Many people are frightened about the prospect of chemotherapy, particularly because of all the publicity that has been given to possible side effects. Modern chemotherapy and modern ways to avoid or reduce side effects have made chemotherapy today much better tolerated than ever before and most people find it is not nearly as bad as they expected. Nevertheless it is a treatment that people would prefer to avoid if they could and when their doctor suggests chemotherapy some people ask what would happen if they didn't have it.

When a cancer of the head and neck region has spread to other organs in the body then treatment with chemotherapy, in this more advanced stage of the cancer, is designed to try and shrink the growth, to improve symptoms, to keep up a good quality of life and to prolong life, if possible. Unfortunately a cure really isn't possible.

Making decisions about treatment in these circumstances is always difficult.

If you do have the chemotherapy it is possible that this will lead to control, and possibly shrinkage, of the cancer with relief of any symptoms, improvement in quality of life, and maybe even some prolongation of life. Some people will have quite significant benefit while others will have no improvement at all and will therefore have the side-effects of the treatment without any benefit. The fitter a person is from a general point of view the more likely they are to have benefit and less likely to have side-effects.

The alternative to having chemotherapy would be to simply have 'supportive treatment' which is aimed not at controlling the cancer itself but at easing any upsetting symptoms as and when they develop and helping to achieve the best possible quality of life possible. 'Non-chemotherapy' medication like steroids and pain killers aim to keep life as normal as possible with minimum side-effects and disruption to daily routine. There would still be active contact with a medical and nursing team to oversee your care during this time. So not having chemotherapy does not mean that you would be left to cope on your own.

At the end of the day, the choice of treatment is a decision which is in your own hands but do discuss this in detail with your doctor to decide about the pros and cons of having chemotherapy and the benefits you might hope to expect in your own individual circumstances. Rest assured that the decision you make will be respected by your medical team who will still continue to ensure you are given the best possible care, whatever you decide.