Chemotherapy for Nasopharyngeal Cancer
Chemotherapy (chemo) is the use of anti-cancer drugs to treat cancer. These drugs are most often given into a vein (IV) or by mouth. They enter the bloodstream and reach throughout the body, making this treatment useful for cancers that have spread beyond the head and neck.
Chemo may be used in different situations to treat nasopharyngeal cancer (NPC):
- Chemo is often used together with radiation therapy as the first treatment for more advanced stages of NPC because some chemo drugs make cancer cells more sensitive to radiation. This treatment is called chemoradiation.
- Chemo may also be given after radiation (or chemoradiation). This is known as adjuvant treatment.
- Chemo is used for patients whose NPC has spread to distant organs such as the lungs, bones, or liver. It may be used either alone or along with radiation.
Doctors give chemo in cycles, with each period of treatment followed by a rest period to allow the body time to recover. Cycles generally last about 3 to 4 weeks. Chemo is often not recommended for patients in poor health, but advanced age by itself is not a barrier to getting chemo.
Cisplatin is the chemo drug used most often to treat NPC. It is used alone as part of chemoradiation, but may be combined with another drug, 5-fluorouracil (5-FU) if given after radiation.
Some other drugs may also be helpful in treating cancer that has spread. These include:
- Carboplatin (Paraplatin®)
- Doxorubicin (Adriamycin®)
- Epirubicin (Ellence®)
- Paclitaxel (Taxol®)
- Docetaxel (Taxotere®)
- Gemcitabine (Gemzar®)
Often, combinations of 2 or more of these drugs are used.
Possible side effects of chemotherapy
Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body such as those in the bone marrow, the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells are also likely to be affected by chemo, which can lead to certain side effects.
The side effects of chemo depend on the type and dose of drugs you are given and how long they are taken. Common side effects include:
- Hair loss
- Mouth sores
- Loss of appetite
- Nausea and vomiting
- 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)
These side effects are usually short-term and go away after treatment is finished. Once chemo is started, let your health care team know if you have side effects, so they can be treated. There are ways to prevent or treat many of the side effects of chemo. For example, many good drugs are available to help prevent or treat nausea and vomiting.
Some drugs can have other side effects. For example, cisplatin can damage nerves (called neuropathy). This can sometimes lead to hearing loss or symptoms in the hands and feet such as pain, burning or tingling sensations, sensitivity to cold or heat, or weakness. In most cases this improves once treatment is stopped, but it may last a long time in some people. For more information on nerve damage, see our document Peripheral Neuropathy Caused by Chemotherapy.
In some cases, the doses of the chemo drugs may need to be reduced or treatment may need to be delayed or stopped to prevent side effects from getting worse.
Last Medical Review: January 15, 2015 Last Revised: August 8, 2016