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Treatment Options for Cancer of the Nasoharynx

A doctor examines x-rays after radiation therapy for nasopharyngeal cancer
Radiation therapy is one of the treatment options for cancer of the nasopharynx.

How is nasopharyngeal cancer treated?

NPC is highly sensitive to both radiation treatment and many forms of drug (chemotherapy) treatment. For this reason and because the nasopharynx is not easily accessible by surgical means, the mainstay of treatment for both localized (head and neck) and metastatic (spreads beyond the head and neck) NPC is radiation and drug treatment.

Cure rates for patients with localized disease are high, even for patients with bulky tumors in their nasopharynx or neck lymph nodes. Major advances in radiation techniques over the past two decades, including intensity modulated radiation treatments (IMRT) have led to excellent local control of NPC. The addition of chemotherapy, especially cisplatin treatments overlapping with radiation, has also been associated with improved cure rates in patients with locally advanced tumors.

For patients with advanced, metastatic tumors, chemotherapy is the mainstay of treatment. Many drugs, including cisplatin, paclitaxel, docetaxel, gemcitabine, and 5- fluorouracil have been shown to be effective.

Three types of standard treatment are used:

Radiation Therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

External radiation therapy to the thyroid or the pituitary gland may change the way the thyroid gland works. The doctor may test the thyroid gland before and after therapy to make sure it is working properly. It is also important that a dentist check the patient's teeth, gums, and mouth, and fix any existing problems before radiation therapy begins.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Surgery

Surgery is a procedure to find out whether cancer is present, to remove cancer from the body, or to repair a body part. Also called an operation. Surgery is sometimes used for pharyngeal cancer that does not respond to radiation therapy. If cancer has spread to the lymph nodes, the doctor may remove lymph nodes and other tissues in the neck.

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