Salivary gland cancer


Chemotherapy

Chemotherapy works by destroying or damaging cancer cells. For salivary gland 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 salivary gland cancer including: 
Adjuvant  This is when chemotherapy is given after surgery and is usually combined with radiation therapy (chemoradiation). It is usually given once a week during radiation therapy. Adding chemotherapy makes the radiation more effective at destroying cancer cells, but also leads to increased side effects for most patients.
Neo-adjuvant  This is when radiation therapy is given before surgery or radiation therapy. It is used to shrink large cancers so they are easier to remove during surgery or target with radiation therapy. Neoadjuvant chemotherapy is rarely used for salivary gland cancer.
Palliative  This is given when the cancer is incurable, because the cancer is too big or has spread too far to be removed by surgery. Even if a cancer is incurable, some patients feel better from palliative chemotherapy as it slows the growth of the cancer, and can relieve or prevent symptoms.

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 its dose. The most common medications used are called cisplatin, carboplatin and fluorouracil (5-FU).

Each individual 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: 
  • ulcers on the lining of the mouth and throat

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

  • loss of feeling in the fingers and toes

  • ringing in the ears (tinnitus), or hearing loss

  • rash

  • change in taste

  • hair loss or thinning

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

  • low levels of red blood cells, sometimes requiring a blood transfusion.

Most of these side effects are short lived and go away once you finish chemotherapy. Some side effects like hearing loss, 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.