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About chemotherapy

When, where and how you have chemotherapy for mouth and oropharyngeal cancer.

What it is

Chemotherapy means treatment using anti cancer (cytotoxic) drugs. These drugs disrupt the growth of cancer cells and destroy them. The chemotherapy drugs circulate throughout the body in the bloodstream, 

When you have it

Advanced mouth cancer

You can have chemotherapy for advanced cancer, or if cancer has come back after surgery and radiotherapy. It can help relieve symptoms and may shrink the cancer or slow it's growth. 

With radiotherapy

Chemotherapy with radiotherapy is called chemoradiotherapy. The chemotherapy helps the radiotherapy work better. You might have this if your cancer that has spread into surrounding areas or lymph nodes. Or rarely, you might have it instead of surgery for small mouth cancers. 

Before surgery or radiotherapy

Rarely, your doctor may suggest chemotherapy before surgery to shrink your cancer. This is called neoadjuvant chemotherapy. Researchers are still looking to see how well neoadjuvant chemotherapy works for mouth cancer. 

Types of chemotherapy

The most common chemotherapy drugs for mouth and oropharyngeal cancer are:

  • cisplatin 
  • fluorouracil (5FU) 
  • carboplatin
  • bleomycin
  • methotrexate 
  • docetaxel (Taxotere)

Clinical trials are looking into different chemotherapy drug combinations, using these drugs:

  • docetaxel (Taxotere)
  • paclitaxel (Taxol) 
  • gemcitabine (Gemzar) 

How you have chemotherapy

You usually have chemotherapy every 3 weeks. Each 3 week period is called a cycle. You may have between 2 and 6 cycles of chemotherapy.

Chemotherapy into your bloodstream

Your nurse puts a small tube into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You’ll sit in a chair for a few hours so it’s a good idea to take newspapers, books or electronic devices to help to pass the time.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

The pharmacists make chemotherapy for each person individually. They do this once your blood test results have come through and it’s worked out based on your weight, height and general health.

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • a lower resistance to infections
  • bleeding and bruising easily
Contact the doctor or nurse immediately if you have any signs of infection such as a temperature higher than 38C or generally feeling unwell. Infections can make you very unwell very quickly.

Side effects depend on:

  • which drugs you have
  • how much of each drug you have
  • how you react

Tell your treatment team about any side effects that you have.

Most side effects only last for the few days that you’re having the chemotherapy drugs. The team caring for you can help to reduce your side effects.

When you go home

Chemotherapy for mouth and oropharyngeal cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.

Diet supplements and alternative therapies

It is very important to tell your doctor if you are taking diet  or herbal supplements or having alternative therapies. 

Some studies seem to suggest that fish oil preparations may reduce the effectiveness of chemotherapy drugs. If you are taking, or thinking of taking, these supplements talk to your doctor to find out whether they could affect your treatment.

Last reviewed: 
14 Oct 2014
  • Cancer and its management (7th edition)
    Tobias J and Hochhauser D 
    Blackwell, 2015

  • Head and Neck Cancer: Multidisciplinary Management Guidelines
    British Association of Otorhinolaryngology, 2011

  • Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy
    Furness S and others, 2011

    Cochrane Database Systematic Review, Volume 4

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