Description

Cancer of the nasopharynx (upper esophagus)

What is nasopharyngeal cancer?

Parts of the throat Nasopharyngeal carcinoma is a cancer
of the nasopharynx that is located behind your nose and in the upper part of
the back of your throat.

Nasopharyngeal carcinoma is rare in the United
States. Nasopharyngeal carcinoma is much more common in other parts of the
world, especially in Southeast Asia.

Nasopharyngeal carcinoma is difficult to detect
early. This is most likely because the nasopharynx is not easy to diagnose
and the symptoms of nasopharyngeal carcinoma mimic the symptoms of other more
common conditions.

Treatment of nasopharyngeal carcinoma usually consists of
radiation therapy, chemotherapy, or a combination of both. You can work
with your doctor to determine the exact treatment method depending on your
condition.

What are the causes of nasopharyngeal cancer?

Cancer begins with the uncontrolled growth of normal
cells as a result of one or more genetic mutations, invading the surrounding
areas and eventually spreading to other parts of the body (metastasis). In
nasopharyngeal carcinomas, this process begins in squamous cells that line the
surface of the nasal cavity.

Although the exact cause of the gene mutations that lead
to nasopharyngeal carcinoma is not known, factors such as Epstein-Barr virus,
which increases the risk of this cancer, have been described. However, in
some people with all the risk factors, it is not clear why the cancer never
develops in those who do not have a prominent risk factor.

Radiation therapy

Radiation therapy uses powerful energy sets such as
X-rays or protons to kill cancer cells.

Radiotherapy for nasopharyngeal carcinoma is usually performed with an operation called external
radiation therapy (EBRT). During this operation, you are placed on a table
and a large machine moves around you, directing radiation beams to precise points
targeting your cancer.

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

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

In recurrent nasopharyngeal carcinoma, brachytherapy (internal radiation) is sometimes used, which is
another radiation therapy. With this treatment, radioactive seeds or wires
are placed inside or very close to the tumor.

Radiation therapy applied to the head and neck, especially when combined with chemotherapy, often causes
serious sores in the neck and mouth. Sometimes these wounds make it
difficult to eat or drink. If this happens, your doctor may suggest that a
tube be placed in your throat or stomach. Food and water are supplied
through this tube until your mouth and throat heal.

 Chemotherapy

Chemotherapy is a treatment that uses chemicals to kill
cancer cells. Chemotherapy can be given in pill form, intravenously, or
both. Chemotherapy can be used to treat nasopharyngeal carcinoma in the
following ways:

Simultaneous chemotherapy with radiotherapy. When
the two treatments are combined, chemotherapy increases the effectiveness of
radiation therapy. This combination is called concomitant treatment or
chemoradiotherapy.

However, the side effects of chemotherapy are compounded
by the side effects of radiation therapy, making it more difficult to adapt to
concomitant treatment.

Chemotherapy after radiation therapy. Your doctor
may suggest chemotherapy after radiotherapy or after concomitant treatment.

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

There is some controversy as to whether complementary
chemotherapy actually increases survival in people with nasopharyngeal
carcinoma. Many people who receive chemotherapy after concomitant
treatment are unable to adapt to the side effects and are forced to discontinue
treatment.

Chemotherapy before radiation therapy. Neoadjuvant
chemotherapy is a chemotherapy treatment given alone or before radiotherapy. Further
research is needed to determine whether neoadjuvant chemotherapy can increase
survival in patients with nasopharyngeal carcinoma.

Your doctor will decide which
chemotherapy medications to take and how often. The side effects you are
likely to experience will depend on which medications you are taking.

Surgical Intervention

Surgical intervention is not very often used as a treatment for nasopharyngeal carcinoma. It can be
used to remove cancerous lymph nodes in the neck of the operation.

In some cases, surgery can be used to remove a tumor from the nasopharynx. This usually requires
surgeons to make an incision in your palate to reach the area to remove the
cancerous tissue.