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What is the best suggested treatment for recurrent nasopharyngeal cancer ?

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General & Family Physician
Practicing since : 2004
Answered : 1777 Questions
I have a brother in law who has fought nasopharyngeal cancer for 10 years with three recurrences. After the last recurrence about 3 years ago he has been taking scans(pet) every three months. Three months ago, scan was clear. Latest one in April showed activity and three masses. One of the areas where mass is cannot be operated on.. XXXXXXX position. But they decided to perform surgery on the two other ones that are below the XXXXXXX XXXXXXX area. When he was originally diagnosed he did have metasTisis. Anyway he has had his limit of radiation and now his only option is chemotherapy. Last time they had him on zeloda because he had bad reaction to erbitux. Because of his history what are the chances these masses are malignant and this is another recurrence. By the way a last minute needle biopsy came back inconclusive. I would appreciate your no punches held opinion.
Fri, 13 Apr 2012 in Skin Cancer
Answered by Dr. Chakravarthy Mazumdar 3 hours later

I am sorry to hear the recurrence of nasopharyngeal carcinoma(NPC).

It would have been good if you could type the specific diagnosis with staging of cancer and other details like age and current symptoms.

I have sent your question to a Head and Neck Surgeon. A head and neck surgeon generally operates on these areas.

It is general tendency of the NPC to recur and it generally said that it recurs in 20 to 58% of persons even after radiotherapy within three years of it. Most often it is a local recurrence. So it is happening as expected in your relative too.

The most common sites of metastasis are Bone and Lung. Since your relative has already has metastasis earlier the radiotherpy may not be an optimal choice. Hence the doctors would have opted for chemotherapy.

In general, the size, extent and location of the residual or recurrent NPC together with the biological behavior of the tumour determine the optimal therapy. The surgical and clinical oncological expertise applied optimally will give the best outcome.

Thank you for the patience.
Above answer was peer-reviewed by
Follow-up: What is the best suggested treatment for recurrent nasopharyngeal cancer ? 19 hours later

I think it was stage 3 when originally diagnosed 10 years ago. As I stated it returned three times but the doctors managed to get it under control. After the third recurrence which was about three or four years ago he has been having scans every three months. This last scan in April showed three masses ( some activity) that had not been there threes months ago. The doctors opted for surgery to remove two of the three TUMORS since the third is in a too XXXXXXX place to operate. Today they tried to remove the two TUMORS and when they tried to Intubate sp?him, the tube would not go through because of how damaged his throat is after all the radiation damage. So the Doctors chose to stop the surgery. Now they are going to try to go in through the nasal cavity next week. One of the things that worries me is the tumor they cannot operate on is the site of the original diagnosis of the cancer. My question is are the chances that the two masses they will remove eventually are malignant or is there a chance they are benign. What is the greater percentage. Also they decided to do a needle biopsy last week and it came back inconclusive.
Follow-up: What is the best suggested treatment for recurrent nasopharyngeal cancer ? 4 minutes later

by the way....his age is now 63 but he was 53 when first diagnosed. It's amazing that he fought this 10 years and still going.....
Answered by Dr. Chakravarthy Mazumdar 1 hour later

Thanks for your patience.

Please find the answer for your query by our specialist Dr.Kumaresh Krishanmoorthy XXXXXXX Head and Neck Surgeon.

You may wish to see his profile on the link below:


A recurrence of Nasopharyngeal Carcinoma is considered malignant and unfortunately the chances of it to be malignant are greater.

The treatment for the recurrence would be confined to the two options

1. A Surgical Removal: Nasopharyngectomy being the procedure

2. Chemotherapy

The 5 year survival rate in a Nasopharyngeal Carcinoma would be shorter as the recurrences increase

If you have any follow ups do not hesitate to write back,I would be happy to answer them.
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