Chemotherapy for laryngeal cancer

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. It is sometimes used to treat laryngeal 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 laryngeal cancer. This is called chemoradiation. The 2 treatments are given during the same time period.

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

• with radiation therapy (chemoradiation) as the main treatment
• before chemoradiation or surgery, called induction chemotherapy, to treat advanced laryngeal cancer
• after surgery, along with radiation therapy, to reduce the risk of the cancer coming back (recurring)
• to relieve pain or control the symptoms of advanced laryngeal cancer (called palliative chemotherapy)

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 larynx.

Single drugs or a combination of 2 or more drugs may be given to treat laryngeal cancer.

Sometimes cetuximab, a targeted therapy drug, is combined with chemotherapy.

Chemotherapy drugs used to treat laryngeal cancer are:

• cisplatin
• carboplatin (Paraplatin, Paraplatin AQ)
• 5-fluorouracil (Adrucil, 5-FU)
• docetaxel (Taxotere)
• bleomycin (Blenoxane)
• ifosphamide (Ifex)
• methotrexate
• paclitaxel (Taxol)
• etoposide (Vepesid)
• capecitabine (Xeloda)

Common chemotherapy drug combinations used to treat laryngeal cancer are:

• cisplatin and 5-fluorouracil
• docetaxel, cisplatin and 5-fluorouracil

Common drugs used in chemoradiation are cisplatin, carboplatin, paclitaxel or docetaxel.

A common regimen for chemoradiation is to give cisplatin once a week for 3 weeks during radiation therapy. Cetuximab (Erbitux), a targeted therapy drug, may be given with radiation therapy for people who cannot cope with the side effects of chemoradiation.

Side effects can happen with any type of treatment for laryngeal 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, if radiation therapy is given at the same time (chemoradiation) and your overall health. Side effects of chemoradiation can be more severe than those of chemotherapy alone.

Some common side effects of chemotherapy drugs used for laryngeal 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.