Surgery for Nasopharyngeal Cancer

Surgery to remove the tumor (endoscopic nasopharyngectomy)

A type of surgery called endoscopic nasopharyngectomy may be an option as a first treatment for small cancers or for small cancers that have come back after the initial treatment. It can help some people live longer.

For this surgery, doctors put flexible fiber-optic scopes and long, thin surgical instruments into your nasal cavity through the nostrils to completely remove some nasopharyngeal tumors.

These complex procedures are done only in specialized centers.

Surgery to remove lymph nodes (neck dissection)

Cancers of the nasopharynx often spread to the lymph nodes in the neck. Many of these cancers respond well to treatment with radiation therapy, sometimes along with chemotherapy. If some cancer remains after these treatments, an operation called a neck dissection might be needed to remove these lymph nodes.

Lymph nodes in the neck might also be taken out to see if there are cancer cells in them.

There are several types of neck dissection surgery. The difference is in how much tissue is removed from the neck. Depending on the location of the tumor, lymph nodes may be removed from one or both sides of the neck.

Selective neck dissection: No nerves, veins, or muscles are affected during this type of neck dissection. Only lymph nodes in selected parts of the neck are removed. This type of surgery removes fewer normal structures to try to keep your shoulder and neck working normally.

Comprehensive neck dissection: Some nerves, veins, and muscles might be removed, along with all the lymph nodes in the neck. Some lymph nodes are located deep behind the throat (called retropharyngeal lymph nodes). These are not easy to remove with surgery because of their location.

Possible risks and side effects of surgery for NPC

Like any surgery, the risks and side effects of surgery for nasopharyngeal cancer depend on the extent of the operation and your general health before the surgery.

If you are considering surgery, your cancer care team will talk with you about the likely side effects. Be sure you understand how surgery could affect the way you look and how your body works.

All surgery carries some risk, including the possibility of blood clots, 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. These risks are generally low, but risk is higher with more complicated operations. Rarely, some people do not survive the surgery.

Endoscopic nasopharyngectomy risks and side effects

Possible risks and side effects of endoscopic surgery of the nasopharynx area include meningitis, fluid in the inner ear, numbness around the eye, watery eyes, or lockjaw.

Neck dissection risks and side effects

Side effects of a neck dissection can include numbness of the ear, weakness when raising the arm above the head, and weakness of the lower lip due to nerve damage from surgery.

Nerves heal slowly, so sometimes these side effects can improve over time, especially when physical therapists teach you exercises to improve your neck and shoulder strength and movement.

If more extensive surgery is needed, the side effects might be permanent.  After more extensive neck dissections, physical therapists can teach you exercises to improve your neck and shoulder strength and movement.