NASOPHARYNGEAL CANCER

Chemotherapy

Chemotherapy works by destroying or damaging cancer cells. For nasopharyngeal cancers, it is usually given into a vein through a needle with a cannula (tube) attached.

There are a number of different types of chemotherapy that may be used to treat nasopharyngeal cancers:
Neo-adjuvant  This is when chemotherapy is given before radiation therapy to help shrink large cancers and make them easier to target with radiation therapy. Sometimes chemotherapy is added to definitive radiation therapy (chemoradiation).
Definitive  Sometimes chemotherapy is added to definitive radiation therapy (chemoradiation). It is usually used for advanced stage nasopharyngeal cancers. This may be given once every 3 weeks or once a week throughout the duration of radiation therapy. This makes the radiation more effective at killing cancer cells but also leads to more side effects in most people.
Adjuvant 

This is when chemotherapy is given after surgery, usually in combination with radiation therapy (called concurrent chemoradiation). It is usually given once a week during radiation treatment. Adding chemotherapy makes the radiation more effective at destroying cancer cells, but also leads to increased side effects for most patients.

Palliative 

This is used when the cancer is incurable. The cancer may be too large or has spread too much to be removed by surgery. Palliative chemotherapy helps to slow the growth of cancer and reduce symptoms. It is important to remember that palliative chemotherapy is not as intense as other types and is much less likely to have significant side effects.

Before you start treatment, your medical oncologist will choose one or more chemotherapy medication that will be best to treat the type of cancer you have.

The particular chemotherapy medications used will depend on:

  • whether the treatment is curative or palliative

  • when it is used

  • ​your medical history.

Side effects 

The side effects of chemotherapy depend on the medication used and and how much you are given by your doctor (the dose). The most common medications are cisplatin, carboplatin and 5-Fluoruracil (5-FU). 

Each person responds to chemotherapy differently. Some people may experience a few side effects while others may not experience any at all. The following are common side effects of chemotherapy: 

  • a feeling of wanting to vomit (nausea) or vomiting

  • more side effects of radiation, if you have chemotherapy at the same time as radiation 

  • loss of feeling in the fingers and toes

  • kidney damage (caused by some medications) 

  • hearing loss/thinning

  • ringing in the ears

  • rash

  • higher risk of infection (if the chemotherapy reduces the number of white cells in the blood).

Most side effects are short lived and may go away once you finish chemotherapy. Some side effects can take months to years to improve or may be permanent.
Once your treatment ends, you will have regular follow-up appointments so that your doctor can check your recovery, make sure the cancer has not returned and monitor and treat any side effects that you may have. Your doctor may recommend that you receive supportive care to help during your recovery.