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NYU Langone doctors may use medications to treat people with nasopharyngeal cancer.
They may prescribe chemotherapy—a group of drugs that destroy cancer cells throughout the body—at the same time as radiation therapy. This approach is called chemoradiation.
Chemotherapy alone may also be prescribed, or it may be combined with a targeted drug, which destroys cancer cells without harming healthy tissue.
For people with nasopharyngeal cancer that has spread to nearby lymph nodes but not to distant parts of the body, doctors may prescribe chemoradiation. With this approach, chemotherapy drugs make cancer cells more sensitive to radiation therapy. The radiation therapy is delivered to the cancer and nearby nodes, helping to destroy more of the tumor.
Medical and radiation oncologists work together to determine the right chemoradiation schedule for you. Most chemotherapy drugs are given through a vein with intravenous (IV) infusion on a schedule called a cycle, a period of time in which you receive treatment, followed by a period of rest. Radiation therapy is also given during this period on a schedule determined by your doctor.
For people who have nasopharyngeal cancer that has spread to distant parts of the body, such as the lungs, liver, and bones, doctors may prescribe chemotherapy alone. Usually, the drugs given to manage nasopharyngeal cancer include cisplatin and 5-fluorouracil.
If cancer has spread to distant parts of the body, our doctors may combine chemotherapy with a targeted drug, which kills cancer cells while sparing healthy tissue.
Our doctors may also prescribe a targeted drug for people who cannot tolerate chemotherapy because of the side effects. Targeted drugs sometimes have different or fewer side effects than chemotherapy.
The drug cetuximab targets a protein called epidermal growth factor receptor, which may be present in nasopharyngeal tumors. This protein signals cancer cells to grow and divide. Cetuximab interferes with the protein’s function, causing tumors to shrink.
The drug is given through a vein with intravenous (IV) infusion about once a week for a period of time determined by your doctor.
Managing Side Effects of Medications
Most side effects from medications used to manage nasopharyngeal cancer are temporary. Chemotherapy side effects may include fatigue, loss of appetite, nausea, vomiting, dry mouth, and sores in the mouth and throat. Chemoradiation may cause similar side effects, as well as those associated with radiation therapy. The targeted drug cetuximab is associated with a skin rash and itching.
Because dry mouth can lead to tooth decay, NYU Langone dentists are available to monitor and manage your dental health.
An experimental test given before and after chemoradiation therapy may help doctors determine how well the cancer is responding to treatment and decide which additional therapies may be needed.
As part of a clinical trial, our doctors take blood samples from people with nasopharyngeal cancer to measure levels of Epstein–Barr virus (EBV). Lower EBV levels may indicate that the cancer is responding to treatment. Higher levels may mean more treatment is needed.
Doctors may withhold additional chemotherapy if EBV is not detectable, or they may consider prescribing more intensive chemotherapy if elevated EBV levels persist. Measuring EBV levels in blood can also help doctors monitor nasopharyngeal cancer recurrence.
NYU Langone doctors can discuss whether this clinical trial is right for you.
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