Head and neck cancer survivor shares his MD Anderson Proton Therapy Center journey
The Latest on Nasopharyngeal Cancer Treatment and Research
Find out what's new in nasophryngeal cancer causes and treatment.
By Chris Iliades, MD
Medically Reviewed by Pat F. Bass III, MD, MPH
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Nasopharyngeal cancer is a very rare type of head and neck cancer that grows from the cells that line the area behind the nose and above the soft palate. Because this is an area that is small and hard to see, most nasopharyngeal cancers are not discovered until they have spread to lymph nodes in the neck.
Causes and Prevention of Nasopharyngeal Cancer
Research has found three major risk factors that may be involved in causing nasopharyngeal cancer:
- Diet.People who eat a diet of salt-cured fish and meat have a much higher incidence of nasopharyngeal cancer. Although nasopharyngeal cancer is rare in the United States, it makes up about 50 percent of head and neck cancers in Hong Kong, where this type of diet is common.
- Infection with the Epstein-Barr virus (EBV).This is the virus that is usually associated with mononucleosis, but research has shown that EBV is present in the cells of many nasopharyngeal cancers and can be associated with these cells becoming cancer cells. Mononucleosis is a common infection and nasopharyngeal cancer is a very rare disease, so there are other factors involved that are not yet clear.
- Genetics.Research has shown that some people are born with genes that may make them more likely to get nasopharyngel cancer. The actual cause of nasopharyngeal cancer is probably a combination of factors that include EBV infection, genetics, and diet.
Other than avoiding foods like salt-cured fish and meat, which are not common in the United States, there is no research that tells us how to prevent nasopharyngeal cancer yet.
New Treatment for Nasopharyngeal Cancer
Because of its location and tendency to spread to lymph nodes early, surgery is usually not part of the treatment for nasopharyngeal cancer.
"Radiation therapy alone is the best treatment for nasopharyngeal cancers that have not spread. If the cancer has spread more extensively, locally or to clinically apparent enlarged lymph nodes, then we use a combination of radiation and chemotherapy," explains Peter Y. Chen, MD, a cancer specialist who treats nasopharyngeal cancer in addition to other head and neck cancers with radiation therapy at the William Beaumont Hospitals in Royal Oak, Mich. "The biggest change in our ability to treat these kinds of cancers has been the introduction of better radiation technology and planning. Intensity modulated radiotherapy, or IMRT, allows us to target the nasopharyngeal cancer better while avoiding vital structures such as the parotid glands, critical parts of the brain, and spinal cord."
In the past, doctors who treated these cancers with radiation would target the X-ray beams from both sides. IMRT uses sophisticated computer planning to shape the X-ray beams to conform to the shape of the nasopharyngeal cancer. "Instead of coming at the cancer from two sides, we can now direct our beams from seven different directions with multiple segments wherein the X-ray energy can be customized in its intensity, conforming more exactly to the shape of the cancer," says Dr. Chen.
What's Next in Nasopharyngeal Cancer Treatment
"The next big advance in our ability to treat nasopharyngeal and other head and neck cancers will be the availability of proton therapy," notes Chen. Traditional X-ray beams are invisible waves of energy called photons. The proton beam is a form of high-energy particle therapy which has the advantage of causing less damage to normal tissue. That's because instead of giving off radiation continually as X-rays travel through the body, the proton beam has a physical property which allows precise delivery of the protons to a predictable depth. "This results in less 'exit dose' to surrounding normal tissues and more effective treatment of cancer tissue," say Chen.
Although nasopharyngeal cancer is a rare type of head and neck cancer that is hard to diagnose in its early stages, new ways of treating these cancers continue to improve our ability to control or cure them.
Video: Introduction to Radiation Therapy of the Head & Neck
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