Nasopharyngeal cancer treatment options include radiation therapy, chemoradiation followed by adjuvant chemotherapy, surgery, and chemotherapy. Inuits in alaska also have an increased risk of nasopharyngeal cancer. 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. Nasopharyngeal cancer center nasopharyngeal cancer is a form of cancer in which malignant cells form in the nasopharynx tissues. Diagnosis and treatment of nasopharyngeal carcinoma in children. If you are diagnosed with nasopharyngeal cancer, your doctor needs to know how aggressive the cancer is, whether it has spread, and if it has, where it has spread in the body. Nasopharyngeal carcinoma npc is a disease in which malignant cells form in the tissues of the nasopharynx. Speechlanguage pathologists should be involved in the palliation of dysphagia. If youve been diagnosed with nasopharyngeal cancer npc, your treatment team will discuss your options with you.
Every cancer treatment can cause side effects or changes to your body and how you feel. Although rare in the us and western europe, it is common in asia and is one of the most common cancers among chinese immigrants in the us, especially those of southern chinese and southeast asian ancestry. The pathology and treatment of nasopharyngeal carcinoma are presented elsewhere. Epsteinbarr virus is an important cancer causing virus. Npc differs significantly from other cancers of the head and neck in its occurrence, causes, clinical behavior, and treatment.
According to statistics available from the american cancer society, the survival rates for nasopharyngeal cancer are noted in different stages in the study done in 19981999. About nasopharyngeal cancer what is nasopharyngeal cancer. Signs of nasopharyngeal cancer include trouble breathing, speaking, or hearing. The recommendations contained in this guideline are a consensus of the alberta provincial head and neck tumour team synthesis of currently accepted approaches to management, derived from a. The prognosis of the patient in stage 1 is excellent. Although npc is rare in most populations, it is a leading form of cancer in a few welldefined populations, including natives of southern china, southeast asia, the arctic, and the middle eastnorth africa. Nasopharyngeal cancer npc in children is treated largely the same way as npc in adults. The type of nasopharyngeal cancer means the type of cell the cancer started in. Eating saltpreserved foods like fish, eggs, leafy vegetables, and roots during early childhood may increase the risk of getting this form of cancer. Treatment options by stage of nasopharyngeal cancer. Common physical side effects from each treatment option for npc are listed in the types of treatment section. One type called imrt delivers highdose radiation directly to the tumor while minimizing damage to nearby. Tnm stages nasopharyngeal cancer cancer research uk. The determination of stages in nasopharyngeal cancer is of utmost importance because the treatment and the prognosis depend on this.
The epsteinbarr virus may also make a person more likely to get nasopharyngeal cancer. This helps your doctor decide which treatment you need. Nasopharyngeal cancer is a rare type of head and neck cancer. Nasopharyngeal carcinoma npc is a unique disease endemic in asia. It can be used on its own to treat very earlystage cancers, or in combination with chemotherapy for more advanced cancers. Benign nasopharyngeal tumors dont always need treatment. Nasopharyngeal cancer is a disease in which malignant cancer cells form in the tissues of the nasopharynx. Depending on the stage of the cancer, your overall health, and other factors, your treatment options may include. Radiation therapy to the tumor and lymph nodes in the neck. May 15, 2017 epsteinbarr virus is an important cancer causing virus. Nasopharyngeal cancerstagescausessymptomstreatment. Your cancer care team will recommend treatment options depending on the stage the extent of the cancer in the nasopharynx and if and how far the cancer has spread.
Nov 17, 2016 a randomized clinical trial comparing prophylactic upper versus wholeneck irradiation in the treatment of patients with nodenegative nasopharyngeal carcinoma. Oct 23, 2012 in this article, we focus on the current and emerging treatments in nasopharyngeal cancer npc. The enigmatic epidemiology of nasopharyngeal carcinoma. Intergroup 0099 established the role for chemoradiotherapy chemort in the treatment of nasopharyngeal carcinoma. Highdose radiation therapy with chemotherapy is the primary treatment of nasopharyngeal cancer, both for the primary tumor site and the neck. Lee center headed an international study that may lead to improved treatment for people with nasopharyngeal cancer. Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer. Treatment for nasopharyngeal carcinoma usually begins with radiation therapy or a combination of radiation and chemotherapy. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer.
Advances in systemic treatment for nasopharyngeal carcinoma. It is an important part of your treatment plan, regardless of your age or the stage of disease. Nasopharyngeal carcinoma npc world health organization. This topic discusses the epidemiology, etiology, diagnosis, and staging of nasopharyngeal carcinoma. Ethnic background and being exposed to the epsteinbarr virus can affect the risk of nasopharyngeal cancer. After nasopharyngeal cancer npc is found and staged, your cancer care team will discuss treatment options choices with you. Npc is highly sensitive to both radiation treatment and many forms of drug chemotherapy treatment. Epidemiological trends in the past decade have shown that its incidence has declined gradually but progressively, and mortality has been reduced substantially. Nasopharyngeal carcinoma is an infectionrelated cancer strongly driven by epsteinbarr virus. Cancer may also have spread to one or more lymph nodes on one or both sides of the neck andor to. New strategy shows promise for treating nasopharyngeal cancer.
D r d e e p i k a m a l i k j r i i i, d e p a r t m e n t o f r a d i a t i o n o n c o l o g y m g i m s, s e v a g r a m nasopharyngeal carcinoma 2. In nasopharyngeal cancer, a metaanalysis of 6 clinical trials including over patients supported the use of cetuximab with radiation therapy in patients with nasopharyngeal cancer who are unable to tolerate cisplatin treatment. You will learn more about coping with the physical, emotional, social, and financial effects of cancer and its treatment. Different types of cancer can develop from each type of cell. Nasopharyngeal carcinoma npc is distinct from other cancers of the head and neck. Doctors call this part of cancer treatment palliative care or supportive care. Nasopharyngeal carcinoma diagnosis and treatment mayo. Staging is a careful attempt to do this, and staging information will help guide treatment decisions. Chemotherapy given with radiation therapy, followed by more chemotherapy. What is the recommended followup after treatment for npc.
Treatment results of 165 pediatric patients with nonmetastatic nasopharyngeal carcinoma. Doctors are seeking ways to personalize treatment for nasopharyngeal cancer based on a blood marker called epsteinbarr virus ebv dna. Treatment of stage iv nasopharyngeal cancer may include the following. Nasopharyngeal cancer is a rare type of cancer that affects the part of the throat connecting the back of the nose to the back of the mouth the pharynx. While radiotherapy rt remains the primary treatment modality with high cure rates for early stage disease, systemic treatment forms an important integral component in the treatment of npc, both in the nonmetastatic as well. A study of customized treatment for nasopharyngeal cancer. Nasopharyngeal carcinoma npc has a unique and complex etiology that is not completely understood. Depending on the stage of the cancer, you may get more than 1 of these. Nasopharyngeal cancer is a form of cancer in which malignant cells form in the nasopharynx tissues. Nasopharyngeal carcinoma npc is a rare malig nant tumor arising from epithelial cells of the nasopharynx.
The stage of a cancer tells you where it is, how big it is and whether it has spread. Practice guidelines for diagnosis, treatment and followup. In addition, you can find a free videobased educational program about cancer clinical trials in another section of this website. Current and emerging treatment options for nasopharyngeal. Traditional herbal medicine as adjunctive therapy for. Nasopharyngeal cancer can be cured properly if it is diagnosed at an early stage. Treating nasopharyngeal cancer american cancer society. Nasopharyngeal carcinoma is characterised by distinct geographical distribution and is particularly prevalent in east and southeast asia. It differs from other head and neck squamous cell carcinomas in epidemiology, histology, natural history, and response to treatment.
Summary people with cancer of the nasopharynx, an area behind the nose, may benefit from a new combination therapy, according to an international study led by memorial sloan kettering radiation. For many reasons, people do not experience the same side effects even when they are given the same treatment for the same type of cancer. Most nasopharyngeal cancers are nasopharyngeal carcinoma npc. For metastatic nasopharyngeal carcinoma, recommended firstline treatment is cisplatin and fluorouracil, or cisplatin doublet regimen and recommended secondline treatment is gemcitabine, taxane, and fluorouracil analogue. The treatment options and prognosis chance of recovery depend on the stage of the cancer whether it affects part of the nasopharynx, involves the whole nasopharynx, or has spread to other places in the body, the type of nasopharyngeal cancer, the size of the tumor, and the patients age and general health. If you or someone you know has just been diagnosed with nasopharyngeal cancer, this short, simple guide can help. Get detailed information about the treatment of newly diagnosed and recurrent nasopharyngeal cancer in this summary for clinicians. Treatment of stage ii nasopharyngeal cancer may include the following.
Nasopharyngeal cancer treatment alberta health services. Prepost cancer treatment, age, cancer typelocation, post cancer treatment, nasopharyngeal, head and neck cancer, speechvoice, swallowing. Cancer has spread beyond the nasopharynx and may have spread to the cranial nerves, the hypopharynx bottom part of the throat, areas in and around the side of the skull or jawbone, andor the bone around the eye. Successful treatment of nasopharyngeal cancer using. Nasopharyngeal cancer and the southeast asian patient. The standard treatment for nasopharyngeal cancer is chemotherapy with the drug cisplatin plus radiation therapy, followed by more chemotherapy. Nasopharyngeal cancer can occur in any age group, including adolescents, and is common in the south china sea region. Rosenmuellers fossa is posterior to the torus tubarius and is the number 1. Evolution of treatment for nasopharyngeal cancer success and setback in the intensitymodulated radiotherapy era. The eustachian tubes enter the lateral nasopharynx, and the posterior aspect of the orifice creates a protuberance torus tubarius. Radiotherapy is the most commonly used treatment for nasopharyngeal cancer. Nasopharyngeal cancer is a rare form that grows in the neck and head region, the upper area of the throat and the backside of the nose. Download free pdfs of our nasopharyngeal cancer information. It is intended as a resource to inform and assist clinicians who care for cancer patients.
Nasopharyngeal cancer treatments stanford health care. In the uk, about 250 people are diagnosed with nasopharyngeal cancer each year. Nasopharyngeal cancer symptoms, diagnosis, and treatment. Knowing these differences help doctors decide on the best treatment. Prepostcancer treatment, age, cancer typelocation, postcancer treatment, nasopharyngeal, head and neck cancer, speechvoice, swallowing. What is the best treatment of locally advanced nasopharyngeal carcinoma. Among multiple treatments, intensitymodulated radiotherapy imrt is the current standard of treatment for npc achieving good tumor coverage and healthy. After cancer treatment, followup speech and swallowing evaluations are suggested as indicated.
Randomized phase ii and phase iii studies of individualized treatment for nasopharyngeal carcinoma based on biomarker epstein barr virus ebv deoxyribonucleic acid dna summary there are two study questions we are asking in this randomized phase iiiii trial based on a blood biomarker, epstein barr virus ebv deoxyribonucleic acid dna for. Commentary current treatment landscape of nasopharyngeal. The standard of care for the treatment of stage i npc is radiotherapy rt, and for. Nasopharyngeal carcinoma diagnosis and treatment mayo clinic. Globally, nasopharyngeal carcinoma npc is an uncommon cancer with. Nasopharyngeal carcinoma npc, or nasopharynx cancer, is the most common cancer originating in the nasopharynx, most commonly in the posterolateral nasopharynx or pharyngeal recess fossa of rosenmuller, accounting for 50% of cases. Stage 4 nasopharyngeal cancer is divided into stages iva, ivb, and ivc. The distinctive racialethnic and geographic distribution of npc worldwide suggests. Longterm outcome and pattern of failure for patients with nasopharyngeal carcinoma treated with intensitymodulated radiotherapy. Find out what the tnm staging system is, and how it is used for nasopharyngeal cancer. Seom clinical guideline in nasopharynx cancer 2017 ncbi. Rare in most parts of the world, the cancer is an epsteinbarr virusassociated malignancy with a remarkable racial and geographical distribution. In this article, we focus on the current and emerging treatments in nasopharyngeal cancer npc. Nasopharyngeal carcinoma npc is a type of head and neck cancer with a distinctive regional and racial prevalence.
Involvement of the masticator space causes trismus. Aug 17, 2018 in the united states, asian immigrants have a higher risk of this type of cancer than do americanborn asians. Nasopharyngeal cancer merck manuals professional edition. These findings probably reflect lifestyle and environmental changes, enhanced understanding of the. It starts in the upper part of your throat, behind the nose. Jan 19, 2019 nasopharyngeal cancer is a rare form that grows in the neck and head region, the upper area of the throat and the backside of the nose. For the management of abnormal cervical screening tests and cancer precursors. Stages of nasopharyngeal cancer stanford health care. Radiation therapy followed by surgery to remove cancer containing lymph nodes in the neck that remain or come back after radiation therapy.
Risk factors include being of chinese or asian ancestry and exposure to the epsteinbarr virus. Nasopharyngeal cancer shouldnt be confused with other types of cancer that also affect the throat, such as. Nasopharyngeal carcinoma symptoms and causes mayo clinic. When feasible, surgery is usually reserved for nodes that fail to regress after radiation therapy or for nodal recurrence following clinical complete response. The nasopharynx is the upper part of the pharynx throat behind the nose. Bengu cobanoglu and others published nasopharyngeal cancer. Ebv based cancer prevention and therapy in nasopharyngeal. Research into the causes, prevention, and treatment of nasopharyngeal cancer npc is being done in many university hospitals, medical centers, and other institutions around the world. Its important to weigh the benefits of each treatment option against the possible risks and side effects.