NYU Langone doctors may use medication to treat people with oral cancer. This type of treatment includes chemotherapy, in which a group of drugs are used to destroy cancer cells throughout the body, and targeted drugs, which hone in on cancer cells. These treatments may be used alone or in combination with each other.
When these treatments are used at the same time as radiation therapy, this approach is called chemoradiation. The use of medications can make cancer cells more sensitive to radiation therapy, helping to shrink tumors.
Chemoradiation is sometimes given to people in whom cancer cells may still remain after oral cancer has been surgically removed. Chemoradiation may also be used in people who have oral cancer that has spread to nearby lymph nodes in the neck.
If a person cannot have surgery because of poor health, chemoradiation may be used to help alleviate discomfort or pain caused by the cancer.
Chemotherapy drugs are usually given through a vein with intravenous (IV) infusion on a treatment schedule called a cycle. NYU Langone medical and radiation oncologists work together to determine the right chemoradiation schedule for you. For example, doctors may give a chemotherapy drug at the beginning, middle, and end of a six- or seven-week radiation treatment period, for a total of three cycles.
Another option is to give a chemotherapy drug once a week during radiation therapy, with each week being a cycle.
If oral cancer has spread to distant parts of the body, such as the lungs, liver, or bones, doctors may prescribe chemotherapy alone.
In a typical cycle, chemotherapy drugs are given on one day or for a few days, followed by one to three weeks of rest. Your medical oncologist determines the number of cycles that’s best for you.
Typically, medications given to manage oral cancer include cisplatin and carboplatin.
If oral cancer has spread to distant parts of the body, doctors may combine chemotherapy with a targeted drug, which is designed to recognize and destroy cancer cells while largely sparing healthy tissue.
Doctors may also prescribe a targeted drug alone for people who cannot tolerate the side effects associated with chemotherapy. Targeted drugs sometimes have different or less severe side effects than chemotherapy.
Cetuximab is a commonly prescribed targeted drug used to treat oral cancer. It targets a protein called epidermal growth factor receptor, which may be present in oral cancer tumors. This protein signals cancer cells to grow and divide. Cetuximab interferes with the protein’s function, causing tumors to shrink. This medication is given through a vein with intravenous (IV) infusion about once a week for a period of time determined by your doctor.
Managing the Side Effects of Medications
Most of the side effects associated with the medications used to manage oral cancer are temporary. Chemotherapy side effects may include fatigue, loss of appetite, nausea, vomiting, dry mouth, sores in the mouth and throat, changes in kidney function, ringing in the ears, and reduced blood cell levels. Chemoradiation can cause these side effects as well as those associated with radiation therapy.
Cetuximab is associated with a short-term skin rash and itching.
NYU Langone offers clinical trials in which new combinations of chemotherapy drugs and other medications are studied for the treatment of oral cancer in adults. For example, doctors are studying the use of immunotherapy—a treatment that helps to boost the body’s immune response to cancer—when the condition has spread.
In addition, oral rinses are being studied to decrease mouth sores that result from chemoradiation treatment. Researchers are also studying the use of medical marijuana to manage pain caused by oral cancer.
You and your doctor can discuss whether a clinical trial is right for you.
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