In this section: Nasopharyngeal Cancer

NASOPHARYNGEAL CANCER 
TREATMENT


What do we mean by 'Nasopharyngeal Cancer'? It is a type of Throat Cancer that starts in or behind the nose. If it's not the cancer type you're looking for, please explore the information about other types of Throat Cancers or other types of Head and Neck Cancers.


 
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1. Treatment options for Nasopharyngeal Cancer

Following a diagnosis of Nasopharyngeal Cancer, your cancer care team will discuss the treatment options, including the possibility of participating in a clinical trial, that are suitable for you.  This is also a good time to consider if you would like a second opinion. 

The most suitable treatment for Nasopharygneal Cancer depends on many things including: 

  • size and location of the cancer
  • whether the cancer has spread
  • personal factors (e.g. age, general health and treatment history)
  • types of treatment available (and whether there are any clinical trials are available)
  • your preferences for treatment

Watch a 3D video explainer about Nasopharyngeal Cancer:
 


2. Radiation Therapy for Nasopharyngeal Cancer

Radiation Therapy is the main treatment for Nasopharyngeal Cancer. 

It uses high-energy waves to destroy or damage cancer cells. The most common radiation therapy approach for Nasopharyngeal Cancer is called external beam radiation. This type of radiation therapy applies radiation from outside the body.

Radiation Therapy may be given using:

  • Intensity modulated radiation therapy (IMRT) or Volumetric arc therapy (VMAT) or Tomotherapy, which use different ways to deliver radiation very precisely, minimising the radiation that gets to healthy parts of the body surrounding the cancer.

  • Stereotactic radiation therapy, which delivers a large and precise dose of radiation in one or a few visits. It can be used as part of radiation therapy to increase the dose of radiation to the nasopharynx cancer. It is sometimes used to treat cancer that has come back.

Radiation Therapy for Nasopharyngeal Cancer can be used definitively or palliatively.
  • Definitive  — this is the main treatment for Nasopharyngeal Cancer. It is used without surgery to cure Nasopharyngeal Cancer. Typically radiation therapy is delivered daily (but not on weekends) over 7 weeks. Sometimes chemotherapy is added to radiation therapy (chemoradiation) to make it more effective.

  • Palliative  — Radiation therapy is also used to relieve symptoms of advanced Nasopharyngeal Cancer. Symptoms that may require palliative radiation therapy include pain, bleeding and pressure symptoms from the tumour pressing on vital structures (e.g. visual disturbance and headaches).


3. Chemotherapy for Nasopharyngeal Cancer

Chemotherapy uses medicines to destroy or damage cancer cells. For Nasopharyngeal Cancers, chemotherapy is usually given into a vein through a needle with a cannula (tube) attached. 

Chemotherapy is usually given during radiation therapy for advanced stage cancers to help the radiation therapy work better. This is called concurrent chemoradiation. 

There are a number of different types of chemotherapy that may be used to treat Nasopharyngeal Cancers:

Neo-adjuvant

This is when chemotherapy is given before radiation therapy to help shrink large cancers and make them easier to target with radiation therapy. Sometimes chemotherapy is added to definitive radiation therapy (chemoradiation).

Adjuvant

This is when chemotherapy is given after surgery, usually in combination with radiation therapy (called concurrent chemoradiation). It is usually given once a week during radiation treatment. Adding chemotherapy makes the radiation more effective at destroying cancer cells, but also leads to increased side effects for most patients.

Definitive

Sometimes chemotherapy is added to definitive radiation therapy (chemoradiation). It is usually used for advanced stage nasopharyngeal cancers. This may be given once every 3 weeks or once a week throughout the duration of radiation therapy. This makes the radiation more effective at killing cancer cells but also leads to more side effects in most people.

Palliative

In cases where cancer is considered incurable, because it may be too large or has spread too much to be removed by surgery, palliative chemotherapy may be suitable. Palliative chemotherapy does not aim to cure a cancer, but helps to slow the growth of cancer and reduce symptoms. It is important to remember that palliative chemotherapy is not as intense as other types and is much less likely to have significant side effects.

Before you start treatment, your medical oncologist will choose one or more chemotherapy medication that will be best to treat the type of cancer you have. The particular chemotherapy medications used will depend on: 

  • whether the treatment is curative or palliative

  • when it is used

  • ​your medical history


4. Surgery for Nasopharyngeal Cancer

Surgery for Nasopharyngeal Cancer is not common because the area is difficult to get to and it is close to important nerves and blood vessels.

But in some cases, surgery may be used, especially if the cancer returns after previous treatment with radiation therapy or chemoradiation. 

Surgical procedures 

The type of surgery used in this situation will depend on the size and location of the recurrent cancer.
 

ENDOSCOPIC SINUS SURGERY

This is where a telescope and surgical instruments are passed through the nose to get to the nasopharynx without external cuts.
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MAXILLARY SWING

This is where a cut is made in the upper lip and next to the nose, and the upper jaw is cut to allow the surgeon to get access to the nasopharynx.
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NECK DISSECTION

This involves removal of lymph nodes from the neck. It is used to take out lymph nodes that have not responded to radiation therapy or to treat cancer that has come back after earlier treatment.
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