Chemotherapy for Laryngeal and Hypopharyngeal Cancer

Chemotherapy (chemo) is the use of anti-cancer drugs to treat cancer. It can be given as treatment for laryngeal and hypopharyngeal cancers, either by itself or along with radiation therapy (chemoradiation).

How is chemo given?

Chemo drugs for laryngeal and hypopharyngeal cancer are most often given into a vein (IV) or by mouth. This allows them to enter the bloodstream and reach most parts of the body. It can be done in a doctor’s office, infusion center, or hospital setting. Chemotherapy is given in cycles: one drug or a combination of drugs given on a set schedule, followed by a rest period. This period of chemo and rest is considered one cycle. The chemo schedule repeats to start the next cycle.

The exact schedule depends on the drugs used, but a common chemo cycle could be once a week, once every 3 weeks, or once every 4 weeks.

Common chemo drugs used to treat these cancers

The following chemo drugs are used most often for cancers of the larynx and hypopharynx. These drugs can be given with or without radiation.

• Cisplatin (Platinol)
• Carboplatin (Paraplatin)
• 5-fluorouracil, 5-FU (Adrucil)
• Paclitaxel (Taxol)
• Docetaxel (Taxotere)

Other drugs that are used less often include:

• Methotrexate
• Capecitabine (Xeloda)

A chemo drug may be used alone or combined with other drugs. Combining drugs often shrinks tumors better but tends to cause more side effects. In certain cases, chemo might be given along with a targeted drug or immunotherapy.

Possible side effects of chemotherapy

Chemo drugs attack cells that divide quickly, which is why they work against cancer cells. But other cells in the body also divide quickly, including cells in the bone marrow, the lining of the mouth and intestines, and the hair follicles. This can lead to certain side effects.

These side effects vary depending on the type of chemo drugs, the dose, and the length of time they are given.

Common side effects

Common short-term side effects of chemo can include:

• Hair loss
• Mouth sores
• Loss of appetite or weight loss
• Nausea and vomiting
• Diarrhea
• Fever
• Rash
• Nail changes
• Skin changes

Chemo can also affect the blood-producing cells of the bone marrow, which can lead to:

• Increased chance of infections, from low white blood cell counts
• Easy bruising or bleeding, from low blood platelet counts
• Fatigue, from low red blood cell counts

Side effects of specific chemo drugs

Along with the risks above, some side effects are seen more often with certain chemo drugs. For example:

• 5-FU often causes diarrhea. This might need to be treated with drugs like loperamide.
• Cisplatin, docetaxel, and paclitaxel can cause nerve damage called neuropathy. This can lead to numbness and tingling in the hands and feet. It often improves once treatment stops, but for some people it lasts a long time.
• Cisplatin can also cause kidney damage. To help prevent this, fluid is often given through a vein (IV) before and after each dose.

Managing side effects

Chemo side effects usually go away over time after treatment ends. There are also ways to prevent or treat many of these side effects. Tell your cancer care team if you have side effects from chemo, so they can help you manage them. For example, many drugs are available to help prevent or treat nausea and vomiting.

In some cases, the doses of chemo drugs may be reduced, or treatment may be delayed or stopped to keep side effects from getting worse.