In this section: Nasopharyngeal Cancer


What do we mean by 'Nasopharyngeal Cancer'? It is a type of Throat Cancer that starts in or behind the nose. If it's not the cancer type you're looking for, please explore the information about other types of Throat Cancers or other types of Head and Neck Cancers.

All the information in this section is available in a PDF.

Download it here.

Treatment options for Nasopharyngeal Cancer

Following a diagnosis of Nasopharyngeal Cancer, your cancer care team will discuss the treatment options, including the possibility of participating in a clinical trial, that are suitable for you.  This is also a good time to consider if you would like a second opinion. 

The most suitable treatment for Nasopharygneal Cancer depends on many things including: 

  • size and location of the cancer
  • whether the cancer has spread
  • personal factors (e.g. age, general health and treatment history)
  • treatments available (and whether any clinical trials are available)
  • your preferences for treatment.
​There are three types of treatment available for nasopharyngeal cancer. These include:
  1. Radiation therapy
  2. Chemotherapy
  3. Surgery

Watch a 3D video explainer about Nasopharyngeal Cancer:

1. Radiation Therapy for Nasopharyngeal Cancer

Radiation Therapy is the main treatment for Nasopharyngeal Cancer. 

It uses high-energy waves to destroy or damage cancer cells. The most common radiation therapy approach for Nasopharyngeal Cancer is called external beam radiation. This type of radiation therapy applies radiation from outside the body.

Radiation Therapy may be given using:

  • Intensity Modulated radiation Therapy (IMRT) or Volumetric Arc Therapy (VMAT) or Tomotherapy, which use different ways to deliver radiation very precisely, minimising the radiation that gets to healthy parts of the body surrounding the cancer.

  • Stereotactic radiation therapy which delivers a large and precise dose of radiation in one or a few visits. It can be used as part of radiation therapy to increase the dose of radiation to the nasopharynx cancer. It is sometimes used to treat cancer that has come back.

Radiation Therapy for Nasopharyngeal Cancer can be used definitively or palliatively.
  • Definitive radiation therapy: is the main treatment for nasopharyngeal cancer. It is used without surgery to cure nasopharyngeal cancer. Typically, radiation therapy is delivered daily (but not on weekends) over 7 weeks. Sometimes chemotherapy is added to radiation therapy (chemoradiation) to make it more effective.
  • Palliative radiation therapy: in cases where a cure is not possible, radiation therapy is used to relieve symptoms of advanced nasopharyngeal cancer. Symptoms that may require palliative radiation therapy include pain, bleeding and pressure symptoms from the cancer pressing on vital structures (e.g. visual disturbance and headaches).

How do I prepare for radiation therapy? 

You will meet with many members of the cancer care team, who will help you learn how to look after yourself through radiation therapy, recovery and long term follow-up. They will also talk to you about side effects and how to manage them. It may be helpful to write down questions as they come up, so you can ask anyone in your cancer care team when you see them.  

Radiation therapy mask-making and simulation 

  • Radiation therapy is a precise treatment. In order to make sure, that the cancer is covered by the treatment, you will need to be very still during the treatment, usually for about five minutes. A radiation therapy mask that is made to fit perfectly to your shape, will be put on you during each treatment to help the machine target where the cancer is.
  • You will have a planning CT scan (and sometimes other scans) with the mask on. Your radiation oncologist and radiation therapists will use these scans with all your other clinical information to develop a radiation therapy plan just for you (a personalised plan). Your plan will be checked by the radiation therapy and radiation oncology physics team before it is ready to be used for your treatment. This whole process can take approximately 2-3 weeks.

Teeth and mouth care

You might need to have some of your teeth taken out, this will depend on the area being treated and the dose of radiation therapy. It is important to take out any broken or infected teeth before radiation therapy. Taking out unhealthy teeth after radiation therapy can cause problems with the jaw bone.



Diet, nutrition and the role of your dietitian

Your cancer and its treatment can make it hard to eat and drink. Your doctor will recommend you see a dietitian to maximise your nutrition during treatment as well as while you are recovering. Sometime feeding tubes may be recommended depending on the area being treated and the dose of radiation therapy.
There are two common types of feeding tubes: 

  • Gastrostomy tube (sometimes called a PEG tube): this type of tube is inserted through your abdominal wall into your stomach, with part of the tube staying outside the stomach.  A syringe can be attached to the tube to give you food this way if needed. The tube is inserted using a camera through the mouth into the stomach (gastroscopy) or using a CT scanner to guide insertion directly through the skin. If a PEG tube is needed, your doctor will organise this before starting your radiation therapy

  • Nasogastric tube: this type of tube goes through the nose down into the stomach and is usually used for short periods (days or weeks). A nasogastric tube can be inserted at any time (before, during or after treatment).


Speech, voice and swallowing

Your cancer and its treatment can make swallowing and speech difficult. Your doctor will recommend you see a speech pathologist, who can help you with ways to manage swallowing and communication difficulties, during and after treatment.



There are many other aspects of supportive care that are available, ask your doctor if you have any specific needs.

Side effects

The side-effects of radiation therapy start around two weeks into treatment and progress through treatment to peak in the last week or just after treatment ends. The side effects start to improve 2-3 weeks after the end of treatment.

Side effects associated with radiation therapy depend on:
  • the dose of radiation therapy

  • the area being treated

  • whether or not chemotherapy is added to the radiation.

Each person responds to radiation therapy differently. Some people may experience a few side effects while others may not experience any at all. The following are some common side effects of radiation therapy.
  • tiredness

  • skin irritation in the treated area e.g. redness, dryness and itching, weeping skin, scaling or sometimes skin breakdown (sores)

  • nasal irritation, blockage and crusting

  • ​ulcers in the mouth and throat that make it painful or difficult to chew or swallow

  • sticky or thick saliva

  • altered taste, which is usually a loss of taste or, sometimes, an unpleasant taste in the mouth​

  • blocked ears from inflammation within ear canals.​

Most side effects are short lived and may go away within 4–6 weeks of finishing radiation therapy. Some side effects may last for months after you finish radiation therapy and some may be permanent.

Long-term side effects of radiation therapy include:

  • dry mouth (called xerostomia) and difficulty eating dry food such as bread/biscuits due to lack of saliva. With modern radiation techniques, some recovery of saliva may be expected up to two years after radiation therapy

  • inability to eat certain foods, in particular sensitivity to spicy or acidic foods

  • gum and tooth problems from lack of saliva 

  • crusty nasal discharge

  • worse hearing or deafness may occur, although with modern radiation therapy techniques the risk of this side effect can be greatly reduced

  • underactive thyroid gland

Rare side effects from nerve damage (called cranial neuropathy) may occur following treatment of very advanced cancers. These include difficulty speaking, swallowing, impaired and double vision. This is because the nasopharynx is very close to a number of important parts of the nervous system (e.g. spinal cord, brain and nerves) involved with seeing, hearing and balance. 

The risk of these rare side effects is very low and with modern radiation therapy techniques, your radiation oncologist will be very careful to avoid these structures by using very precise radiation therapy techniques. You can talk to your radiation oncologist to find out if these concerns apply to your situation and to find out more about these rare side effects.

Once your radiation therapy ends, you may continue to have follow-up appointments so that your doctor can check your recovery and monitor any side effects that you may have. Usually your doctor may arrange for a PET scan about 12 weeks after finishing radiation therapy to make sure the cancer has completely gone.

Your doctor may recommend that you receive specific supportive care to help during your treatment and recovery.

To learn more about Radiation Therapy and to watch
a video of an Immobilisation Maks being made click here


2. Chemotherapy for Nasopharyngeal Cancer

Chemotherapy uses medicines to destroy or damage cancer cells. For Nasopharyngeal Cancers, chemotherapy is usually given into a vein through a needle with a cannula (tube) attached. 

Chemotherapy is usually given during radiation therapy for advanced stage cancers to help the radiation therapy work better. This is called concurrent chemoradiation. 

There are a number of different types of chemotherapy that may be used to treat Nasopharyngeal Cancers:


This is when chemotherapy is given before radiation therapy to help shrink large cancers and make them easier to target with radiation therapy. Sometimes chemotherapy is added to definitive radiation therapy (chemoradiation).


This is when chemotherapy is given after surgery, usually in combination with radiation therapy (called concurrent chemoradiation). It is usually given once a week during radiation treatment. Adding chemotherapy makes the radiation more effective at destroying cancer cells, but also leads to increased side effects for most patients.


Sometimes chemotherapy is added to definitive radiation therapy (chemoradiation). It is usually used for advanced stage nasopharyngeal cancers. This may be given once every 3 weeks or once a week throughout the duration of radiation therapy. This makes the radiation more effective at killing cancer cells but also leads to more side effects in most people.


In cases where cancer is considered incurable, because it may be too large or has spread too much to be removed by surgery, palliative chemotherapy may be suitable. Palliative chemotherapy does not aim to cure a cancer, but helps to slow the growth of cancer and reduce symptoms. It is important to remember that palliative chemotherapy is not as intense as other types and is much less likely to have significant side effects.

Before you start treatment, your medical oncologist will choose one or more chemotherapy medication that will be best to treat the type of cancer you have. The particular chemotherapy medications used will depend on: 

  • whether the treatment is curative or palliative

  • when it is used

  • ​your medical history

Side effects 

The side effects of chemotherapy depend on the medication used and and how much you are given by your doctor (the dose). The most common medications are cisplatin, carboplatin and 5-Fluoruracil (5-FU). 

Each person responds to chemotherapy differently. Some people may experience a few side effects while others may not experience any at all. The following are common side effects of chemotherapy: 

  • a feeling of wanting to vomit (nausea) or vomiting

  • more side effects of radiation, if you have chemotherapy at the same time as radiation 

  • loss of feeling in the fingers and toes

  • kidney damage (caused by some medications) 

  • hearing loss/thinning

  • ringing in the ears

  • rash

  • higher risk of infection (if the chemotherapy reduces the number of white cells in the blood).

Most side effects are short lived and may go away once you finish chemotherapy. Some side effects can take months to years to improve or may be permanent.
Once your treatment ends, you will have regular follow-up appointments so that your doctor can check your recovery, make sure the cancer has not returned and monitor and treat any side effects that you may have. Your doctor may recommend that you receive supportive care to help during your recovery. 

3. Surgery for Nasopharyngeal Cancer

Surgery for Nasopharyngeal Cancer is not common because the area is difficult to get to and it is close to important nerves and blood vessels.

Surgery may be needed, if the cancer returns after previous treatment with radiation therapy.

How can I prepare for the surgery?

Your doctor will explain details of the surgery, general risks and side effects of surgery. Ask your doctor if you have questions. They may recommend:

  • stopping blood thinners (e.g. aspirin) before surgery to reduce the risk of bleeding

  • special stockings to reduce the risk of blood clots

  • early mobilisation (i.e. not staying in bed) to reduce the risk of blood clots and chest infection

  • antibiotics to lower the risk of wound infection.

If you smoke, it is important that you consider stopping smoking before starting treatment to help reduce the risk of infection and help you recover after your treatment.

 Surgical procedures 

The type of surgery used in this situation will depend on the size and location of the recurrent cancer.

ENdoscopic sinus surgery 

This is where a telescope and surgical instruments are passed through the nose to get to the nasopharynx without external cuts.
download pdf

Maxillary swing

This is where a cut is made in the upper lip and next to the nose, and the upper jaw is cut to allow the surgeon to get access to the nasopharynx.
download pdf

Neck dissection

This involves removal of lymph nodes from the neck. It is used to take out lymph nodes that have not responded to radiation therapy or to treat cancer that has come back after earlier treatment.
download pdf 

Side effects of surgery

Treatment for nasopharyngeal cancer may lead to a number of side effects. You may not experience all of the side effects. Speak with your doctor if you have any questions or concerns about treatment side effects.
  • What is Nasopharyngeal Cancer?
  • What is the nasopharynx?
  • What does the nasopharynx do?
  • What causes Nasopharyngeal Cancer?
  • Signs and Symptoms of Nasopharyngeal Cancer
  • Tests for Nasopharyngeal Cancer
  • Treatment options for Nasopharyngeal Cancer
  • Surgery 
  • Radiation Therapy
  • Chemotherapy
All the information in this section is available in a PDF.

Download it here.
  1. Head and Neck Cancer Australia Resources 
  2. External Links to other Head and Neck Cancer Resources