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Chemoradiotherapy

Chemoradiotherapy means having chemotherapy and radiotherapy treatment together.

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.

Radiotherapy uses high energy x-rays to treat cancer cells.

When do you have it?

You might have chemoradiotherapy if you have a locally advanced laryngeal cancer (stage T3 or T4).

Your doctor might suggest this treatment to try and cure your cancer instead of having surgery to remove your larynx. An advantage of chemoradiotherapy is that you might still be able to speak afterwards.

But you might need surgery if there are still signs of your cancer after chemoradiotherapy. Or if your cancer comes back later.

Chemoradiotherapy can be difficult to cope with. You will have tests to find if you are fit enough. If you aren't you might be able to have surgery to remove the cancer followed by radiotherapy.

Chemotherapy

You usually have treatment in the chemotherapy day unit or you might need to stay in hospital for a day or more.

When you have chemoradiotherapy, you might have any of these chemotherapy drugs:

  • cisplatin and fluorouracil (5FU) together
  • cisplatin
  • carboplatin
  • taxol or taxotere

You usually have these drugs as a drip into your vein (intravenously). 

Into your bloodstream

A nurse puts a small tube into one of your veins and connects it to the drip or you might need a central line. This is a long plastic tube that gives the drug into a large vein, either in your chest or in your arm. It stays in while you’re having treatment, which might be for a few weeks.

You might also have some of these treatments as part of a clinical trial.

Radiotherapy

Planning your treatment

Before you begin treatment, the radiotherapy team works out how much radiation you need. They divide it into a number of smaller treatments. They call each treatment a fraction.

The radiographers might make small marks on your skin in the treatment area and you usually have a mask made. 

Having treatment

It can take a few days or up to 3 weeks before you start treatment.

You lie under a large machine to have radiotherapy.

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

You will probably have some side effects from your treatment. These are the same kinds of side effects you would get from radiotherapy or chemotherapy alone. But when you have both treatments together some of the side effects can be more severe. It also depends on the type of chemotherapy you have.

The side effects gradually get worse during the treatment. They can continue to get worse after your treatment ends. But most of the effects begin to improve after 1 or 2 weeks.

Below are 2 of the possible side effects of chemoradiotherapy. 

Sore mouth and throat

Your mouth and throat might get sore. It may be painful to swallow drinks or food. You will have mouth washes to keep your mouth healthy.

You can have painkillers to reduce the soreness. Take them half an hour before meals to make eating easier.

Tell your doctor or nurse if your throat is sore.

You are likely to get a very sore mouth and throat. You might need strong painkillers such as morphine. 

Morphine is often used as the dose can be easily adjusted to your needs. 

Difficulty swallowing

During and after treatment, you might have a feeling of a lump in the throat when you swallow. This can make it difficult to swallow solid foods.

This problem is often at its worst about 10 days to 2 weeks after you finish treatment.

Ask to see a dietitian if you have problems with eating and drinking
Tips for eating and drinking
  • Drink about 3 litres of water a day while having treatment.
  • Eat soft foods.
  • Eat slowly and avoid eating late in the day.
  • Drink plenty during and after meals to soften your food.
  • Eat small amounts often rather than big meals.
  • Try different foods to find out which are easiest to swallow.
  • You can have high calorie drinks to boost your calorie intake if you need them.

You might need to have liquid food through a tube into your nose or stomach if you can’t eat enough. This is called tube feeding.

There is further information about side effects in the chemotherapy and radiotherapy sections. 

Smoking

If you smoke your doctor will advise you to stop. Smoking during treatment can make the side effects much worse. 

Last reviewed: 
23 Jul 2018
  • Squamous cell carcinoma of the head and neck: EHNS–ESMO–ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    V. Gregoire and others
    Annals of Oncology, 2010. Vol. 21. Issue 5

  • Improving outcomes in head and neck cancer - the manual 
    The National Institute for Health and Care Excellence (NICE), November 2004 

  • Diagnosis and management of head and neck cancer 
    The National Institute for Health and Care Excellence (NICE), November 2006 

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