Chemotherapy for nasopharyngeal cancer

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. It is usually used to treat nasopharyngeal cancer. Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of chemotherapy. You may also receive other treatments.

Chemotherapy is often combined with radiation therapy to treat nasopharyngeal cancer. This is called chemoradiation. The 2 treatments are given during the same time period. Each treatment makes the other more effective.

Chemotherapy is given for different reasons. You may have chemotherapy or chemoradiation:

• as the first treatment before radiation therapy
• to destroy cancer cells left behind after radiation therapy and reduce the risk that the cancer will come back (recur) (called adjuvant chemotherapy)
• to destroy cancer cells left behind after surgery
• to treat nasopharyngeal cancer that has spread (metastasized) to other parts of the body

Chemotherapy is usually a systemic therapy. This means that the drugs travel through the bloodstream to reach and destroy cancer cells all over the body, including those that may have broken away from the primary tumour in the nasopharynx.

The most common chemotherapy drugs used alone to treat nasopharyngeal cancer are:

• cisplatin, as part of chemoradiation
• fluorouracil (also called 5-fluorouracil or 5-FU)

The most common chemotherapy drug combination used to treat nasopharyngeal cancer is cisplatin and fluorouracil.

If nasopharyngeal cancer does not respond to drugs used in earlier treatments or if it comes back, the following drugs may be used alone or in combination:

• methotrexate
• epirubicin
• doxorubicin
• paclitaxel
• capecitabine (Xeloda)
• bleomycin
• gemcitabine
• docetaxel
• carboplatin

Other chemotherapy combinations used to treat nasopharyngeal cancer include:

• cisplatin with either docetaxel, paclitaxel, gemcitabine or capecitabine
• carboplatin with either docetaxel or paclitaxel

Side effects can happen with any type of treatment for nasopharyngeal cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

Chemotherapy may cause side effects because it can damage healthy cells as it kills cancer cells. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after chemotherapy. Sometimes late side effects develop months or years after chemotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of chemotherapy will depend mainly on the type of drug, the dose, how it’s given, whether radiation therapy is given at the same time (chemoradiation) and your overall health. Side effects of chemoradiation can be more severe than side effects of chemotherapy alone.

Some common side effects of chemotherapy drugs used for nasopharyngeal cancer are:

• nausea and vomiting
• sore mouth and throat
• loss of appetite
• diarrhea
• low blood cell counts
• hair loss
• fatigue
• peripheral nerve damage (peripheral neuropathy)

Tell your healthcare team if you have these side effects or others you think might be from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.

Find out more about chemotherapy and side effects of chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.