Chemotherapy for mouth and oropharyngeal cancer

When you have it

You usually have chemotherapy with radiotherapy (chemoradiotherapy) for mouth and oropharyngeal cancer. Chemotherapy can help the radiotherapy to work better.

You might have chemoradiotherapy:

• as your main treatment for oropharyngeal cancer if surgery is not a suitable option

• after surgery for mouth cancer that has spread into surrounding tissues or into nearby lymph nodes

• after surgery for oropharyngeal cancer that has spread into surrounding tissues or outside lymph nodes

• for advanced oropharyngeal cancer

Read more about chemoradiotherapy for mouth and oropharyngeal cancer

You might have chemotherapy on its own if your cancer has come back. Or if your cancer has spread to other parts of the body (advanced cancer).

For mouth cancer that is advanced or has come back, you may have chemotherapy with the targeted drug cetuximab.

Find out more about treatment for mouth and oropharyngeal cancer

Types of chemotherapy

You may have one drug or a combination of drugs to treat mouth and oropharyngeal cancer. The most common types of chemotherapy drugs are:

• cisplatin 

• fluorouracil (5FU) 

• carboplatin

• docetaxel (Taxotere)

• methotrexate 

Check the name of the chemotherapy treatment with your doctor or nurse, then find out about it on our A to Z list of cancer drugs.

A to Z list of cancer drugs

How you have chemotherapy

You have most of the chemotherapy drugs for mouth and oropharyngeal cancer into your bloodstream (intravenously). You can have methotrexate in different ways.

You usually have chemotherapy every 3 to 4 weeks. Each treatment is called a ​cycle.​

Into your bloodstream

You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment. This means your doctor or nurse won't have to put in a cannula every time you have treatment.

Find out more about central lines

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.

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

Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.

Watch the video below about what happens when you have chemotherapy. It is almost 3 minutes long.

Before you start chemotherapy

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

Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test. 

DPD deficiency

Between 2 and 8 out of 100 people (2 to 8%) have low levels of an enzyme called dihydropyrimidine dehydrogenase (DPD) in their bodies. A lack of DPD can mean you’re more likely to have severe side effects from capecitabine or fluorouracil. It might take you a bit longer to recover from the chemotherapy. These side effects can rarely be life threatening.

Before starting treatment with capecitabine or fluorouracil you have a blood test to check levels of DPD. So you may start treatment with a lower amount (dose) of the drug or have a different treatment. Your doctor or nurse will talk to you about this.

Find out more about having a DPD deficiency

Side effects

The side effects you have may be different from the list below if you have chemotherapy with radiotherapy. 

Common chemotherapy side effects include:

• feeling sick

• loss of appetite

• losing weight

• feeling very tired

• increased risk of getting an infection

• bleeding and bruising easily

• diarrhoea or constipation

• hair loss

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 a few days or so. Your treatment team can help to manage any side effects that you have.

If you have cisplatin as part of your chemotherapy course you might have some hearing loss. Especially with high pitched sounds. Or you might also have some ringing in your ears (tinnitus). Let your doctor or specialist nurse know if this happens to you.

When you have chemoradiotherapy the side effects are the same as those for radiotherapy or chemotherapy alone. But they can be more severe.

Read about the side effects of chemoradiotherapy for mouth and oropharyngeal cancer

Dietary or herbal supplements and chemotherapy

Let your doctors know if you:

• take any supplements

• have been prescribed anything by alternative or complementary therapy practitioners

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.

Read about the safety of complementary and alternative therapies

When you go home

Chemotherapy for mouth and oropharyngeal cancer can be difficult to cope with. Tell your treatment team 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.