Treatments for stage 3 nasopharyngeal cancer

The following are treatment options for stage 3 nasopharyngeal cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Chemoradiation

Chemoradiation is the main treatment for stage 3 nasopharyngeal cancer. In chemoradiation, chemotherapy is given during the same time period as radiation therapy. Each treatment makes the other more effective.

Chemoradiation therapy for stage 3 nasopharyngeal cancer uses cisplatin and external radiation therapy.

Radiation therapy

You may be offered radiation therapy for stage 3 nasopharyngeal cancer if you can’t tolerate chemoradiation and its side effects. External radiation is given to the site of the tumour and to the lymph nodes in the neck (cervical lymph nodes).

The type of external radiation therapy used for stage 3 nasopharyngeal cancer is usually intensity-modulated radiation therapy (IMRT).

Chemotherapy

Chemotherapy with cisplatin and fluorouracil (also called 5-fluorouracil or 5-FU) is often given after chemoradiation or radiation therapy to lower the chance that the cancer will come back (recur).

Surgery

A neck dissection is surgery to remove cervical lymph nodes. It is done if cancer in the cervical lymph nodes doesn’t respond to chemoradiation or radiation therapy.

If the tumour is only on one side of the nasopharynx, the surgeon will only remove the lymph nodes on the same side of the neck as the tumour. If the tumour is near the centre of the nasopharynx, the surgeon will remove the lymph nodes on both sides of the neck in case the tumour has spread to both sides.

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.
  • 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

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