How long can you live with nasopharyngeal cancer?

Doctor, how long can a person with stage 3 nasopharyngeal cancer live? What should I do to live with the disease, doctor? (Hoang, 62 years old, Ho Chi Minh City)

Reply:

According to Globocan (the cancer database of the International Agency for Research on Cancer), nasopharyngeal cancer is among the 10 types of cancer with the highest number of newly detected cases and deaths in Vietnam in 2020.

Stage 3 nasopharyngeal cancer is a locally advanced stage - in the region. At this stage, the tumor has invaded surrounding organs such as the skull base, cervical spine, paranasal sinuses, metastasized to the cervical lymph nodes on both sides (high cervical lymph nodes), causing pain, nasal congestion or cervical lymph nodes ulcerating on the skin. Care and treatment are more difficult and expensive than in the early stages.

Nasopharyngeal cancer is staged based on three factors: tumor (location, size, degree of invasion), metastasis to nearby lymph nodes (regional lymph nodes) and distant metastasis (to other organs in the body such as the contralateral lung, brain, bones, adrenal glands... or metastasis to non-regional lymph nodes).

According to the guidelines of the American Joint Committee on Cancer (AJCC), nasopharyngeal cancer is assessed as stage 3 when the tumor invades the bone structures of the skull base, cervical spine, sphenoid bone and/or paranasal sinuses or has metastasis to the cervical lymph nodes on both sides (high cervical lymph nodes), the largest lymph node size is less than or equal to 6 cm, and there is no distant metastasis.

For stage 3 nasopharyngeal cancer, data from AJCC shows that the 5-year survival rate is 81%. In addition to stage, the Epstein-Barr virus DNA load (EBV DNA) before treatment also plays an important role in survival prognosis. When combining stage and EBV DNA load, the 5-year survival rate of stage 3 nasopharyngeal cancer is 66% if the EBV DNA load is low (less than 4000 copies/ml); and 54% if the EBV DNA load is high (greater than or equal to 4000 copies/ml). In addition, the survival prognosis of nasopharyngeal cancer patients also depends on factors such as age, health status, underlying diseases, response to treatment, etc.

Patients may have difficulty eating and living due to side effects after treatment. Photo: Freepik

The treatment method applied to patients with stage 3 nasopharyngeal cancer is concurrent chemotherapy and radiotherapy. In some cases, patients may receive chemotherapy first (also known as induction chemotherapy) or adjuvant chemotherapy after chemotherapy and radiotherapy.

Patients with stage 3 nasopharyngeal cancer often have difficulty eating and daily activities due to cancer symptoms and side effects of chemotherapy and radiotherapy. Caring for patients with nasopharyngeal cancer at this stage requires attention to the following issues:

The diet needs to have 3 main components: starch (rice, bread...), protein (meat, seafood, nuts...), fat (soybean oil, margarine, sunflower seeds...). Patients should eat lots of fresh fruits and vegetables to supplement fiber, vitamins, minerals and antioxidants; limit spicy foods, carbonated drinks, alcohol... Food should be cooked soft, thick or liquid for easy chewing and swallowing, divided into many meals with small amounts.

Patients should practice oral hygiene according to the doctor's instructions to reduce side effects on the oral and throat mucosa caused by chemotherapy and radiotherapy. Gentle exercise (healthcare, yoga, walking, swimming, etc.) also helps improve the patient's health. Family members should encourage, motivate, and accompany the patient during the treatment process. When there are unusual signs or symptoms (pain, vomiting, etc.) that cannot be controlled with the medication being used, the patient should see a doctor early for appropriate treatment.

MD.CKI Vu Tran Minh Nguyen
Oncology Department, Tam Anh General Hospital, Ho Chi Minh City

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