Head and Neck Cancer: Chemotherapy
What is chemotherapy?
Chemotherapy uses anticancer medicines to kill cancer cells. The medicines are made to attack and kill cancer cells that grow quickly. Some normal cells also grow quickly. Because of this, chemotherapy can also harm those cells. This can cause side effects.
When might chemotherapy be used for head and neck cancer?
Chemotherapy might be used for head and neck cancer:
Alone or with radiation therapy before surgery, to shrink the tumor and make it easier to remove
Along with radiation therapy after surgery, to kill any cancer cells that may have been left behind
Alone or with radiation therapy for tumors that are too big or too widespread to remove with surgery
How is chemotherapy given for head and neck cancer?
Chemotherapy medicine is most often given through an IV. It may also be taken by mouth as a pill, or as an injection. The treatment may be done as an outpatient visit to a hospital. This means you go home the same day. Or it may be done at your healthcare provider’s office, a chemotherapy clinic, or at home. In some cases, you may stay in the hospital during treatment.
You get chemotherapy in cycles over a period of time. That means you may take the medicine for a set amount of time and then you have a rest period. Each period of treatment and rest is 1 cycle. You may have several cycles. Having treatment in cycles helps by:
Killing more cancer cells. The medicine can kill more cancer cells over time, because cells aren't all dividing at the same time. Cycles allow the medicine to fight more cells.
Giving your body a rest. Treatment is hard on other cells of the body that divide quickly. This includes cells in the lining of the mouth and stomach. This causes side effects, such as sores and upset stomach. Between cycles, your body can get a rest from the chemotherapy.
Giving your mind a rest. Having chemotherapy can be stressful. Taking breaks between cycles can let you get an emotional break between treatments.
Chemotherapy medicines may be used alone. But more often, several medicines are used together. The medicines used will depend on things such as:
The exact type of cancer you have
Where your cancer is located
How big the tumor is
Your overall health
If radiation therapy will be used at the same time
What common medicines are used to treat head and neck cancer?
The chemotherapy medicines used will depend partly on the exact type of head and neck cancer. Some of the most common medicines are:
What are common side effects of chemotherapy?
Chemotherapy affects normal cells as well as cancer cells. The possible side effects depend on what kind of medicine you take and the dose.
These are common side effects of chemotherapy:
Upset stomach and vomiting
Short-term hair loss
Extreme tiredness, or fatigue
Other common side effects are a decrease in blood counts, such as:
A decrease in white blood cells. This is an important risk factor for infection. If you have a fever during chemotherapy, tell your doctor or nurse right away.
A decrease in platelets. This puts you at risk for bleeding. Tell your doctor or nurse about any bleeding or easy bruising you have during chemotherapy.
A decrease in red blood cells. This causes fatigue, weakness, and lack of energy. These symptoms can be treated. Tell your doctor or nurse about them.
Working with your healthcare provider
It's important to know which medicines you're taking. Write your medicines down, and ask your healthcare team how they work and what side effects they might have.
Talk with your healthcare providers about what signs to look for and when to call them. For example, chemotherapy can make you more likely to get infections. Make sure you know what number to call with questions. Is there a different number for evenings and weekends?
It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.
June 21, 2018
NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers Ver 2.2017 -- May 8, 2017, National Comprehensive Cancer Network
LoCicero, Richard, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS