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Chemotherapy treatment for nasopharyngeal cancer

Chemotherapy means treatment using anti cancer or cytotoxic drugs. These drugs disrupt the growth of cancer cells and destroy them. The drugs circulate in the bloodstream around the body.

How do you have chemotherapy?

You might have:

  • chemotherapy together with radiotherapy (chemoradiotherapy)
  • chemotherapy on its own

You might have chemotherapy before radiotherapy. This aims to shrink the tumour and make it easier to treat with radiotherapy.

You might have 2 or more chemotherapy drugs together. Using a combination of drugs can work better than using one drug, but there are more side effects.

Chemotherapy with radiotherapy (chemoradiotherapy)

If your nasopharyngeal cancer has grown into the lymph nodes or tissues around your nasopharynx, you may have chemotherapy and radiotherapy at the same time. You might hear your doctor call this chemoradiotherapy.

Some chemotherapy drugs make cancer cells more sensitive to radiotherapy, so doctors use them together. Chemoradiotherapy is quite a tough treatment to get through. You will have some tests to see if you’re fit enough to cope with the side effects. If chemoradiotherapy is not suitable for you, you have radiotherapy alone to treat your cancer.

Chemotherapy on its own

There is some research to suggest that people with stage 3 and stage 4 nasopharyngeal cancer may be helped by extra chemotherapy as well as chemoradiotherapy. This can help to control the disease and reduce the risk of the cancer coming back. You may have the extra chemotherapy before or after your chemoradiotherapy. Doctors call it adjuvant chemotherapy if you have it after radiotherapy, or neo adjuvant if you have it before.

Having chemotherapy over a longer period of time does cause added side effects and may only be suitable for some patients. There are still some questions to be answered about this extra chemotherapy, such as the best drugs to use, the precise dose and the timing of treatments. We also need to know more about how useful extra chemotherapy is in improving long term survival.

If the cancer has spread to another part of your body or has come back after treatment, you may have chemotherapy alone. This may shrink the cancer and help to control any symptoms the cancer is causing.

Chemotherapy drugs

Cisplatin and fluorouracil (5FU) are the most common chemotherapy drugs used for nasopharyngeal cancer.

How do you have chemotherapy?

You have the treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula) 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 do 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 newspapers, books or electronic devices to 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.

Before you start chemotherapy

COVID swab test

Due to coronavirus, you need to have a test to check for coronavirus before you have treatment. The test is called a COVID swab test.

To have the test your nurse takes a sample from the inside of your nose and the back of your throat. They use a long cotton bud to take the sample. Or the sample might be saliva or other fluid. Depending on which test your hospital uses, it can take from 90 minutes to a few days to get a result.

At most hospitals, you have a COVID swab test 48 to 72 hours (up to 3 days) before going for your treatment in the chemotherapy unit.

This means you might have the swab test on the same day that you visit the hospital for blood tests and your doctor’s clinic appointment. If you have treatment weekly or more often, some hospitals will ask you to have the swab test on the day of treatment.

Check with your team about when you’ll have the test as there are some differences between hospitals.

Blood tests

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.

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
  • diarrhoea or constipation
  • hair loss
Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C, 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 a few days or so. Your treatment team can help to manage any side effects that you have.

You can read about side effects in detail on the pages about each chemotherapy drug.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you take any supplements or if you have been prescribed anything by alternative or complementary therapy practitioners.

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

When you go home

Chemotherapy 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.

Last reviewed: 
18 Feb 2021
Next review due: 
18 Feb 2024
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    J Tobias and D Hochhauser
    Blackwell, 2015

  • Nasopharyngeal carcinoma: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up

    P Bossi and others

    Annals of Oncology, 2020