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Because the nasopharynx is a difficult place to operate on and
because other types of treatment are often effective, surgery is seldom
the main treatment for patients with nasopharyngeal cancer.
With newer surgical techniques, doctors can completely remove
some nasopharyngeal tumors, but this is appropriate only for a small
number of patients. These complex procedures are done only in
specialized centers. Surgery does have some advantages -- for example,
it lets doctors look at the cancer (and nearby tissues) closely in the
lab to make sure it has all been removed.
The risks and side effects of any surgery depend on the extent
of the operation and a person's general health before the surgery. All
surgeries carry some risk, including the possibility of bleeding,
infections, complications from anesthesia, and pneumonia. Most people
will have some pain for a while after the operation, although this can
usually be controlled with medicines. Other possible side effects can
include problems with speech or swallowing. If you are considering
surgery, your doctor will discuss the likely side effects with you
beforehand.
Neck dissection
Cancers of the nasopharynx often spread to the lymph nodes in
the neck. These cancers often respond well to treatment with radiation
therapy (and sometimes chemotherapy). But if some cancer remains after
these treatments, an operation called a neck dissection may be
necessary to remove these lymph nodes.
There are several types of neck dissection surgery. They
differ in the amount of tissue removed from the neck.
- A partial or selective neck dissection removes only lymph
nodes that are closest to the primary tumor site and most likely to
have cancer spread.
- A modified radical neck dissection removes lymph nodes on
one side of the neck between the jaw bone and collarbone, as well as
some muscle and nerve tissue. The main nerve to the shoulder muscle is
usually preserved.
- A radical neck dissection removes more lymph nodes on one
side as well as some muscles, nerves, and veins.
Possible risks
and side effects: The risks during neck dissection are
the same as those for any other operations, as noted previously.
The most common problem after any neck dissection is numbness
of the earlobe. This is caused by the removal of the greater auricular
nerve. There may also be weakness in raising the arm above the head
(caused by removal or injury to the spinal accessory nerve). Weakness
of the lower lip (caused by injury to lower branches of the facial
nerve) is sometimes seen as well. This and any other nerve weakness may
be short or long term. After the more extensive neck dissections,
physical therapists can teach you exercises to improve neck and
shoulder strength and mobility.
Last Medical Review: 01/21/2009
Last Revised: 01/21/2009
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