Treatment

You and your doctor work together to devise a treatment plan based on several factors, such as the stage of your cancer, your treatment goals, your overall health and the side effects you're willing to tolerate.

Treatment for nasopharyngeal carcinoma usually begins with radiation therapy or a combination of radiation and chemotherapy.

Radiation therapy

Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer cells.

Radiation therapy for nasopharyngeal carcinoma is usually administered in a procedure called external beam radiation. During this procedure, you're positioned on a table and a large machine is maneuvered around you, directing radiation to the precise spot where it can target your cancer.

For small nasopharyngeal tumors, radiation therapy may be the only treatment necessary. In other situations, radiation therapy may be combined with chemotherapy.

Radiation therapy carries a risk of side effects, including temporary skin redness, hearing loss and dry mouth.

A type of internal radiation therapy, called (brachytherapy), is sometimes used in recurrent nasopharyngeal carcinoma. With this treatment, radioactive seeds or wires are positioned in the tumor or very close to it.

Radiation therapy to the head and neck, especially when combined with chemotherapy, often causes severe sores in the throat and mouth. Sometimes these sores make it difficult to eat or drink. If this occurs, your doctor may recommend inserting a tube into your throat or stomach. Food and water are delivered through the tube until your mouth and throat recover.

Chemotherapy

Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy drugs can be given in pill form, administered through a vein or both. Chemotherapy may be used to treat nasopharyngeal carcinoma in three ways:

• Chemotherapy at the same time as radiation therapy. When the two treatments are combined, chemotherapy enhances the effectiveness of radiation therapy. This combined treatment is called concomitant therapy or chemoradiation.

  However, side effects of chemotherapy are added to the side effects of radiation therapy, making concomitant therapy more difficult to tolerate.

• Chemotherapy after radiation therapy. Your doctor might recommend chemotherapy after radiation therapy or after concomitant therapy.

  Chemotherapy is used to attack any remaining cancer cells in your body, including those that may have broken off from the original tumor and spread elsewhere.

  Some controversy exists as to whether additional chemotherapy actually improves survival in people with nasopharyngeal carcinoma. Many people who undergo chemotherapy after concomitant therapy are unable to tolerate the side effects and must discontinue treatment.

• Chemotherapy before radiation therapy. Neoadjuvant chemotherapy is chemotherapy treatment administered before radiation therapy alone or before concomitant therapy. More research is needed to determine whether neoadjuvant chemotherapy can improve survival rates in people with nasopharyngeal carcinoma.

What chemotherapy drugs you receive and how often will be determined by your doctor. The side effects you're likely to experience will depend on which drugs you receive.

Surgery

Surgery is not often used as a treatment for nasopharyngeal carcinoma. Surgery may be used to remove cancerous lymph nodes in the neck.

In certain cases, surgery may be used to remove a tumor from the nasopharynx. This usually requires surgeons to make an incision in the roof of your mouth to access the area to remove the cancerous tissue.