Surgery for Nasopharyngeal Cancer
Because the nasopharynx is a hard place to operate on and because other types of treatment are often effective, surgery is seldom the main treatment for patients with nasopharyngeal cancer (NPC). When surgery is used, it is most often to remove lymph nodes in the neck that haven’t responded to other treatments.
Removing the tumor
With newer endoscopic surgery techniques, doctors can use flexible fiberoptic scopes and long, thin surgical instruments to completely remove some nasopharyngeal tumors. But this is only an option for a small number of patients. These complex procedures are done only in specialized centers.
Surgery does have some advantages over other treatments such as radiation therapy – for example, it lets doctors look at the cancer (and nearby tissues) closely in the lab to make sure that none has been left behind.
Removing lymph nodes
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 needed 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 nearly all lymph nodes on one side as well as even more muscles, nerves, and veins.
Possible risks and side effects of surgery
The risks and side effects of any surgery depend on the extent of the operation and a person's general health before the surgery. If you are considering surgery, your doctor will discuss the likely side effects with you beforehand.
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 of surgery in the head and neck area can include problems with speech or swallowing.
The most common side effects of any neck dissection are numbness of the ear, weakness when raising the arm above the head, and weakness of the lower lip. These side effects are caused by the effects of the operation on certain nerves that supply these areas. After a selective neck dissection, the weakness of the shoulder and lower lip usually go away after a few months. But if either of the nerves that supply these areas is removed as part of a radical neck dissection or because of involvement with tumor, the weakness will be permanent.
After more extensive neck dissections, physical therapists can teach you exercises to improve neck and shoulder strength and mobility.
Last Medical Review: January 15, 2015 Last Revised: August 8, 2016