Chemotherapy for laryngeal cancer
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate around the body in the bloodstream.
Chemotherapy is often given with radiotherapy for laryngeal cancer (chemoradiotherapy). If you have advanced cancer, you might have chemotherapy to relieve symptoms and improve your quality of life.
When you might have chemotherapy
Chemotherapy with radiotherapy (chemoradiotherapy)
You might have radiotherapy and chemotherapy at the same time for locally advanced or advanced laryngeal cancer. This is called chemoradiotherapy. These treatments can often work better when they are given together and can lower the risk of the cancer coming back.
You might have chemoradiotherapy to treat your cancer instead of having surgery to remove your larynx. But you might need to have surgery if there are still signs of your cancer after chemoradiotherapy. Or if your cancer comes back later.
Chemotherapy after surgery
You might have chemotherapy on its own after surgery. But chemotherapy is most often given with radiotherapy (chemoradiotherapy). This is called adjuvant treatment. You might have this if there is a risk the cancer may return after having surgery.
Chemotherapy before other treatments
You might have chemotherapy first followed by radiotherapy or chemoradiotherapy in certain situations. This is now less common. You are more likely to have chemoradiotherapy.
Chemotherapy for advanced laryngeal cancer
You sometimes have chemotherapy for advanced laryngeal cancer. Chemotherapy can relieve symptoms and may slow the growth of your cancer. This is called palliative chemotherapy.
Chemotherapy for laryngeal cancer that has come back after treatment (recurrent cancer)
If your cancer comes back after treatment your doctor will do some tests and may take a 
to find out more information. They will explain what treatment you can have. This may include chemotherapy.
Types of chemotherapy
You may have one drug or a combination of drugs to treat laryngeal cancer. The most common types of chemotherapy drugs are:
- cisplatin
- fluorouracil
- capecitabine
- carboplatin
- paclitaxel (Taxol)
- docetaxel (Taxotere)
- methotrexate
Check what the name of your regimen is with your doctor or nurse, then take a look at our A to Z list of cancer drugs.
How you have chemotherapy
You have most of the chemotherapy drugs into your bloodstream (intravenously). Capecitabine is a tablet.
Into your bloodstream
You have the treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.
You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:
- central line
- PICC line
- portacath
Taking tablets
You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.
Treatment cycles
You take some cancer medicines in treatment cycles. This means you take the drug for a set period, followed by a break. For example, you might take a drug every day for a week and then not take it for 2 weeks. This 3 week period in total is one cycle of treatment.
Take your cancer drugs exactly as your doctor, specialist nurse or pharmacist has told you to. The break from treatment is important too. For many cancer drugs, it allows your body to recover.
Before you start chemotherapy
You need to have blood tests to make sure it’s safe to start treatment. You usually have these a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.
Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test.
DPD deficiency
Between 2 and 8 out of 100 people (2 to 8%) have low levels of an enzyme called dihydropyrimidine dehydrogenase (DPD) in their bodies. A lack of DPD can mean you’re more likely to have severe side effects from capecitabine or fluorouracil. It might take you a bit longer to recover from the chemotherapy. These side effects can rarely be life threatening.
Before starting treatment with capecitabine or fluorouracil you have a blood test to check levels of DPD. So you may start treatment with a lower amount (dose) of the drug or have a different treatment. Your doctor or nurse will talk to you about this.
Where you have chemotherapy
You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.
You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.
For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.
Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.
Watch the video below about what happens when you have chemotherapy. It is almost 3 minutes long.
Clare Disney (nurse): Hello, my name is Clare and this is a cancer day unit.
So when you arrive and you’ve reported into with the receptionist, one of the nurses will call you through when your treatment is ready, sit you down and go through all the treatment with you.
Morning, Iris. My name is Clare. I am the nurse who is going to be looking after you today. We’re going to start by putting a cannula in the back of your hand and giving you some anti sickness medication. And then I am going to come back to you and talk through the chemotherapy with you and the possible side effects you may experience throughout your treatment. Is that okay?
Before you have each treatment you’ll need to have a blood test to check your bloods are okay. And you’ll also be reviewed by one of the doctors to make sure you’re fit and well for your treatment. Sometimes you’ll have the blood test taken on the day of your treatment; other times you’ll have it the day before your treatment when you see the doctor.
Each chemotherapy is made up for each individual patient, depending on the type of cancer they have and where it is and depending their height, weight and blood results.
So, depending on where your cancer is some people have their chemotherapy drug, their cancer drug by drip, some will have an injection and other people will have tablets.
So, Iris, your chemotherapy is going to be given to you in what we call cycles and the cycles are given every three weeks for a period of six cycles. So, you will be coming in for approximately five months for your chemotherapy.
Depending on where your cancer is and what type of cancer you have will be dependent on how often you come in for treatment. An example of a treatment cycle would be for you to come in on Day 1, Day 8 and Day 15 then to have a week’s break before you come back again for Day 1 treatment.
Depending on the type of treatment that you are having we will also give you some anti sickness tablets to take alongside your chemotherapy and also some drugs to prevent any reactions if that’s appropriate.
All chemotherapy is given over different time periods so it’s best to check with your nurse about how long you are likely to be in the unit for. This can range from anything up to an hour to an all day treatment slot so please be prepared to bring along some bits to keep you occupied, such as books and music.
So, before you go home it’s important to make sure you have got the tablets you need to go home with your anti sickness medications and any other symptom control tablets that you may require. Also, to make sure that you’ve got the telephone numbers for the oncology unit to phone if you have a temperature or you are experiencing any other symptoms at home that you need to ask advice about.
So, please make sure when you leave the unit that you’ve got all the information you require and if you’ve got any questions at all don’t hesitate to ask the nurse who will be able to answer them for you.
Before your next cycle of treatment you will come in and see the doctor in the clinic room, you’ll have a blood test and an examination to make sure you are fit and well for treatment you will then come back the following day or later on that week for treatment.
Side effects
Common chemotherapy side effects include:
- feeling sick
- loss of appetite
- losing weight
- feeling very tired
- increased risk of getting an infection
- bleeding and bruising easily
- diarrhoea or constipation
- hair loss
Side effects depend on:
- which drugs you have
- how much of each drug you have
- how you react
Tell your treatment team about any side effects that you have.
If you have cisplatin as part of your chemotherapy course you might have some hearing loss. Especially with high pitched sounds. Or you might also have some ringing in your ears (tinnitus). Let your doctor or specialist nurse know if this happens to you.
When you have chemoradiotherapy the side effects are the same as those for radiotherapy or chemotherapy alone. But they can be more severe.
Dietary or herbal supplements
We don't yet know much scientifically about how some nutritional or herbal supplements might interact with treatment. Some could be harmful.
It is very important to tell your doctors if you are:
- taking supplements
- thinking of taking any supplements
- prescribed supplements by alternative or complementary therapy practitioners
Some supplements could make treatment side effects worse. Or it could make the treatment work less well.
Talk to your healthcare team about any other tablets or medicines you take while you are having treatment.
When you go home
Chemotherapy for laryngeal cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. Your nurse will give you telephone numbers to call if you have any problems at home.
