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National Cancer Institute

PDQ® bullet Treatment  bullet Patients

Nasopharyngeal cancer


Table of Contents

OVERVIEW OF PDQ
What is PDQ?
How to use PDQ
DESCRIPTION
What is cancer of the nasopharynx?
STAGE EXPLANATION
Stages of cancer of the nasopharynx
Stage I
Stage II
Stage III
Stage IV
Recurrent
TREATMENT OPTION OVERVIEW
How cancer of the nasopharynx is treated
Treatment by stage
STAGE I NASOPHARYNGEAL CANCER
STAGE II NASOPHARYNGEAL CANCER
STAGE III NASOPHARYNGEAL CANCER
STAGE IV NASOPHARYNGEAL CANCER
RECURRENT NASOPHARYNGEAL CANCER
TO LEARN MORE

OVERVIEW OF PDQ


What is PDQ?

PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. It is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.

To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.


How to use PDQ

PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your doctor, who knows you and has the facts about your disease. PDQ can also provide the names of additional health care professionals who specialize in treating patients with cancer.

Before you start treatment, you also may want to think about taking part in a clinical trial. PDQ can be used to learn more about these trials. A clinical trial is a research study that attempts to improve current treatments or finds information on new treatments for patients with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help patients with cancer. Information is collected about new treatments, their risks, and how well they do or do not work. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. Listings of current clinical trials are available on PDQ. Many cancer doctors who take part in clinical trials are listed in PDQ.

To learn more about cancer and how it is treated, or to learn more about clinical trials for your kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer cancer-related questions.

PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.


DESCRIPTION


What is cancer of the nasopharynx?

Cancer of the nasopharynx is a disease in which cancer (malignant) cells are found in the tissues of the nasopharynx. The nasopharynx is behind the nose and is the upper part of the throat (also called the pharynx). The pharynx is a hollow tube about 5 inches long that starts behind the nose and goes down to the neck to become part of the esophagus (tube that goes to the stomach). Air and food pass through the pharynx on the way to the trachea (windpipe) or the esophagus. The nares, the holes in the nose through which people breathe, lead into the nasopharynx. Two openings on the side of the nasopharynx lead into the ear.

Cancer of the nasopharynx most commonly starts in the cells that line the oropharynx (the part of the throat behind the mouth). If a person has cancer that started in the lymph cells of the nasopharynx (a lymphoma), see the PDQ patient information summary on non-Hodgkin's lymphoma.

A doctor should be seen if a person has trouble breathing or speaking, frequent headaches, a lump in the nose or neck, pain or ringing in the ear, or trouble hearing.

If there are symptoms, the doctor will examine the throat using a mirror and lights. A special instrument (called a nasoscope) may be put into the nose to see into the nasopharynx. The doctor will also feel the neck for lumps. If tissue that is not normal is found, the doctor will need to cut out a small piece and look at it under the microscope to see if there are any cancer cells. This is called a biopsy.

The chance of recovery (prognosis) depends on where the cancer is in the throat, whether the cancer is just in the throat or has spread to other tissues (the stage), and the patient's general state of health.


STAGE EXPLANATION


Stages of cancer of the nasopharynx

Once cancer of the nasopharynx is found, more tests will be done to find out if cancer cells have spread to other parts of the body. This is called staging. A doctor needs to know the stage of the disease to plan treatment. The following stages are used for cancer of the nasopharynx:


Stage I

The cancer is in only one part of the nasopharynx and has not spread to lymph nodes in the area (lymph nodes are small bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells).


Stage II

The cancer is in more than one part of the nasopharynx and has not spread to lymph nodes in the area.


Stage III

Either of the following may be true:


Stage IV

Any of the following may be true:


Recurrent

Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the nasopharynx or in another part of the body.


TREATMENT OPTION OVERVIEW


How cancer of the nasopharynx is treated

There are treatments for all patients with cancer of the nasopharynx. Three kinds of treatment are used:

Biological therapy (using the body's immune system to fight cancer) is being tested in clinical trials.

Radiation therapy is the most common treatment for cancer of the nasopharynx. Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy). External radiation to the thyroid or the pituitary gland may change the way the thyroid gland works. A doctor may wish to test the thyroid gland before and after therapy to make sure it is working properly.

Surgery is sometimes used for cancer of the nasopharynx that does not respond to radiation. If cancer has spread to lymph nodes, the lymph nodes may be removed (lymph node dissection).

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body.

Biological therapy tries to get the body to fight cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body's natural defenses against disease. Biological therapy is sometimes called biological response modifier (BRM) therapy or immunotherapy.

Because the nasopharynx helps in breathing and is close to the face, a patient may need special help adjusting to the side effects of the cancer and its treatment. A doctor will consult with several kinds of doctors who can help determine the best treatment. Trained medical staff can also help patients recover from treatment. Patients may need plastic surgery if a large part of the nasopharynx is taken out.


Treatment by stage

Treatment for cancer of the nasopharynx depends on where the cancer is in the nasopharynx, the stage of the disease, and the patient's age and overall health.

Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in many parts of the country for patients with cancer of the nasopharynx. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.


STAGE I NASOPHARYNGEAL CANCER

Treatment will probably be radiation therapy to the cancer and the lymph nodes in the neck.


STAGE II NASOPHARYNGEAL CANCER

Treatment will probably be radiation therapy to the cancer and the lymph nodes in the neck.


STAGE III NASOPHARYNGEAL CANCER

Treatment may be one of the following:

1. Radiation therapy to the cancer and the lymph nodes in the neck.

2. Radiation therapy followed by surgery to remove lymph nodes in the neck that remain large after radiation.

3. A clinical trial of chemotherapy followed by surgery or radiation therapy.

4. A clinical trial of radiation therapy followed by chemotherapy.

5. A clinical trial of surgery, radiation therapy, and chemotherapy.

6. A clinical trial of chemotherapy combined with radiation therapy.


STAGE IV NASOPHARYNGEAL CANCER

Treatment may be one of the following:

1. Radiation therapy to the cancer and the lymph nodes in the neck.

2. Radiation therapy followed by surgery to remove lymph nodes in the neck that remain large after radiation.

3. A clinical trial of chemotherapy followed by surgery or radiation therapy.

4. A clinical trial of surgery, radiation therapy, and chemotherapy.

5. A clinical trial of chemotherapy combined with radiation therapy.


RECURRENT NASOPHARYNGEAL CANCER

Treatment may be one of the following:

1. Radiation therapy.

2. Surgery to remove the cancer.

3. Chemotherapy.

4. A clinical trial of chemotherapy and/or biological therapy.


TO LEARN MORE

TO LEARN MORE..... CALL 1-800-4-CANCER

To learn more about cancer of the nasopharynx, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, trained information specialists can answer your questions.

The Cancer Information Service also has booklets about cancer that are available to the public and can be sent on request. The following general booklets on questions related to cancer may be helpful:

What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care About
Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again

There are many other places where people can get material and information about cancer treatment and services. The social service office at a hospital can be checked for local and national agencies that can help with getting information about finances, getting to and from treatment, getting care at home, and dealing with problems.

For more information from the National Cancer Institute, please write to this address:

National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

Date Last Modified: 02/1999


If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.


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