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Lawrence Chow / ENT Doctor

Choosing The Right Treatment For Your Child’s Nasopharyngeal Cancer

Cancer is a word that strikes fear into the hearts of many people, but the reality is that the majority of cancer cases are curable. In this article, we’ll be exploring several different treatment options for childhood nasopharyngeal cancer and how to choose the right one for your child.


What is nasopharyngeal cancer?

Nasopharyngeal cancer is a rare type of cancer that begins in the upper part of the throat, or nasopharynx. It’s often caused by infection with Epstein-Barr virus (EBV) but can also be caused by other viruses, chemicals, and even radiation. These cancers are usually found at an early stage because they often cause symptoms like stuffy nose, sore throat, hoarseness, and enlarged lymph nodes in the neck. It is more common in teens than in children younger than 10 years of age.


Treatment Option Overview

There are different types of treatment for children with nasopharyngeal cancer. Some are standard treatment currently used, and some are being tested in clinical trials to help improve current treatments or obtain information on new treatments.


Four types of standard treatment:

  1. Chemotherapy

It is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.


  1. Radiation therapy

It is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.


  1. Surgery

Surgery is used to remove the tumor if the tumor has not spread throughout the nasal cavity and throat at the time of diagnosis. If a mass is small, it can be removed with an endoscope, a thin, flexible tube with a light and camera at the end. If it’s larger, a surgeon will make an incision in the skin. The mass may be removed in pieces with a very small tool and then put back together.


  1. Immunotherapy

It is a type of biologic therapy treatment that uses the patient’s immune system to fight cancer. Several types of immunotherapy are being used to treat children with nasopharyngeal cancer:

(1) Interferon may stop cancer cells from growing and it may also help kill cancer cells.

(2) EBV-specific cytotoxic T-lymphocytes are a type of immune cell that can kill certain cells, including foreign cells, cancer cells, and cells infected with the Epstein-Barr virus. They are being studied to treat refractory or recurrent nasopharyngeal cancer.

(3) Immune checkpoint inhibitor therapy blocks certain proteins. PD-1 is a protein on the surface of T cells that helps keep the body’s immune responses in check. PD-L1 is a protein found on some types of cancer cells. When PD-1 attaches to PD-L1, it stops the T cell from killing the cancer cell. PD-1 and PD-L1 inhibitors keep PD-1 and PD-L1 proteins from attaching to each other. This allows the T cells to kill cancer cells. Pembrolizumab and nivolumab are types of PD-1 inhibitors that have been used to treat adults with refractory nasopharyngeal cancer and may be considered to treat children.


The right treatment for nasopharyngeal cancer will depend on the size of the cancer, how fast it’s growing, and where it’s located. The most common treatments are surgery to remove the tumor, chemotherapy with radiation therapy, or radiation therapy alone. More uncommon treatments include stem-cell transplantation.

Usually, treatment of newly diagnosed nasopharyngeal cancer in children may include the following:

  • Chemotherapy followed by chemotherapy and external radiation therapy given at the same time. Interferon may also be given.
  • Chemotherapy followed by external radiation therapy.
  • Surgery to remove the tumor.


Side effects that go away after treatment include:

Nausea and vomiting are common side effects of many different medicines and treatments. These side effects may lessen after the child finish treatment.

Pain, sore pink skin, bleeding and swelling are also common side effects of radiation therapy. These side effects usually go away after treatment ends.


Considerations when choosing a treatment for a child

Children are typically not able to make decisions related to their treatment. In order to make a decision, you will need to consult with your child’s team of doctors and therapists. You will also need to take into account the location of the tumor as this can affect the type of treatment that is available. Depending on the severity of treatment, you may be able to take it back home with you.

Did you find the information useful? If so, continue reading our posts.


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