Chemotherapy for laryngeal cancer

When chemotherapy may be used Back to top

Chemotherapy can be used in several ways to treat laryngeal cancer:

• It can be given before radiotherapy for larger laryngeal tumours. By shrinking the tumour, it can make the radiotherapy treatment more effective. Or, if there’s a possibility that there are cancer cells somewhere else in the body, giving chemotherapy sooner rather than later may increase the chance of controlling them. This is sometimes called neoadjuvant chemotherapy.
• Chemotherapy and radiotherapy can be given at the same time. This is called chemoradiotherapy or chemoradiation. Certain chemotherapy drugs, such as cisplatin, may improve the effectiveness of radiotherapy. However, giving the two treatments at the same time also increases the side effects.
• Chemotherapy may also be used if the cancer has spread to other parts of the body. It aims to shrink the tumour, improving symptoms and extending a good quality of life. In some people, chemotherapy will achieve this. Unfortunately for others, chemotherapy will not shrink the cancer, and they’ll have the side effects of the treatment with little benefit.

The chemotherapy drugs most commonly used to treat laryngeal cancer are:

• cisplatin
• fluorouracil (also known as 5FU)
• docetaxel (Taxotere®).

Other drugs that may be used include:

• carboplatin
• paclitaxel (Taxol®).

How chemotherapy is given Back to top

People will often have their chemotherapy drugs given by injection into a vein (intravenously). The drugs may be given through a vein in the back of your hand (cannula), through a plastic line in your chest (central line|) or through a thin tube inserted into a vein in the crook of your arm (PICC line|). Sometimes chemotherapy is given as tablets.

While having chemotherapy, you may need to stay in hospital for a few days or you may be treated as a day patient. The treatment is generally repeated every three weeks. 

Side effects Back to top

Chemotherapy drugs may cause unpleasant side effects, but these can usually be controlled well with medicines. Not all drugs cause the same side effects, and some people may have very few side effects. Your doctor will tell you about any problems that your treatment may cause.

Lowered resistance to infection (neutropenia)

While the drugs are acting on the cancer cells in your body, they also temporarily reduce the number of normal white cells in your blood. When these cells are reduced, you’re more likely to get an infection| and you may tire easily|. Your blood will be tested regularly during chemotherapy, and if necessary, you’ll be given antibiotics to treat any infection.

If your temperature rises above 38°C (100.4°F) or if you suddenly feel unwell, even with a normal temperature, you may have an infection. Contact your chemotherapy nurse or doctor at the hospital straight away.

Anaemia (low level of red blood cells)

While having chemotherapy you may become anaemic. This can make you feel very tired and lethargic. You may also become breathless|. Anaemia can be treated with blood transfusions|.

Bruising and bleeding

Chemotherapy can also reduce the production of platelets, which help the blood to clot. Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin.

Feeling sick (nausea) or being sick (vomiting)

Some of the drugs used to treat laryngeal cancer can make you feel sick (nauseous) or be sick (vomit)|, but there are very effective anti-sickness (anti-emetic) drugs to prevent this. If the sickness is not controlled or continues, even with anti-sickness treatment, let your doctor know. They can prescribe other medicines that may be more effective.

Tiredness

Chemotherapy affects people in different ways. Some people find they are able to lead a fairly normal life during treatment, but many find they have to take things much more slowly. Tiredness| can build up over a course of treatment, and can last for several months or more after your treatment has finished.

Planning ahead can help to cope with tiredness. Keeping a treatment diary can help you record your energy levels and plan activities for when you are feeling stronger. There may be times when you feel less tired. Light exercise like walking can help with the symptoms of fatigue.

Sore mouth and loss of appetite

Some chemotherapy drugs can make your mouth| sore and cause small ulcers. It’s important to rinse your mouth regularly to keep it clean. Using a child’s soft toothbrush can help. Your doctor or nurse will check your mouth regularly for any sign of infection. Let them know if your mouth becomes sore, as they can prescribe painkillers to help.

Hair loss

Unfortunately, some chemotherapy drugs can cause hair loss|. If you lose your hair it will usually start to grow back within 3-6 months of finishing your treatment. People who lose their hair often cover up by wearing wigs, bandanas, hats or scarves. If you’re being treated as an inpatient, or are on income support, you can get a free wig from the NHS. If not, you can still get a wig at a lower cost from the hospital. If you experience hair loss, it’s important to protect your scalp from the sun.

Numbness or tingling in the hands or feet

This is due to the effect cisplatin| has on the nerves, and is known as peripheral neuropathy|. Tell your doctor if you notice these symptoms. This problem usually improves slowly over a few months after the treatment is over.

Diarrhoea

Some of the chemotherapy drugs used to treat laryngeal cancer can cause diarrhoea|. This often starts several days after treatment. It’s important to let your doctor or nurse know if you have diarrhoea, as your treatment may need to be interrupted. Medicine can be prescribed to help. It is important to drink plenty of fluids if you have diarrhoea.

Sore hands and feet

5FU| may cause soreness of the palms of the hands or soles of the feet. This is known as palmar plantar syndrome. A vitamin can be prescribed to help control it, and unperfumed moisturising creams can often help to relieve symptoms.

Our chemotherapy| section iscusses this treatment and its side effects in more detail.