Oral cancer

Chemotherapy

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

There are a number of ways that chemotherapy may be used to treat oral cancers including: 
Adjuvant

This is when chemotherapy is given after surgery in combination with radiation therapy (called concurrent chemoradiation). It 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. Unlike chemotherapy for many other cancers, most people do not lose their hair or have severe nausea and vomiting. 

Neo-adjuvant This is when chemotherapy is given before surgery or radiation therapy to help shrink large cancers, making them easier to remove during surgery, or target with radiation therapy. This is very rarely used for oral cancer but may be used for sarcomas.
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 medications that will be best to treat the type of cancer you have. 

The chemotherapy medications your doctor chooses may 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 is given by your doctor (the dose). The most common medications used are called cisplatin, carboplatin and cetuximab. 

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 of these side effects are short lived and may go away once you finish chemotherapy. Some side effects can take months or years to improve or may be permanent. 

Once your treatments end, 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 some specific supportive care to help during your recovery.