When is chemotherapy recommended for nasopharyngeal cancer?

Nasopharyngeal cancer begins in the area behind the nose and above the throat. Chemotherapy can be given before radiotherapy to reduce tumour bulk, together with radiotherapy to strengthen treatment, or after initial treatment when the team is addressing the risk of cancer elsewhere. It may also be used for recurrent or metastatic disease.

The plan depends on examination and imaging findings, biopsy results, the extent of disease, hearing and kidney function, previous treatment and your ability to manage side effects. The team may combine chemotherapy with radiotherapy or use medicines in sequence.

Ask how the treatment is timed with radiotherapy and whether you need dental, hearing, kidney or nutrition assessments first. Tell the team about ringing in the ears, hearing loss, swallowing difficulty, weight change, kidney problems, medicines and allergies. Plan for mouth care, fluids, transport and help with meals if treatment makes eating difficult.

Keep a record of swallowing, hearing, pain, nausea and temperature. Report changes early so supportive treatment can be offered and the schedule reviewed when needed.

Contact the oncology team urgently for fever or chills, inability to drink, repeated vomiting or worsening swallowing difficulty. Emergency care is appropriate for severe breathing trouble, chest pain, confusion, fainting, uncontrolled bleeding or sudden facial weakness. A severe headache, new vision change or rapidly worsening neck swelling also needs prompt assessment.

Is chemotherapy planned before, during or after radiotherapy, and why? What benefit is expected? How will hearing, kidney function, nutrition and swallowing be protected? Which symptoms should prompt a same-day call?