Chemotherapy is the use of anticancer drugs for Cancer Treatment. The medications are injected into a vein or taken by mouth. This enables drugs to enter the bloodstream and kill cancer that has spread across the body.

How is chemo used to treat oral cavity and oropharyngeal cancers?

Chemo may be used in several different situations:

Chemo, typically combined with Radiation therapy may be used as the primary treatment for certain cancers, instead of Surgery.

Chemo combined with Radiation therapy may be administered after Surgery to try to kill any small deposits of cancer cells left behind.

This is called adjuvant Chemotherapy.

Chemo, sometimes with Radiation therapy can be used before Surgery to try to shrink some of the larger cancers. This is called induction Chemotherapy or neoadjuvant. In some cases this would allow less radical Surgery to be used and less tissue to be removed. It can lead to less severe surgical side-effects.

Chemo, with or without radiation therapy, can be used to treat cancers that are too large or have spread too far to be removed by Surgery. The goal is to slow the growth of the cancer for as long as possible and to help relieve any symptoms the cancer is causing.

Which chemo drugs are used?

The chemo drugs used most often for cancers of the oral cavity and oropharynx are:

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

Other drugs that are used less often include

• Methotrexate
• Bleomycin
• Capecitabine

Possible side effects of chemotherapy

Chemo drugs target rapidly dividing cells and thus they function against cancer cells. But other cells within the body, such as those in the bone marrow, mouth and intestine lining, and hair follicles, divide rapidly and are also affected. That can result in side effects.

Chemo’s side effects depend on the type and dose of drugs given, and how long they are used. Its side effects can include:

• Hair loss
• Mouth sores
• Loss of appetite
• Nausea and vomiting
• Diarrhoea
• Low blood counts

Chemo can affect the blood-producing cells of the bone marrow, leading to low blood cell counts. This can lead to:

• Increased chance of infections (due to low white blood cell counts)
• Easy bruising or bleeding (due to low blood Platelet counts)
• Fatigue (due to low red blood cell counts)

Along with the above dangers, other side effects of other chemo drugs are more commonly seen. 5-FU for instance also causes Diarrhoea. This could need to be treated with such drugs as loperamide. Cisplatin, docetaxel, and paclitaxel can cause damage to the nerves (called neuropathy). That can lead to tingling and numbness in the hands and feet. This often improves once treatment is discontinued, but it can last a long time for some people. Cisplatin also can cause damage to the kidneys. The intravenous (IV) fluid is administered before and after each dose to help avoid this.

While most side effects improve over time after treatment is discontinued, some may last a long time or may even be permanent. When your doctor is considering chemotherapy, be sure to clarify the drugs that will be used and the potential side effects. If you note any changes, or have any side effects, inform your health care team once chemo is underway. Many of the side effects of chemo are prevented or treated in ways.