Nasopharyngeal Cancer: Survival Rates, Recurrence, and Nutrition

Hello, doctor!

Hello, doctor! I would like to ask about my father, who was diagnosed with stage IV nasopharyngeal cancer a month ago.
What is the likelihood of recovery? Is there a chance of recurrence? What kind of foods can he eat? Will chemotherapy cause significant suffering for the patient? Please, I am really worried about my dad.
Thank you!

Miss He, 10~19 year old female. Ask Date: 2007/12/22

Dr. Chen Sirong reply Oncology

1.
The probability of recovery in stage IV is divided into IVA, where there is more severe local invasion of the nasopharynx; IVB, where lymph node metastasis occurs to the supraclavicular lymph nodes; and IVC, where there is distant metastasis to the liver, lungs, or bones.
The recovery rates vary among these stages.
According to various reports, the recovery probability ranges from 40% to 60%.
Generally, both IVA and IVB still have a chance for complete treatment, while IVC, which has metastasized to other organs, can only be controlled, allowing for coexistence with cancer.
2.
For recurrence, IVC cancer that has metastasized to other organs cannot be completely eradicated with current chemotherapy, radiation, and surgical treatments.
It can only be controlled, allowing for coexistence with cancer.
Therefore, the issue is one of metastasis rather than recurrence.
Both IVB and IVA have a high probability of complete cure with this treatment, but some individuals may experience recurrence or metastasis.
The dangerous period is within 2-3 years, and typically, the recurrence rate for head and neck tumors after three years of treatment is less than 3%.
3.
It is advisable to limit the intake of irritating and spicy foods.
Patients should eat their favorite foods whenever possible and have multiple meals to maintain a healthy weight.
If vomiting occurs, a physician can prescribe anti-nausea injections, which may cost between NT$500-800.
Nutritional supplements or health products can be taken based on individual financial capability.
I do not recommend using folk remedies or traditional Chinese medicine for treatment; however, traditional Chinese medicine can be considered for body conditioning if intake is insufficient, and it may be beneficial to receive nutritional injections a few days a week.
4.
Chemotherapy is advancing, so significant side effects are not always expected.
Radiation therapy may cause oral mucositis, leading to difficulties in eating.
However, with proper support, patients can endure the long treatment process.
I have personally treated individuals over 80 years old, so I believe that age should not be a significant issue.
Wishing you well, Chen Si-Rong.

Reply Date: 2007/12/22

More Info

Understanding nasopharyngeal cancer, especially at an advanced stage like stage IV, can be quite daunting for both patients and their families. Your concerns about survival rates, recurrence, nutrition, and the effects of chemotherapy are valid and important to address.

Survival Rates and Recurrence:
Nasopharyngeal cancer (NPC) is known for its unique characteristics and treatment responses. The prognosis for stage IV NPC can vary significantly based on several factors, including the patient's overall health, the specific characteristics of the tumor, and how well the cancer responds to treatment. Generally, the five-year survival rate for stage IV NPC can range from 30% to 50%, depending on the extent of the disease and whether it has metastasized to other organs.
Recurrence is a concern with any cancer, particularly at advanced stages. NPC can recur locally in the nasopharynx or regionally in the lymph nodes, and distant metastasis can occur as well. The likelihood of recurrence is influenced by the initial treatment response, the completeness of the initial treatment, and the biological behavior of the tumor. Regular follow-ups and imaging studies are crucial for early detection of any recurrence.

Nutrition:
Nutrition plays a vital role in supporting your father's health during treatment. A well-balanced diet can help maintain strength, support the immune system, and improve overall well-being. Here are some dietary recommendations:
1. High-Protein Foods: Foods rich in protein, such as lean meats, fish, eggs, dairy products, legumes, and nuts, can help maintain muscle mass and support recovery.

2. Fruits and Vegetables: A variety of colorful fruits and vegetables can provide essential vitamins, minerals, and antioxidants that may help combat cancer and improve health.

3. Hydration: Staying well-hydrated is crucial, especially if your father experiences side effects from treatment that can lead to dehydration.

4. Soft Foods: If your father has difficulty swallowing or experiences mouth sores due to chemotherapy or radiation, soft foods like smoothies, yogurt, and soups can be easier to consume.

5. Avoiding Irritants: It may be beneficial to avoid spicy, acidic, or very hot foods that could irritate the throat or mouth.

Chemotherapy and Side Effects:
Chemotherapy can indeed be challenging and may cause various side effects, including nausea, fatigue, hair loss, and changes in appetite. However, the severity of these side effects varies from person to person. Many patients find that supportive care, including anti-nausea medications, hydration, and nutritional support, can help manage these effects.

It's essential to maintain open communication with your father's healthcare team. They can provide guidance on managing side effects and adjusting treatment plans as necessary. Additionally, palliative care services can be beneficial in addressing pain and discomfort, ensuring that your father maintains the best possible quality of life during treatment.

In conclusion, while the diagnosis of stage IV nasopharyngeal cancer is serious, understanding the prognosis, focusing on nutrition, and preparing for the challenges of chemotherapy can empower you and your family. Encourage your father to stay positive and engaged with his treatment plan, and don't hesitate to reach out to healthcare professionals for support and guidance throughout this journey.

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