Treatments for recurrent nasopharyngeal cancer

Recurrent nasopharyngeal cancer means that the cancer has come back (recurred) after it has been treated. The following are treatment options for recurrent nasopharyngeal cancer. Your healthcare team will suggest treatments based on your needs and talk with you to develop a treatment plan.

Treatment options depend on where the cancer comes back and which treatments you received for the original cancer.

Chemoradiation

Chemoradiation is a treatment for recurrent nasopharyngeal cancer. In chemoradiation, chemotherapy is given during the same time period as radiation therapy. The chemotherapy makes the radiation more effective.

Chemoradiation usually uses cisplatin, with or without fluorouracil (5-fluorouracil or 5-FU) or another drug, and external radiation therapy.

Radiation therapy

You may be offered radiation therapy for recurrent nasopharyngeal cancer. If you have had radiation therapy to treat the original tumour, treating the same area with radiation again can cause more severe side effects. The radiation team will base treatment doses and schedules on the amount of radiation that was previously used to treat the cancer.

External radiation therapy is the type of radiation therapy that is usually given for recurrent nasopharyngeal cancer.

Stereotactic radiosurgery may also be given as a boost after external beam radiation therapy or chemoradiation.

Brachytherapy may be used to treat a recurrent nasopharyngeal cancer if external radiation therapy was used to treat the original tumour. Brachytherapy may also be given as a boost with external radiation to increase the amount of radiation delivered to the tumour.

Surgery

Surgery may be a treatment option for nasopharyngeal tumours that come back in the same place as the original tumour. The goal of surgery is to remove the tumour. The type of surgery that may be used is a nasopharyngectomy to remove part of the nasopharynx.

A neck dissection removes the lymph nodes in the neck (cervical lymph nodes). It may be done if the cancer comes back in the lymph nodes.

Other surgeries may be offered to relieve symptoms or give supportive care for advanced nasopharyngeal cancer. These include:

  • placement of a feeding tube (usually with a gastrostomy) to make sure you get enough nutrients
  • placement of a breathing tube (called a tracheostomy) to help you breathe

Chemotherapy

You may be offered chemotherapy for recurrent nasopharyngeal cancer. Cancer that comes back in distant places is usually treated with chemotherapy. The following drugs may be used alone or in combination:

  • methotrexate
  • epirubicin
  • doxorubicin
  • paclitaxel
  • capecitabine
  • bleomycin
  • gemcitabine
  • docetaxel
  • cisplatin
  • carboplatin

If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Clinical trials

Talk to your doctor about clinical trials open to people with nasopharyngeal cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Expert review and references

  • American Cancer Society. Treating Nasopharyngeal Cancer. 2022.
  • Guideline Resource Unit (GURU). Nasopharyngeal Cancer Treatment. Version 2 ed. Edmonton: Alberta Health Services; 2021: Clinical Practice Guideline HN-003. https://www.albertahealthservices.ca/info/cancerguidelines.aspx.
  • Bossi P, Chan AT, Licitra L, Trama A, Orlandi A, et al. Nasopharyngeal carcinoma:ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2021: 32(4) 452-465.
  • Chua MLK, Lechner M, Ma BBY. Cancer of the nasopharynx. DeVita VT Jr, Lawrence TS, Rosenberg S. eds. DeVita Hellman and Rosenberg's Cancer: Principles and Practice of Oncology. 12th ed. Philadelphia, PA: Wolters Kluwer; 2023: Kindle version, chapter 24, https://read.amazon.ca/?asin=B0BG3DPT4Q&language=en-CA.
  • National Comprehensive Cancer Network . NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancer Version 2.2023 . 2023: https://www.nccn.org/guidelines/category_1.
  • PDQ® Adult Treatment Editorial Board. Nasopharyngeal Cancer Treatment (Adult) (PDQ®) – Health Professional. Bethesda, MD: National Cancer Institute; 2022: https://www.cancer.gov/.

Medical disclaimer

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.

We do our best to make sure that the information we provide is accurate and reliable but cannot guarantee that it is error-free or complete.

The Canadian Cancer Society is not responsible for the quality of the information or services provided by other organizations and mentioned on cancer.ca, nor do we endorse any service, product, treatment or therapy.


1-888-939-3333 | cancer.ca | © 2024 Canadian Cancer Society