Once the diagnosis has been made by biopsy , CT and MRI scans are essential in determining stage, for the tumor cannot be seen directly. A chest x-ray is usually done because there may be lung metastases. Liver scans and bone scans may also be needed to search for metastases. Staging is difficult to determine exactly. Most patients are probably in Stage IV at the time of diagnosis.
Various factors appear to affect prognosis , including bone involvement, the presence of pain, the length of time symptoms have been present and the location of lymph nodes involved by tumor. Patients who have evidence of Epstein-Barr virus infection (as shown by a blood test) have a poorer prognosis after treatment.
Treatment Overview Small cancers of the nasopharynx are curable by radiotherapy in 80 to 90 percent of cases. Moderately advanced tumors that have not spread to the lymph nodes in the neck can be cured in 50 to 70 percent of cases. Advanced tumors, especially with extension to other structures such as bone or cranial nerves, are difficult to control.
• In patients with extension of tumor into the skull bones or involving cranial nerves, the use of surgery is rarely
of help and is seldom attempted.
• Radiotherapy is used for treatment of neck metastases. Surgery is usually used only for lymph nodes that do
not disappear after radiotherapy or that reappear. Radiation implants may be used in certain selected
