Chemotherapy for nasal and paranasal sinus cancer

What is chemotherapy?

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

When might you have chemotherapy

Chemotherapy with radiotherapy (chemoradiotherapy)

You might have chemotherapy at the same time as radiotherapy for some types of nasal and paranasal sinus cancers. This is also called chemoradiotherapy.

Your doctor might suggest chemoradiotherapy if you are not fit enough to have surgery. Or you might have it because your cancer has spread to other parts of your body. You might also have it after surgery to reduce the risk of the cancer coming back.

Chemoradiotherapy can be a tough treatment to get through. The side effects are the same as for chemotherapy and radiotherapy on their own. But some are likely to be more severe. You will have some tests to make sure you are fit enough for it. If not, you might still be able to have radiotherapy on its own.

Read more about the side effects of radiotherapy

Chemotherapy to shrink a large cancer

Your doctor might suggest chemotherapy before surgery. This will be if your cancer hasn't spread to other organs, but is too big to be operated on.   It is not a commonly used treatment and is called neo adjuvant chemotherapy.

The aim is to shrink your cancer with chemotherapy before your surgery or before radiotherapy. This makes it easier to remove or means that you can have a smaller operation.

You might have this treatment to avoid needing to remove nearby organs, such as the eye. This type of treatment is still being tested in clinical trials.

Chemotherapy to control a cancer that has come back

You might have chemotherapy on its own if your cancer is advanced. Or you might have it if your cancer has come back after treatment with surgery or radiotherapy.

This can help to relieve your symptoms and may slow the growth of your cancer.

Types of chemotherapy

It is most common to have 2 or more chemotherapy drugs together. You might hear this called combination chemotherapy. Using 2 or more drugs together often works better than using one drug. The most common drugs are:

• cisplatin

• fluorouracil (5-FU)

Other chemotherapy drugs you might have include:

• carboplatin

• docetaxel (Taxotere)

• paclitaxel (Taxol)

• etoposide

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 usually have treatment into your bloodstream (intravenously).

You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

• central line

• PICC line

• portacath

If you don't have a central line you might have treatment through a thin short tube (a cannula). The cannula goes into a vein in your arm each time you have treatment.

Read more about central lines

What are treatment cycles?

You take some cancer medicines in treatment cycles. This means you take the drug for a set period, followed by a break. For example, you might take a drug every day for a week and then not take it for 2 weeks. This 3 week period in total is one cycle of treatment.

Take your cancer drugs exactly as your doctor, specialist nurse or pharmacist has told you to. The break from treatment is important too. For many cancer drugs, it allows your body to recover.

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.

Side effects of chemotherapy

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.

Read more about the side effects of cancer drugs

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 nasal and paranasal sinus 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.