Chemotherapy (chemo) uses anti-cancer drugs that are injected into a vein or given by mouth. These drugs enter the bloodstream and reach all areas of the body, making this treatment useful for cancers that have spread.

Chemo may be used in these ways for laryngeal and hypopharyngeal cancers:

Along with radiation as the main treatment for more advanced cancers of the larynx. This treatment, called chemoradiation, can allow some patients to avoid laryngectomy and be able to speak. Chemoradiation is a common treatment for laryngeal and hypopharyngeal cancers. As part of chemoradiation following Surgery to remove the cancer. The goal is to try to kill any small areas of cancer that might remain to lower the risk of the cancer returning. This is called adjuvant treatment.

In order to help shrink a large tumour before Chemotherapy or surgery, it may be easier to treat or relieve issues. It could be called induction Chemotherapy or neoadjuvant treatment. It is also thought that tumour response to chemo induction may help in making plans for the next therapy. If there is a good response (the tumour shrinks), it may be best to get chemoradiation and preserve the organ. If tumour response is low, Surgery may be required.

To help alleviate symptoms of cancers that are too large or that have spread too far to be completely removed by Surgery. It is called palliative or compassionate treatment.

Chemo drugs

Chemo drugs function by targeting rapidly dividing cells, which includes cancer cells. Many of the widely used chemo-drugs for larynx and hypopharynx cancers include:

• Cisplatin
• Carboplatin
• 5-fluorouracil
• Docetaxel
• Paclitaxel
• Epirubicin

Treatment can require the combination of a single drug, or 2 or more. Cisplatin and 5-FU are a common combination but other combinations are also used. Doctors administer chemo in cycles, with each treatment phase followed by a recovery period to allow the body time to heal. Each cycle normally lasts for a few weeks.

Chemoradiation

Chemoradiation (also known as chemoradiotherapy) is Chemotherapy that is given simultaneously with radiation. This has been shown to shrink laryngeal and hypopharyngeal tumours more than either treatment alone. Some call this organ preservation treatment because instead of surgery, chemoradiation can be used so that the structures in and near the larynx are not altered.

Chemoradiation can be used in different situations:

As the primary treatment for certain laryngeal and hypopharyngeal cancers. If the tumour goes away with chemoradiation completely, then no further treatment may be required. However, if there is still any cancer, Surgery might be needed.

As the primary treatment for people who are too sick for Surgery or who do not want Surgery.

Trying to reduce the risk of cancer returning after Surgery. This may be necessary if cancer is found at the edges (margins) of the removed tumour, or if the cancer has other properties that make it more likely to return after Surgery. Where cancer has spread to lymph nodes.

A common practice is to give a dose of cisplatin every 3 weeks (for a total of 3 doses) during radiation. For people who cannot tolerate chemoradiation, the targeted drug cetuximab is often used with radiation instead.

Chemo side effects

Chemo drugs destroy rapidly dividing cells and they function against cancer cells. However, other cells, such as those in the bone marrow (where new blood cells are made), mouth and intestine lining, and hair follicles, are dividing rapidly, too. Chemo can affect these cells as well. That results in side effects. Side effects depend on the drugs used specifically, their dose and the length of treatment. If chemo is delivered along with radiation, side effects begin to get worse.

Common Chemo side effects include:

• Nausea and vomiting
• Loss of appetite
• Mouth sores
• Diarrhea
• Hair loss
• An increased chance of infection (from a shortage of white blood cells)
• Problems with bleeding or bruising (from a shortage of blood platelets)
• Fatigue or shortness of breath (from low red blood cell counts)

Some chemo drugs can cause other side effects, in addition to the above risks. Cisplatin, docetaxel, and paclitaxel, for example, can cause nerve damage (called neuropathy), which can result in numbness, tingling, or even Pain in the hands and feet. Cisplatin-induced nerve damage can also cause hearing loss. This often improves once treatment has been stopped, but in some people it can last a long time.

Even though most side effects improve after treatment is ended, some can linger for a long time or even forever. If your doctor is planning chemo treatment, be sure to discuss the medications that will be used and the possible side effects. When you have side effects, let the health care team know once chemo is underway, so they can be treated. There are ways to avoid or treat many of the chemo’s side effects. For instance, approaching complementary and alternative medicine can effectively manage side Chemotherapy related side effects.