Paraplatin AQ)
• paclitaxel (Taxol)
• docetaxel (Taxotere)
• ifosfamide (Ifex)
• bleomycin (Blenoxane)
• capecitabine (Xeloda)
• hydroxyurea (Hydrea)

The most common chemotherapy drug combinations used to treat oral cancer are:

• cisplatin and 5-fluorouracil
• cisplatin and paclitaxel
• carboplatin and 5-fluorouracil
• carboplatin and paclitaxel
• cisplatin and methotrexate

The most common chemotherapy drugs used in chemoradiation are:

• cisplatin
• carboplatin

Side effects can happen with any type of treatment for oral cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

Chemotherapy may cause side effects because it can damage healthy cells as it kills cancer cells. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after chemotherapy. Sometimes late side effects develop months or years after chemotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of chemotherapy will depend mainly on the type of drug, the dose, how it’s given and your overall health. Some common side effects of chemotherapy drugs used for oral cancer are:

• low blood cell counts (bone marrow suppression)
• weakened immune system
• increased chance of infection
• easy bruising and bleeding (low platelet count)
• constipation
• diarrhea
• fatigue
• nausea and vomiting
• loss of appetite
• sore mouth and throat
• hand-foot syndrome
• nervous system damage
• kidney problems
• bladder problems
• hair loss
• heart damage

Tell your healthcare team if you have these side effects or others you think might be from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.

Find out more about chemotherapy and side effects of chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.