Nasopharyngeal cancer treatment by stage

The stage of a cancer means how far it has grown and whether it has spread. You can find a description of each stage of nasopharyngeal cancer in this section of CancerHelp UK.

Radiotherapy is the main choice of treatment for stage 1 nasopharyngeal cancer. The doctor carefully plans your treatment so that radiation beams will hit your cancer and kill the cancer cells. With this stage of cancer there is no sign that the cancer has spread to the lymph nodes. But you may have radiotherapy to the nodes in your neck, just in case any cancer cells have strayed there.

For stage 2 nasopharyngeal cancers you may have either of these treatments

• Radiotherapy to the tumour and the lymph nodes in your neck
• Chemotherapy and radiotherapy together (chemoradiation) to the tumour and the lymph nodes in your neck

For stage 3 nasopharyngeal cancer, you may have one of these treatments

• Radiotherapy to the tumour and the lymph nodes in your neck
• Chemotherapy and radiotherapy together (chemoradiation) to the tumour and lymph nodes in your neck
• Surgery to remove cancerous lymph nodes in the neck, if the cancer has come back after radiotherapy
• Chemotherapy or biological therapy before or after radiotherapy

We know from research that for these cancers, having a combination of treatments improves your survival and helps stop the cancer from coming back. 

If your cancer is diagnosed at stage 3 or 4, you are most likely to have chemotherapy and radiotherapy together.

If your cancer has come back, the treatment you will have depends on where in your body the cancer is.

If your cancer comes back in the same place (the primary site) you will usually have radiotherapy again. This may be external radiotherapy, either on its own or with internal radiotherapy or chemotherapy. In some circumstances, you might have surgery to remove the tumour, but this is less common.

If the cancer has come back in the lymph nodes in your neck, you are most likely to have surgery to remove them. An operation to remove lymph nodes in the neck is called a neck dissection. Another possible treatment is more radiotherapy, although this is less likely.

If your cancer comes back in another part of your body, you are likely to have chemotherapy. If your cancer has spread to your bones you might have radiotherapy to the affected bones. Sometimes your doctor might suggest new drugs that are being tested as part of a clinical trial. There is information about the newer drugs for nasopharyngeal cancer in our section about nasopharyngeal cancer research.

Your doctor may suggest further treatment with radiotherapy, chemotherapy or both. The aim of this treatment is to shrink the cancer and help to control the symptoms the cancer is causing. Although it’s not likely to cure your cancer, it may well slow it down a bit.

If your cancer is very advanced your doctor will refer you to a palliative care team for expert control of your symptoms. Palliative care specialists care for people in the final stages of their illness, but they also work with people at any stage of cancer. The palliative care team can provide expert help with troublesome symptoms. 

Palliative care involves helping to

• Control symptoms such as pain, sickness and breathing problems
• Support you with diet and physical care
• Help you have the best possible quality of life, whether you are at home, or in a hospital or hospice