Surgery for Nasopharyngeal Cancer

Because the nasopharynx is a hard place to operate on and because other types of treatment often work well, surgery is not usually the main treatment for people with nasopharyngeal cancer (NPC). Surgery is more often done to remove lymph nodes in the neck that haven’t responded to other treatments.

Surgery to remove 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 removed tumor (and nearby tissues) closely in the lab to make sure that no cancer has been left behind.

Surgery to remove 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. 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. They differ in the amount of tissue removed from the neck. Depending on the location of the tumor, lymph nodes may be removed from both sides of the neck.

  • A partial or selective neck dissection removes only lymph nodes that are closest to the tumor 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 saved.
  • A radical or comprehensive 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. Be sure you understand how surgery may affect how you look and how your body works.

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. Surgery can lead to nerve damage and cause these side effects. Nerves heal slowly. 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 movement.

More information about Surgery

For more general information about  surgery as a treatment for cancer, see Cancer Surgery.

To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Amerian Society of Clinical Oncology. Nasopharyngeal Cancer: Treatment Options. 07/2016. Accessed at www.cancer.net/cancer-types/nasopharyngeal-cancer/treatment-options on April 23, 2018.

National Comprehensive Cancer Network, Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Head and Neck Cancers, Version I.2018 -- February 15, 2018. Accessed at www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf on April 23, 2018.

Last Medical Review: September 24, 2018 Last Revised: September 24, 2018

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