What Are the Treatments for Nasopharyngeal Cancer?

Nasopharyngeal refers to cancers that originate in the back of the nose near the skull, the area called the nasopharynx. The nasopharynx is about 1 1/2 inches long on each side and is shaped like a cube. In some patients, symptoms of the cancer include sore throats and/or difficulty breathing.

Treatment

• The appropriate treatment for Nasopharyngeal cancer depends on the stage of the cancer and the extent of the spread of cancer cells. Nasopharyngeal cancer is staged using the standard cancer staging system developed by the American Joint Committee of Cancer. Called the AJCC system, or the TNM system, three factors are determined to identify the appropriate stage. The "T" factor considers the size of the tumor, the "N" factor evaluates lymph node involvement and the "M" factor refers to whether the cancer has metastasized or spread. Nasopharyngeal cancer in children and adults is treated with the same treatment methods, which are determined using this staging system.

Stages 0, I and IIA

• For early stage Nasopharyngeal cancer, treatment is generally targeted radiotherapy. This involves aiming external radiation beams at the tumor itself. Lymph nodes in the back of the neck near the tumor as also often treated with radiation, although early stage cancer by definition has an "N" number of 0 and no lymph node involvement. The lymph nodes are treated as a preventative measure to ensure that there was no undetected cancer in the lymph nodes which could cause the cancer to come back.

Stages IIB, III, IVA and IVB

• In more advanced Nasopharyngeal cancer, the cancer cells have spread beyond the nasopharynx to lymph nodes in the neck or above the collarbone. This more advanced Nasopharyngeal cancer is treated with chemotherapy and radiation. Cisplatin is the most common chemotherapy agent used. Generally, chemotherapy occurs first to attempt to shrink or kill cancer cells, followed by radiation, followed by an additional dose of chemotherapy. But chemotherapy leads to more side effects, which can affect quality of life. It's important to understand what the side effects are likely to be before starting this treatment. If this fails, neck dissection surgery may be performed to remove lymph nodes in the neck that are affected by cancer cells.

Stage IVC

• Stage IVC refers to Nasopharyngeal cancers that have spread to parts of the body distinct from the throat, neck and lymph nodes in the collarbone. Stage IV is generally not curable but is treatable. Chemotherapy is given to attempt to destroy cancer cells in the Nasopharyngeal and the sites of metastases. If no cancer cells are present after chemotherapy, radiation is administered to the Nasopharyngeal and lymph nodes in the neck. If the initial course of chemotherapy does not kill the cancer cells, different regimens may be used.

Recurrent nasopharyngeal cancer

• If Nasopharyngeal cancer returns after the initial treatment was successful, additional radiation therapy may be an option for patients if it was successful the first time. However, in certain instances additional radiation would be too dangerous or ineffective and neck dissection may be recommended to remove the lymph nodes and cancer cells.