Chemotherapy for nasal and paranasal sinus cancer
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.
You might have chemotherapy on its own or with radiotherapy for nasal and paranasal sinus cancer. You might also have chemotherapy for advanced nasal and paranasal sinus cancer. Common chemotherapy drugs for nasal and paranasal sinus cancer are cisplatin and fluorouracil (5-FU).
When you have it
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.
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.
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.
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.
Clare Disney (nurse): Hello, my name is Clare and this is a cancer day unit.
So when you arrive and you’ve reported into with the receptionist, one of the nurses will call you through when your treatment is ready, sit you down and go through all the treatment with you.
Morning, Iris. My name is Clare. I am the nurse who is going to be looking after you today. We’re going to start by putting a cannula in the back of your hand and giving you some anti sickness medication. And then I am going to come back to you and talk through the chemotherapy with you and the possible side effects you may experience throughout your treatment. Is that okay?
Before you have each treatment you’ll need to have a blood test to check your bloods are okay. And you’ll also be reviewed by one of the doctors to make sure you’re fit and well for your treatment. Sometimes you’ll have the blood test taken on the day of your treatment; other times you’ll have it the day before your treatment when you see the doctor.
Each chemotherapy is made up for each individual patient, depending on the type of cancer they have and where it is and depending their height, weight and blood results.
So, depending on where your cancer is some people have their chemotherapy drug, their cancer drug by drip, some will have an injection and other people will have tablets.
So, Iris, your chemotherapy is going to be given to you in what we call cycles and the cycles are given every three weeks for a period of six cycles. So, you will be coming in for approximately five months for your chemotherapy.
Depending on where your cancer is and what type of cancer you have will be dependent on how often you come in for treatment. An example of a treatment cycle would be for you to come in on Day 1, Day 8 and Day 15 then to have a week’s break before you come back again for Day 1 treatment.
Depending on the type of treatment that you are having we will also give you some anti sickness tablets to take alongside your chemotherapy and also some drugs to prevent any reactions if that’s appropriate.
All chemotherapy is given over different time periods so it’s best to check with your nurse about how long you are likely to be in the unit for. This can range from anything up to an hour to an all day treatment slot so please be prepared to bring along some bits to keep you occupied, such as books and music.
So, before you go home it’s important to make sure you have got the tablets you need to go home with your anti sickness medications and any other symptom control tablets that you may require. Also, to make sure that you’ve got the telephone numbers for the oncology unit to phone if you have a temperature or you are experiencing any other symptoms at home that you need to ask advice about.
So, please make sure when you leave the unit that you’ve got all the information you require and if you’ve got any questions at all don’t hesitate to ask the nurse who will be able to answer them for you.
Before your next cycle of treatment you will come in and see the doctor in the clinic room, you’ll have a blood test and an examination to make sure you are fit and well for treatment you will then come back the following day or later on that week for treatment.
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.
Side effects
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.
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.
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.
