Chemotherapy for Salivary Gland Cancer

When is chemotherapy given to treat salivary gland cancer?

For people with salivary gland cancers, chemo is most often used:

• When the cancer has spread (metastasized) to distant organs
• If the cancer could not be controlled by surgery and radiation therapy
• Combined with radiation therapy, called chemoradiation

Chemo sometimes shrinks the tumors, but it’s not likely to cure this type of cancer.

How is chemotherapy given?

Chemo drugs for salivary gland cancer are usually given by mouth or IV (into a vein) as an infusion over a certain period of time. This can be done in a doctor’s office, infusion center, or in a hospital setting.

A special kind of IV known as a central venous catheter (CVC), central venous access device (CVAD), or central line might be needed for treatment. They can also be used to take blood for tests. There are different kinds of CVCs. The most common types are the port and the PICC line.

Chemotherapy is given in cycles. The chemo or a combination of chemo drugs is given on a set schedule, followed by a rest period.

Common schedules of chemo cycles can be once a week, once every 3 weeks, or once every 4 weeks. The schedule depends on the drugs used. The chemo schedule repeats to start the next cycle.

Which chemo drugs are used to treat salivary gland cancers?

Some of the chemo drugs that might be given to treat salivary gland cancer include:

• Carboplatin
• Cisplatin
• Fluorouracil
• Gemcitabine
• Mitoxantrone
• Paclitaxel
• Vinorelbine
• Cyclophosphamide
• Doxorubicin

Chemo drugs are often given together in 2 or 3 drug combinations. For example, cisplatin, cyclophosphamide, and doxorubicin or carboplatin and gemcitabine.

Because salivary gland cancers are not common and because there are different types of salivary gland cancers, no large studies have been done to prove one chemo plan is better than the others.

The best way to use chemotherapy to treat salivary gland cancer is not clear. New chemo drugs and combinations of drugs are being studied in clinical trials.

Possible side effects of chemo

Chemo drugs affect cells that grow fast. Cancer cells multiply quickly, but so do other healthy cells in the body, including blood-forming cells, hair cells, and cells that make up the lining of your gut. When chemo damages these fast-growing healthy cells, it can lead to side effects.

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

Your cancer care team will watch you closely for side effects. Sometimes, your cancer care team might recommend blood work or other tests to check for side effects of the chemo drugs.

Common effects

Some common short-term side effects of chemo drugs include:

• Hair loss
• Mouth sores
• Loss of appetite
• Nausea and vomiting
• Diarrhea or constipation

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

• Increased chance of infections from low white blood cells
• Easy bruising or bleeding from low platelets
• Fatigue from low red blood cells

Most short-term side effects go away after treatment is finished. Often there are ways to make these side effects less severe during treatment. For example, you can take medicines to help prevent and treat nausea and vomiting.

Chemotherapy can also have some longer-term side effects or late effects that appear long after treatment has finished, such as nerve or organ damage.

Talk to your cancer care team if you have any questions about chemo side effects. Tell them about any side effects you have so they can help you control them.

Side effects of specific chemo drugs

Some chemo drugs have specific side effects. For example: