Nasopharyngeal cancer is a type of head and neck cancer. Cancers affecting the head and neck are not common. People with this type of cancer are usually treated in specialist centres by a team of specialist healthcare professionals.
Your treatment will depend on the stage and grade of the cancer, as well as your general health. Your specialist doctor or nurse will explain the best treatment for you and any likely side effects.
The main treatment for nasopharyngeal cancer is radiotherapy. For early-stage nasopharyngeal cancer, this may be the only treatment needed.
If cancer has spread into areas around the nasopharynx, chemotherapy is often given with radiotherapy. This is called chemoradiation. Sometimes chemotherapy is given to shrink a tumour before chemoradiation. Chemotherapy and radiotherapy can also be given if the cancer has spread to other parts of the body.
Cancer that has come back in the nasopharynx or neck lymph nodes can be treated with one treatment, or a combination of treatments. These can include surgery, radiotherapy and chemotherapy.
Radiotherapy uses high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells.
Radiotherapy is given on its own for stage 1 nasopharyngeal cancer, or with chemotherapy for more advanced cancers.
Having chemoradiation is more effective than having chemotherapy or radiotherapy alone, but it can cause more severe side effects. It is important that you are well enough to cope with the side effects of having both treatments together.
Radiotherapy is also usually given to the lymph nodes in the neck, even if there are no signs of cancer there. This is to reduce the risk of the cancer coming back in this area.
Types of radiotherapy
The type of radiotherapy usually used is called intensity-modulated radiotherapy (IMRT). IMRT uses high-energy rays that are shaped very precisely to target the area of cancer. This means a higher dose of radiation is given to the tumour, and healthy areas nearby get a lower dose. This can reduce side effects.
Another way giving radiotherapy is called stereotactic radiotherapy. It uses many small beams of radiation to target the tumour. This delivers high doses of radiotherapy to very specific areas of the body, which can reduce side effects. You may only need 1 session of treatment.
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. For nasopharyngeal cancer, it is usually given with radiotherapy (see above). Chemotherapy may also be given if the cancer has come back or spread to other parts of the body.
Cisplatin is the most common chemotherapy drug used with radiotherapy to treat nasopharyngeal cancer. Other drugs are sometimes given with cisplatin, such as fluorouracil (5FU) or gemcitabine (Gemzar®). These drugs are given into a vein by infusion (drip).
Surgery is sometimes used to remove cancer that comes back or that is left behind after the radiotherapy or chemoradiation.
The surgeon aims to remove as much of the cancer as possible from the nasopharynx or the neck lymph nodes, or both. They will explain what to expect and what support is available.