NYU Langone doctors may use medication, such as chemotherapy or targeted drugs, to treat people with oropharyngeal cancer. They may prescribe chemotherapy—a group of drugs that destroy cancer cells throughout the body—at the same time as radiation therapy, an approach called chemoradiation.
Doctors may prescribe chemotherapy alone to manage cancer that has spread throughout the body. The drugs may also be used to shrink tumors to help relieve pain in people with advanced cancer.
A targeted drug, which destroys cancer cells while sparing healthy tissue, may be prescribed for people who cannot tolerate chemotherapy.
Chemoradiation may be prescribed for people who have a large oropharyngeal tumor or whose cancer has spread to nearby lymph nodes in the neck.
Chemotherapy is used to make cancer cells more sensitive to radiation therapy. This helps to destroy more cancer cells. Chemotherapy drugs are usually given through a vein with intravenous (IV) infusion on a treatment schedule called a cycle.
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 seven-week treatment period with intensity modulated radiation therapy. Another option is to give a chemotherapy drug once a week during radiation therapy.
For people who have oropharyngeal cancer that has spread to distant parts of the body, such as the lungs or liver, doctors may prescribe chemotherapy alone. Chemotherapy can also help relieve pain in people with advanced oropharyngeal cancer. Common drugs given to manage oropharyngeal cancer include cisplatin, carboplatin, taxotere, and 5-fluorouracil.
In a typical chemotherapy cycle, the drugs are given for one day or over a period of a few days, followed by a one- to three-week period of rest. Your medical oncologist determines the number of cycles that is best for you.
Doctors may also prescribe chemotherapy alone, given every three weeks for three cycles, before giving chemoradiation. This approach, called induction chemotherapy, may allow doctors to deliver reduced doses of radiation therapy.
If a person cannot tolerate the side effects of chemotherapy, a targeted drug may be an option. Targeted drugs usually have different or fewer side effects than chemotherapy.
The drug cetuximab targets a protein called epidermal growth factor receptor, which may be present in tumors. This protein signals cancer cells to grow and divide. Cetuximab interferes with the function of this protein, causing tumors to shrink. It is given by IV infusion about once a week for an amount of time determined by your doctor.
Managing Side Effects of Medication
Most side effects of chemotherapy and targeted drugs are temporary. Chemotherapy side effects may include fatigue, loss of appetite, nausea, vomiting, dry mouth, and sores in the mouth and throat. Chemoradiation may also cause these side effects, as well as those associated with radiation therapy. The targeted drug cetuximab may cause a skin rash and itching.
NYU Langone doctors may prescribe immunotherapy in a clinical trial setting to manage oropharyngeal cancer that has spread throughout the body. Immunotherapy helps boost the body’s immune response to oropharyngeal cancer. It is given through IV infusion on a schedule determined by your doctor. NYU Langone doctors can discuss whether a clinical trial is an option for you.
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