Early Nasopharyngeal Cancer Treatment Options

Treatment-related

Hello Doctor, my father had a blood test two weeks ago which showed abnormal EBV levels, and he underwent a CT scan at the hospital, followed by a biopsy (the doctor mentioned it was very small, so it was completely removed).
The report confirmed a diagnosis of nasopharyngeal carcinoma and indicated that it is in the early stage, with no involvement in other areas.
He recently had a PET scan, but the results are not yet available.
I would like to ask: 1.
If the pathology results confirm nasopharyngeal carcinoma cells, is radiation therapy necessary? Since the biopsy indicated it was a very small tumor and it was completely excised.
2.
Which treatment option should be chosen between TrueBeam and Tomotherapy? Thank you for taking the time to respond! Best wishes for your health.

Yang, 20~29 year old female. Ask Date: 2022/10/15

Dr. Chen Sirong reply Oncology

Yang / 25 years old / Female
Hello,
1.
If the pathology results indicate nasopharyngeal carcinoma cells, is radiation therapy necessary?
A:
1.1 Yes,
1.2 Surgery is not an option for nasopharyngeal tumors; radiation therapy is the only treatment available.

1.3 Generally, for other cancers, surgery requires a safe margin; a small biopsy cannot be considered sufficient for surgical intervention.

1.4 If you choose not to treat, will you feel at ease?
2.
Which should be chosen: TrueBeam or Tomotherapy?
A:
2.1 Both are viable options.

2.2 TrueBeam should not require out-of-pocket expenses, while Tomotherapy likely will.

2.3 The success rate for early-stage nasopharyngeal carcinoma should be over 90%, and both machines should have similar treatment outcomes.
Tomotherapy may have slightly fewer side effects, so if you have insurance, it would be advisable to use Tomotherapy.

Wishing you a smooth treatment process.

Taoyuan Hospital
Chen Si-Rong

Reply Date: 2022/10/15

More Info

Understanding early nasopharyngeal cancer treatment options is crucial for ensuring the best possible outcomes for patients. In your father's case, it is encouraging to hear that the cancer has been identified at an early stage, and that the tumor was small enough to be completely excised during the biopsy. However, there are several important considerations regarding the next steps in treatment.

1. Need for Radiation Therapy: In early-stage nasopharyngeal cancer, even if the tumor has been completely removed, radiation therapy is often recommended as a precautionary measure. This is because nasopharyngeal cancer can have microscopic extensions that are not visible during surgery. Radiation therapy can help eliminate any remaining cancer cells and reduce the risk of recurrence. The decision to proceed with radiation therapy typically depends on various factors, including the specific characteristics of the tumor, the patient's overall health, and the presence of any risk factors that might suggest a higher likelihood of recurrence. It is essential to discuss these factors with your father's oncologist, who can provide personalized recommendations based on the pathology results and the PET scan findings.

2. Choosing Between True Beam and Tomotherapy: Both True Beam and Tomotherapy are advanced forms of radiation therapy that offer precise targeting of tumors while minimizing damage to surrounding healthy tissue. True Beam is known for its speed and efficiency, allowing for high doses of radiation to be delivered in fewer sessions. It uses advanced imaging and treatment delivery techniques to ensure accuracy. On the other hand, Tomotherapy combines traditional radiation therapy with computed tomography (CT) scanning, allowing for continuous imaging during treatment. This can be particularly beneficial for tumors located in complex anatomical areas, such as the nasopharynx, where surrounding structures are sensitive to radiation.

The choice between these two modalities should be made in consultation with your father's radiation oncologist, who can evaluate the specifics of his case, including the tumor's location, size, and any potential impact on surrounding tissues. They will also consider your father's overall health and any other medical conditions he may have.

In summary, while your father's early-stage nasopharyngeal cancer is a positive factor, it is essential to follow up with appropriate treatment to ensure the best outcomes. Radiation therapy is typically recommended even after complete excision of the tumor. The choice between True Beam and Tomotherapy should be made based on a thorough discussion with the healthcare team, considering the unique aspects of your father's condition. It is important to maintain open communication with his medical team to address any concerns and to ensure that he receives the most effective treatment tailored to his needs.

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