Cancer drugs for head and neck cancer

The main type of cancer drug for head and neck cancer is chemotherapy. Immunotherapy or targeted therapy drugs may also be used. These work differently to chemotherapy and have different side effects.

You may be offered some cancer drugs as part of a clinical trial.

Cancer drugs are sometimes called systemic anti-cancer drugs or SACT as they treat cancer throughout the body.

Cancer drugs are often given as several sessions of treatment, with rest periods in between. This makes up one cycle of treatment. Your cancer team will explain the number of cycles you need for your course of treatment.

Most cancer drugs for head and neck cancer are given as a drip into a vein (intravenously). Immunotherapy drugs may be given as an injection under the skin (subcutaneous).

You usually have your treatment at a day unit or clinic as an outpatient. For some treatments, you might need to stay in hospital. If you are having a cancer drug as a tablet or capsule, you take these at home.

If you are having your treatment by drip (infusion), you will have this through one of the following:

• a cannula – a short, thin tube the nurse puts into a vein in your arm or hand
• a central line – a fine tube that goes under the skin of your chest and into a vein close by
• a PICC line – a fine tube that is put into a vein in your arm and goes up into a vein in your chest
• an implantable port (portacath) – a disc that is put under the skin on your chest or arm and goes into a vein in your chest.

A central line, PICC line or port stays in place during the course of your treatment. It can be used to give you treatment but also for blood samples.

Immunotherapy drugs use the immune system to find and attack cancer cells.

Checkpoint inhibitors are a type of immunotherapy drug. They help the immune system to find and attack the cancer cells. The drugs pembrolizumab (Keytruda^®) and nivolumab (Opdivo^®) are used to treat head and neck cancer.

For pembrolizumab, tests are done on the cancer cells first, to see if the drug is likely to be helpful for you.

You might have pembrolizumab before surgery and then after surgery to reduce the risk of the cancer coming back.  You have it for up to a year. 

Immunotherapy drugs may be used on their own if the cancer is advanced.

These drugs are given as an injection under the skin or as a drip (infusion) into a vein.

These drugs may cause a reaction when they are first given. Your nurse will monitor you for signs of this.

Common side effects of nivolumab and pembrolizumab include:

• feeling tired
• skin changes
• diarrhoea
• feeling short of breath
• hormone problems.

Side effects of checkpoint inhibitor drugs may be mild. But they can sometimes become serious very quickly if they are not treated. Side effects can start weeks, months, or sometimes more than a year after you finish treatment.

Your cancer doctor, specialist nurse or pharmacist will give you information about managing side effects. It is important to tell them about any side effects you have, even after you have stopped having treatment.

They will also give you a card with information about your treatment on it. It is important to always have the card with you during treatment and after treatment finishes. You should show it to any doctor or healthcare professional involved in your care.