Chemotherapy for pharyngeal cancer

Chemotherapy uses drugs to destroy cancer cells. These drugs target rapidly dividing cells throughout the whole body. This means that chemotherapy kills cancer cells, but it can also damage healthy cells.

With most types of chemotherapy, the drugs travel through the blood to reach and destroy cancer cells all over the body, including cells that may have broken away from the primary tumour. This is described as systemic therapy.

Most people with pharyngeal cancer have chemotherapy. If you have chemotherapy, your healthcare team will use what they know about the cancer and about your health to plan the drugs, doses and schedules.

Chemotherapy and radiation therapy are most often given during the same time period to treat pharyngeal cancer. This is called chemoradiation. Some chemotherapy drugs can help make radiation work better by making cancer cells more sensitive to radiation. Combining chemotherapy and radiation therapy can be more effective than either treatment on its own.

Chemotherapy is given for different reasons. You may have chemotherapy or chemoradiation:

• as the main treatment for some pharyngeal 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 (called adjuvant chemotherapy)
• if the cancer is too large or has spread too far to be removed with surgery
• to relieve pain or control the symptoms of advanced pharyngeal cancer (called palliative chemotherapy)

A single drug or a combination of 2 or more drugs may be given to treat pharyngeal cancer.

The chemotherapy drugs used to treat pharyngeal cancer are:

• cisplatin
• carboplatin
• fluorouracil (also called 5-fluorouracil or 5-FU)
• gemcitabine
• capecitabine
• methotrexate
• paclitaxel
• docetaxel
• bleomycin
• ifosfamide
• doxorubicin
• irinotecan
• vinorelbine

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

• cisplatin and fluorouracil
• cisplatin, fluorouracil and docetaxel
• cisplatin and gemcitabine
• cisplatin and docetaxel or paclitaxel
• cisplatin, paclitaxel and fluorouracil

The most common drugs used for chemoradiation are:

• high-dose cisplatin
• cisplatin and fluorouracil
• cisplatin and gemcitabine
• carboplatin and paclitaxel
• carboplatin
• docetaxel

Sometimes targeted therapy or immunotherapy drugs are combined with chemotherapy to treat pharyngeal cancer.

Side effects of chemotherapy will depend mainly on the drug, the dose, how it’s given and your overall health. Tell your healthcare team if you have side effects that you think are from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

The side effects that occur when chemotherapy is combined with radiation therapy (chemoradiation) can be more severe than the side effects of chemotherapy alone.

Some common side effects of chemotherapy drugs and chemoradiation used for pharyngeal cancer are:

• nausea and vomiting
• sore mouth and throat
• loss of appetite
• diarrhea
• low blood cell counts
• hair loss
• fatigue
• nerve damage (peripheral neuropathy)

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

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