Chemotherapy for oropharyngeal cancer
Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. It is usually used to treat oropharyngeal 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 oropharyngeal cancer. This is called chemoradiation. The 2 treatments are given during the same time period. The chemotherapy makes the radiation more effective.
Chemotherapy is given for different reasons. You may have chemotherapy or chemoradiation:
- as the main treatment for some cancers
- to shrink a tumour before other treatments such as surgery (called neoadjuvant chemotherapy)
- to destroy cancer cells left behind after surgery to reduce the risk that the cancer will come back (recur) (called adjuvant chemotherapy)
- if the cancer is too large or has spread too far to remove
- to relieve pain or control the symptoms of advanced oropharyngeal cancer (called palliative chemotherapy)
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 oropharynx.
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Single drugs or a combination of 2 or more drugs may be given to treat oropharyngeal cancer.
The most common chemotherapy drugs used to treat oropharyngeal cancer are:
- carboplatin (Paraplatin, Paraplatin AQ)
- 5-fluorouracil (Adrucil, 5-FU)
- paclitaxel (Taxol)
- docetaxel (Taxotere)
- bleomycin (Blenoxane)
- ifosfamide (Ifex)
Sometimes the targeted therapy drug cetuximab (Erbitux) is combined with chemotherapy to treat oropharyngeal cancer.
The most common chemotherapy drug combination used to treat oropharyngeal cancer is cisplatin and 5-fluorouracil. Docetaxel is sometimes added to this combination.
Cisplatin is usually the chemotherapy drug given with radiation therapy as part of chemoradiation.
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Side effects can happen with any type of treatment for oropharyngeal 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, whether radiation therapy is given at the same time (chemoradiation) and your overall health. Side effects of chemoradiation can be more severe than side effects of chemotherapy alone.
Some common side effects of chemotherapy drugs used for oropharyngeal cancer are:
- nausea and vomiting
- sore mouth and throat
- loss of appetite
- low blood cell counts
- hair loss
- peripheral nerve damage (peripheral neuropathy)
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.
American Cancer Society. Oral Cavity and Oropharyngeal Cancer. 2014: https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer.html.
American Society of Clinical Oncology. Oral and Oropharyngeal cancer. 2016: http://www.cancer.net/cancer-types/oral-and-oropharyngeal-cancer/view-all.
National Cancer Institute. Oropharyngeal Cancer Treatment (PDQ®) Health Professional Version. 2017: https://www.cancer.gov/types/head-and-neck/hp/oropharyngeal-treatment-pdq#section/all.