The average age is 59 years old. Sarcomas or cancers of the salivary glands, thyroid or paranasal sinuses are usually younger than 59 years old, while those with squamous cell cancers of the mouth, pharynx, and larynx are generally older than 59 years old.

How common is Nasopharynx cancer?

Each year in the United States there are about 11,000 new cases of nasopharynx cancer. 8,000 males and 3,000 females. Cancer of the nasopharynx is primarily prevalent in immigrant Chinese and slightly less prevalent in first-generation Chinese Americans. In certain Chinese provinces, rates as high as 20,000 per 100,000 have been reported! The incidence remains high for descendants of Southern Chinese living in other countries, suggesting a genetic predisposition to the disease, in combination with environmental triggers.

What is Cancer of the Nasopharynx?

Cancer of the nasopharynx is a disease in which cancer (malignant) cells are found in the tissues of the nasopharynx. Cells in the nose are subjected to lots of injury from heat and abrasion, and thus must divide frequently to replace those lost due to injury and old age. Normally, cells divide quickly as we develop in the womb and through infancy, and then the rate slows down considerably, just to replace cells that die. the division of cells in the nose and elsewhere are under very tight control, regulated by the genes within the cells. When this control is lost, the cells may start to divide in a haphazard, uncontrolled manner, and grow to form a swelling of abnormal cells, called a "tumor." A "benign" tumor only grows within it's local area, it does not spread to distant organs, and it is not cancer. In contrast, a "malignant" tumor can spread to any area of the body. it is cancer . It is this ability to spread, or "metastasize," to vital organs which makes a cancer so dangerous. Cancers of the nose and the mouth tend to grow to large sizes locally before they spread, but any cancer can spread at any time. Cancer of the nasopharynx most commonly starts in the cells which line the area, called "squamous" cells. These are similar to the lining cells of the mouth and upper throat. they give rise to a cancer called"squamous cell carcinoma." Less commonly, the cancer may originate from gland cells within the nasopharynx, it is then called "adenocarcinoma." About 60% of nasopharynx cancer spreads from other "primary sites" such as lung, prostate, breast, stomach, colon, or kidneys. When the first evidence of cancer is found in the the neck, due to lymph gland swelling there, the most likely area it started was in the upper respiratory tract. Likely sites are the nasopharynx, tonsils, base of tongue, and an area behind the base of the tongue called the pyriform sinus. As will be seen, all of these sites are routinely examined when the patient is suspected of having a nasopharynx cancer.

What is Tornwaldt's Cyst?

Also called a "nasopharyngeal cyst," it is usually found in the midline of the nasopharynx. It tends to be on the surface lining, and is covered by the mucous membrane of the nasopharynx. If infected, it may cause persistent discharge with a foul taste and odor, eustachian tube obstruction ( the tube that connects the middle ear with the throat and allows the air pressure on both sides of the eardrum to be equalized), and sore throat. A discharge may be seen at the opening of the cyst. These symptoms may initially be confused with nasopharynx cancer.

What Causes, or Increases Risk for Nasopharynx Cancer?

Like any cancer, the exact reason why one person gets nasopharynx cancer and another does not remains unknown . However, several "risk factors" have been shown to be much more likely to be present in nasopharynx cancer patients. These include :

1) Tobacco usage - This is the single strongest risk factor for developing cancers of the head and neck. Any form of tobacco taken through the mouth, whether smoked or chewed, increases the risk over time. The more tobacco that is used, for a longer period of time, the higher the chance is to get cancer. Likewise, when use is stopped, the risk declines to normal over a 5 to 10 year period.

2) Infections such as syphilis and some viruses can lead to cancer over time, these cause sores which heal poorly. The constant attempt to heal leads to "chronic cell division" and thus more chance for cancer. Viruses can also get into the cells of the nose themselves and change the genes in them to form a cancer cell. This elaborate process is called "oncogene activation." The most common virus noted to do this in the upper respiratory tract is the Human Papillomavirus (HPV). Some people seem genetically predisposed to getting cancer from viruses.

3) Lowered Immunity such as from AIDS or transplant anti-rejection drugs will increase the risk for many cancers, including those of the "aero-digestive tract" (i.e. the area from the nose and mouth to the lungs and stomach). This will be especially important in combination with the other risk factors noted.

4) History of Cancer of the aero-digestive tract can mean as much as 5% chance of a separate simultaneous cancer, and a 25% chance of developing another cancer in this area over time (especially if risks like smoking are continued).

5) Breathing sawdust and smoke from certain fires increases the risk for nasopharynx and sinus cancers, probably from chronic irritation.

What are the Symptoms of Nasopharynx Cancer?

A cancer must grow to 1 billion cells to be just 1 cm. (about 1/2") across, so a very early cancer will have no symptoms and likely to go undetected. As it grows, it produces symptoms in it's local area, and eventually in distant areas as it spreads. A nasopharynx cancer may be first noticed by the patient with these possible findings:

1) Breathing problems, frequent headaches, a lump in the nose or neck, pain or ringing in the ear, speech difficulty, or trouble hearing. Swallowing and eating may be mechanically obstructed as the cancer grows down into the throat.

2) Local pain is possible as the tumor enlarges, especially if it invades nerves. The nose shares nerves with the ear, mouth and throat, so some deep nasopharynx cancers cause pain in these areas ('referred pain') Interestingly, the further back in the mouth the cancer, the deeper in the ear the pain appears.

3) Swelling in the Neck is possible as the lymph nodes in the neck are invaded. The nasopharynx has a rich blood and lymph supply, and 80% of patients will have involvement of the lymph glands in the neck! This swelling is usually firm and painless. Neck lymph nodes can also swell up from non-cancerous conditions such as infection, so swelling alone does not prove cancer. However, larger, harder and more persistent swellings are more likely to be cancerous.

4) Nasal obstruction, nasal discharge, smell loss, and sinus congestion, are so commonly associated with non-cancerous conditions that they are frequently neglected until the disease is advanced. Bleeding may occur.

5) Nerve Problems in the eyes, face and neck occur as the cancer invades into the cavernous sinus ("Jacod's syndrome") or into lymph glands that press against the nerves exiting the base of the skull ("Villaret's syndrome").

6) Signs of Distant Spread, to lung, liver, bone, and brain when advanced.

How does Nasopharynx cancer spread?

The behavior of a disease in the average patient is called it's "natural history." Recall that cancer starts in a single cell, which divides in an uncontrolled manner to make millions and billions of copies of itself. It generally starts on the surface of of the nasopharynx and gradually penetrates deeper. As it goes deeper, it can invade lymphatic channels and spread to local lymph nodes in the neck. It may invade nerves and cause pain, and into underlying bone to destroy it. Commonly, an untreated nasopharynx cancer will grow larger and larger in it's local area ultimately become a huge, infected and bleeding mass. It may then protrude through the skin to form a gaping and seeping wound, and spread via the bloodstream to distant organs. Ultimately, cancer kills by anemia, infection, debility.

How is Nasopharynx Cancer Diagnosed and Evaluated?

Examination of the a patient with a neck lump (mass) should include inspection of the ears, nasal cavities, nasopharynx, oropharynx, hypopharynx, and larynx (voice box), as well as examination of the palatine tonsils, base of the tongue, and thyroid and salivary glands. The only way to absolutely diagnose any cancer is to get a piece of it ("biopsy") and analyze it under the microscope . A special instrument (called a nasoscope) may be put into the nose to see into the nasopharynx. If an originating site ("primary site") cannot be found the mass may be sucked ("aspirated") up with a fine needle for further evaluation to locate a precise site. A pathologist examines the biopsy specimen, this is a physician who specializes in making diagnoses from tissue samples. The usual steps in evaluation of a suspected nasopharynx cancer include:

1) Physical Examination is done carefully and includes a meticulous description of the tumor, including it's location, size, color, texture, and whether it is "fixed" to underlying tissue or can be moved about. the doctor looks for white patches ("leukoplakia") and reddish patches ("erythroplasia") which may be precancerous areas. A through exam of the neck is always done, noting any enlarged glands which may represent the cancer spreading to lymph nodes. the back of the throat is examined, and a mirror is used to visualize the vocal cords ("indirect laryngoscopy"). The nerves which arise from the brain (12 of the called "cranial nerves") supplying the face, eyes, ears, nose and throat are tested to look for signs of nerve invasion or compression by cancerous lymph nodes. Naturally, it is also appropriate to do a complete exam of the rest of the body to assess general health and look for signs of distant cancer spread.

2) Endoscopic Examination means placing a visualization tube under light local anesthesia into the nose and down the throat. the preferred procedure is a "triple endoscopy," which looks at the nose, esophagus and larynx (voice box). Clear Endoscopic visualization of the larynx is called "direct laryngoscopy." A biopsy is taken of any suspicious area, and sometimes "blind biopsies" are taken of areas most likely to develop cancer (such as the tonsil). This is done since, as mentioned 5% of patients will have a "second primary" when they come to medical attention - that means another simultaneous cancer. Endoscopy is a very safe procedure, and is the clearest way to actually look at tissues of the aero-digestive tract, and take samples for pathologist evaluation.

3) Blood and Urine Tests are standard preoperative ones to assess general health; there are no special blood tests ("tumor markers") yet to detect spread of squamous cell cancer as there are for some other cancers. Routine tests include Complete Blood Count ("CBC") to look for anemia and infection. A Blood Chemistry Panel ("SMA") measures sodium, potassium, blood sugar, cholesterol and liver and kidney function. If a major surgery is contemplated , blood tests for clotting ability (PT, PTT and bleeding time) are standard. A Urinalysis (UA) to check for protein, blood, or infection completes the lab tests.

4) Imaging Tests are done in the radiology department and standardly include a Chest X-ray to look for signs of infection or lung tumors. Special imaging of the head and neck is obtained. A "panorex" is a series of jaw X-rays which is excellent for detecting spread of cancer to local bone. A CT scan in "thin slices" of the tumor area helps define the extent of the tumor, as does the more expensive Magnetic Resonance Imaging (MRI) scan. MRI, which uses magnetism instead of radiation, allows the area to be viewed in three dimensions. It is great for looking at the tumor as well as checking local muscle, cartilage and nerves for signs of invasion by cancer. Other more exotic tests are only obtained in the presence of suspicious symptoms. For instance, a bone scan is gotten if there is new bone pain. A CT of the Chest and Abdomen is obtained if the plain Chest X-ray appears to show tumor in the lung, and a CT of the Brain is gotten if new neurological symptoms occur. T here are special tests which can be ordered to look at just about any area of the body - but only if necessary.

5) Biopsy of the tumor is crucial, since only by examining an actual piece of the tumor under the microscope can a diagnosis of cancer be made, and the particular type known with certainty. For a small tumor, the whole of it may be removed along with a "safety margin" of surrounding normal tissue, and sent fro evaluation ("Excisional Biopsy"). For a larger tumor, a cut is made into it so some tissue can be removed for examination ("Incisional Biopsy") It usually takes several days (of anxious waiting) for the pathology report to come back.

How is the Nasopharynx Gauged ?

Like all cancer, the extent of nasopharynx cancer is given by the "stage." These stages were developed by the American Joint Committee on Cancer (AJCC) to help make appropriate treatment decisions, and tally the results of therapy for various levels of disease. The stage grouping for nasopharynx cancer is:

Patients over the age of 70 often have longer disease-free intervals and better survival rates than younger patients, since their cancer tends to be slower growing.

What is the Conventional Treatment for Nasopharynx Cancer?

Conventional treatment for nasopharynx cancer involves surgery,chemotherapy, and biological therapy (using the bodies' immune system to fight cancer) is being tested in clinical trials. Chemotherapy is in itself not curative for squamous cell carcinoma, but may be used as an "adjunct" (extra therapy) along with radiation and surgery to improve cure rates. The specifics of each therapy is now described.

Surgery is an excellent way to deal with small (i.e. stage I or II) cancers which have not spread to lymph nodes; the lymph nodes must be sampled for all but the smallest cancers ("lymph node dissection") . It also has it's place in more advanced cancers, when combined with other treatment. This is because radiation does not well treat lymph nodes larger than 3 cm, they need surgery first to remove the bulk of the tumor. If all the cancer was removed at surgery, the patient will be cured. the surgery is performed by an "otolaryngologist," that is a head and neck surgeon (an ENT who specializes in cancer surgery). The chance of being able to remove all of the cancer decreases as the tumor gets larger and lymph nodes are involved. Two other important considerations in surgery are not comprising function (i.e. drastic surgery which leaves the patient unable to breath through the nose) and cosmesis (how the patient looks after surgery. If the cancer has invaded into the cavernous sinus or brain, a "neurosurgeon" will also be present to operate there. Heroic operations to remove large cancers are rarely successful, Since the cancer has usually spread by this time to structures that the surgeon cannot safely remove. patients themselves usually do not want an operation that cuts off the nose or leaves their appearance socially unacceptable. Fortunately, advances in surgical techniques, such as plastics and using tissue from other body areas to fill in gaps, have been developed. The following are some considerations for surgery:

1) For small cancers, either surgery or radiation are generally equally effective, but only one of the "modalities" should be used. The other treatment is then saved for "salvage" if the initial treatment fails. There is no sense in giving the side-effects of both therapies if not necessary. If the patient is in decent medical health then surgery will be recommended first. The cancer is removed with a wide "safety margin" of surrounding normal tissue, and sent to pathology for confirmation of "clear margins" (meaning no cancer specimen's edge). If there is suspicion of neck lymph node involvement, a "neck dissection" can be done to look for disease there; this leaves skin scarring. Overall, surgery for small cancers is quick, with healing time of several weeks and high cure rate. If the cancer has not been totally removed at surgery, either at its original site or in the neck, then subsequent radiation therapy will be necessary for cure.

2) For larger cancers (stage II, III and locally advanced stage IV) both surgery and radiation are needed for the best chance of cure. The goal of surgery is to help restore function immediately (such as smell which has been blocked by a large tumor, and try to remove all "gross disease" (that which can be seen). Radiation treatment is then used after operation to mop up residual disease. The extremes to which surgery are taken depend upon the likelihood for cure, and the effectiveness of radiation for destroying remaining microscopic disease. Surgery is indicated for large primary tumors and lymph nodes larger than 3cm. in the neck, since a high enough radiation dose to eradicate here will cause unacceptable side effects (see section on radiation therapy). In general, when both surgery and radiation are to be combined, studies have favored doing the surgery first, waiting about 4 weeks for the surgical wounds to close, and then starting the post-operative radiation treatments. This requires close cooperation between the surgeon, pathologist, radiation oncologist, dentist, nutritionist, social worker, speech pathologist and the patient's family members. treating advanced nasopharynx cancer is truly an "interdisciplinary" approach! It is critical for the patient to have clear communication with the surgeon to know exactly what to expect with the surgery, especially in terms of breathing, speech and appearance.

3) Tumors with Distant Spread are not curable with local surgery. In this case, the role of surgery is palliative, that is to increase patient comfort and improve the quality of life. Obviously, major surgical adventures that are justifiable for curing local disease only are inappropriate if we know the disease has spread. Often, the problem is determining if the disease has actually spread, or just may have . For instance, if the standard chest X-ray shows a small abnormality in the lung, we really don't know if that is cancer or not. While a CT scan of the chest will help define the shape of the abnormality, only an actual biopsy of it (commonly done in the radiology department under CT guidance) will prove if it's cancer or not. These "staging procedures" are crucial to determine the proper therapy. if spread cannot be proven (but is possible), or is very small and removed, the patient in good condition may want to be aggressive, and get major surgery. It is possible that control of the local disease in the nasopharynx will lengthen lifespan, and it will certainly improve daily life. Some surgeons are willing to be much more aggressive than others, and the key is to pick a highly experienced cancer surgeon and be comfortable with them. Commonly, however a patient with evidence of distant spread will be referred for radiation treatment, with the addition of chemotherapy if cure is the goal.

Radiation Therapy has been used for eight decades for many cancer, including those of the nasopharynx. In fact, radiation is quite successful in treatment of nasopharynx cancer, and is the treatment of choice for most nasopharynx cancer. Radiation may be given alone, or be added to surgery ("adjuvant therapy") . It may be combined with chemotherapy, or all three methods of surgery, radiation, and chemotherapy can be offered together ("multimodality therapy") . External radiation to the thyroid or the pituitary gland may change the way the thyroid gland works. The surgeon will make tests to your thyroid gland both before and after therapy to make sure it is functioning properly. Radiation is prescribed by a "radiation oncologist," who is a cancer doctor specializing in it's administration. It can be given in several forms, most commonly a series of "external beam" treatments with photons or electrons. After being seen in consultation by the radiation oncologist, the patient getting external beam treatment is scheduled for"simulation."

During simulation, the patient is placed on a replica treatment machine, and the area to be treated is marked out. Instead of placing marks on the patients skin, a "mask" is made for head and neck cancers, and the marks designating the treatment area are placed on the mask. X-rays are taken to confirm positioning. information from the simulation, along with other scans, is fed into a "treatment planning computer" and a "plan" is generated. This plan tells how much radiation is going to the cancer, and how much to local normal tissues. Special lead "blocks," which fit into the head of the treatment machine, determine the shape of the radiation field administered. The patient then returns to the department for their "treatment start," which takes about 45 minutes. They lay upon a hard table in a shielded room, and are aligned with laser lights shone upon the marks on the mask. The actual machine which delivers photons or electrons is called a "linear accelerator" or Linac for short; occasionally Cobalt-60 machines are still used. The head of the machine pivots around the patient, so they stay perfectly still during the treatment, even as the radiation is delivered from various angles. The actual treatment only takes several minutes per day, and is usually given from Monday through Friday for 6 or 7 weeks. The usual dose is 60 to 75 Gray (units of radiation) to the actual tumor, with less to surrounding tissues. this is given in "fractions" of about 2 Gray per treatment, accounting for the 7 or so weeks of total therapy. For head and neck cancers, a combination of photons and electrons is often utilized. Photons will penetrate very deep, and tend to spare the skin, while electrons give shallower dose to "boost" up the dose to the more superficial tissues. the "plan" from the simulation helps determine the optimal mixture of photon and electron dose. If a treatment day is missed, it is simply tacked onto the end so that the same total prescribed dose is given. The actual treatment is given by "radiation therapy technologists," or R.T.T.'s, who are supervised by the physician. A radiation physicist checks over the treatment plan as a safety measure.

Radiation is usually very well tolerated, treatments themselves are painless. The side-effects of localized radiation are generally only within the area treated. That is, patients will lose scalp hair only if the actual scalp is treated, or becomes sterile only if the testicles or ovaries are treated. The side effects of radiation are thus specific for the area treated, and are divided into "acute" and "late" reactions. "Acute" reactions occur during the treatment period, while "late" reactions may occur months to years later. Common acute reactions, which start after about a week of treatment, include skin reddening and irritation; this may progress to frank peeling. Special salves or steroid creams may be prescribed to alleviate this. A foreign, "metallic" taste may be noted in the mouth, and the saliva thickens. The salivary glands may initially swell, and mouth dryness occurs as the dose to these glands builds up. Soreness and the mouth dryness occurs as the dose to these glands builds up. Soreness and the mouth and throat may be quite painful, and require special numbing agents ( viscous lidocaine) to make eating less uncomfortable. Mild narcotic may be needed for relief. Weight loss is common with treatment for head and neck cancers, so nutrition must be carefully monitored. Some patients even require a temporary feeding tube ("PEG") placed through the abdominal wall and into the stomach during treatment. this tube is removed when the acute radiation reaction subsides. Mouth and throat pain may be increased by fungal infections, like thrush, which are more likely during radiation. Hair on the face is lost during treatment, but a man's beard will usually grow back, albeit thinner. There is often a sense of fatigue during the therapy period. Overall, treatment is not pleasant, but is made more tolerable by prescribing relieving medications as appropriate. People differ in their tolerance to radiation, and to really effectively kill the tumor cells, it is necessary to get the acute reaction showing that both cancer and normal cells in the nasopharynx are dying. The normal ones can be repaired and replaced, but not the cancerous ones. this is why radiation works.

The matter of more ultimate concern is "late" reactions, for these will stay with the patient indefinitely. The frequency and severity of late reactions are less when therapy is given as many small fractions, and this is why we take many weeks to give it all. The most common late reaction from treatment of mouth cancer is dry mouth, called "xerostomia" in medical parlance. This is due to damage to the salivary glands, which then produce a thickened, whitish saliva. Artificial saliva ("salivary"), pills which will stimulate saliva (pilocarpine"), humidifiers and plain spray bottles may be tried to moisten the mouth. The skin in the area of treatment is often slightly discolored, and may be of tougher texture. A more grave concern is of damage to the spinal cord, which in this area tolerated about 50 gray of radiation. Beyond this, the chance for damage increases dramatically. Mild damage is shown by a shock-like sensation going through the body with neck flexion (Lhermitte's sign"), but this is actually temporary and scary but not dangerous. Serious damage results in paralysis, but fortunately this is extremely rare with modern radiation techniques (less that 1 in 500 patients). Another rare but possible complication is the development of a second cancer in the area due to radiation,these are usually of the bone, cartilage, or muscle ("sarcomas"). High resolution CT and MRI scans can "upstage" patients by identifying lymph nodes that were not thought involved on physical examination. Patients who have CT scans as part of radiation treatment planning have improved disease control and 5 year survival. Memorial Sloan Kettering in New York has published on the advantages of using 3-dimentional conformal treatment for nasopharynx cancer. Previously, patients would tend to fail under spinal cord blocks, in the "parapharyngeal area." Careful treatment plans can help prevent this, while still adequately protecting the spinal cord. The worst complication is failure of treatment to control the existing cancer, so it is crucial that radiation be given meticulously yet aggressively by a highly experienced radiation oncologist. It is truly remarkable and gratifying to see the locally advanced cancers cured by proper radiation treatment!

What About Relapsed Nasopharynx Cancer?

Rarely, a patient will have limited recurrent disease localized in the nasopharynx that can be treated surgically, by performing surgery to the side of the skull base. However, this surgery is practiced at relatively few major hospitals and is not in itself an established treatment. The main problem is getting a good "margin" around the tumor, since the normal structures around the skull base (nerves and blood vessels) are critical to life. It doesn't make sense to leave tumor behind, unless the area can be radiated afterward. If this type of surgery is performed, it is done by a neurosurgeon. Side effects of this type of surgery include nerve damage, leakage of blood and spinal fluid, and infection risks. The CT and MRI scans of the area can help tell if surgery if feasible. The greatest experience is in Europe, such as at the Gustav Roussy Institute in France. There results suggest a benefit in a small selected group of people with nasopharynx cancer, with 50% living 5 years.

More commonly, it is possible to give further radiation therapy, with almost 50% of patients who can get 50 Gray being alive at 5 years. The longer time between the original treatment and the failure, the better patients do. Since it is difficult to give further high dose external-beam radiation over the whole area, best results are obtained when a high-dose local radioactive implant is combined with lower dose external-beam therapy in relapsed disease. This type of therapy is available at the Joint Center at Harvard University, Memorial Sloan Kettering, M.D. Anderson, Mayo Clinic, and other major University Hospitals.

Chemotherapy is not used alone for nasopharyngeal cancer, but is appropriate for patients suspected of having distant spread who wish to get aggressive therapy. Several agents have been used, being the ones usually selected for other head and neck cancers. Specifically, methotrexate, cyclophosphamide, nitrosourea, cisplatin and bleomycin have been used, and are more effective when used in combination than as single drugs. The best chemotherapy results today combine bleomycin, cytoxan, methotrexate and 5-Fluorouracil (the BCMF regimen) which gives up to 80% response rates. Although the duration of the response is usually less than 1 year, some of those with longer response appear to have been cured in the Gustav-Roussy Institute trials in France.

Chemotherapy can be effective when given at the same time as radiation, this is called neo-adjuvant therapy. It gives complete response of over 80%, but is not yet proven to increase survival. It certainly increases the toxicity of treatment, with more local radiation reaction, dropping of blood cell counts, nausea, hair loss, sterility, and the other side-effects of certain chemotherapy agents - so judgment is key!

Latest Effective Treatment:

Overall, the latest effective treatment has involved refining of conventional treatment, as above. The newest radiation technique for initial or recurrent nasopharynx cancer is "stereotactic radiosurgery," where the head is immobilized and numerous arcs of high-dose radiation are pinpointed on the tumor in 3 dimensions, in a single afternoon treatment session. This technique was originally developed for brain tumors, and can be used in conjunction with regular external-beam therapy to deliver a high dose to the primary tumor area with minimal effects on surrounding normal tissue. Also, surgery to remove the cancer is better than ever before with improved surgical techniques and imaging scans. For maximum aggressiveness, giving simultaneous chemotherapy and radiation (usually starting with a couple of chemotherapy doses first to induce shrinkage and potentiate the radiation) can be done as part of a clinical trial, or by a "gung-ho" oncologist willing to stick his neck out. Taxol and Platinum together appear very effective in early trials for head and neck cancer, along with radiation. If your doctor isn't aggressive enough, and you want to be - Get Another Opinion!

Biological therapy, using the body's immune system to fight cancer is being tested in clinical trials, and is not yet standard therapy. Biological therapy tries to get your own body to fight cancer. It uses materials made by your own body or made in a laboratory to boost, direct, or restore your body's natural defenses against disease. Biological therapy is sometimes called biological response modifier (BRM) therapy or immunotherapy. It is most effective to get rid of small residual cancers, such as after radiation treatment. Supplemental interferon trials where this immune agent was given to nasopharynx cancer patients have not worked. In a way, patients can do their own immunotherapy via exercise, nutrition, positive thinking and spiritual outlook, all of which seem to boost our body's immune systems.

You may receive treatment that is considered standard based on its effectiveness in a number of patients in past studies, or you may choose to go into a clinical trial. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat nasopharynx cancer and are based on the most up-to-date information. Clinical trials are going on in many parts of the country for patients with cancer of the nasopharynx. The National Cancer Institute maintains an Internet listing of currently available clinical trials.