Chemotherapy for salivary gland cancer

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. Chemotherapy is rarely offered for salivary gland tumours because treatment with surgery and radiation therapy is usually effective. 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 used to treat metastatic salivary gland cancer. It may also be given for salivary gland cancer that has come back in the area where it started (local recurrence) if surgery or radiation can't be used again. Chemotherapy may also be offered to people who do not want to have surgery or radiation 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 salivary gland.

Because salivary gland cancer is so rare, research has not shown that one standard chemotherapy regimen is more effective than the others.

Salivary gland cancer is most often treated with a combination of drugs. The most common chemotherapy combinations used are:

• cyclophosphamide (Procytox), doxorubicin and cisplatin
• cisplatin, doxorubicin and fluorouracil
• cisplatin, epirubicin and fluorouracil
• vinorelbine and cisplatin
• gemcitabine and cisplatin

Single drugs may be offered because they may cause fewer side effects than chemotherapy combinations, while still having an effect on the cancer. The most common chemotherapy drugs used alone to treat salivary gland cancer are:

• cisplatin
• vinorelbine
• paclitaxel
• mitoxantrone
• epirubicin
• fluorouracil
• docetaxel (Taxotere)

Side effects can happen with any type of treatment for salivary gland 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 and your overall health. Some common side effects of chemotherapy drugs used for salivary gland cancer are:

• low blood cell counts
• diarrhea
• sore mouth
• nausea and vomiting
• fatigue
• nervous system problems
• hair loss

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.