As tumors shrink, Taipei hospital adjusts radiation plans to reduce nasopharyngeal cancer side effects

“Doctor, after I recover, will I still be able to eat and speak normally?” That was the concern of a 42-year-old man diagnosed with stage-three nasopharyngeal cancer before beginning radiation treatment.

Doctors at Taipei Hospital say the tumor can shrink during the usual six- to seven-week course of radiation. If clinicians continue using the original treatment plan, high-dose radiation intended for the tumor may keep reaching healthy tissue that no longer needs the same level of exposure. That can increase the risk of dry mouth and difficulty swallowing.

Radiation oncologist Jen Chung-wen said nasopharyngeal cancer responds well to radiation, but the tumor lies close to important structures including the parotid glands, spinal cord and brainstem. The challenge is to destroy the cancer while protecting normal tissue as much as possible.

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Doctor, after I recover, will I still be able to eat and speak normally?

Jen used an adaptive approach that included repeating CT simulation and replanning the radiation field according to the patient’s progress. As the tumor shrank, the treatment area was adjusted so that organs such as the parotid glands could move out of the high-dose region.

The patient developed oral mucositis and painful swallowing during treatment, but completed the course with continued medical care. More than three years into follow-up, his tumor remains controlled with no sign of recurrence. He has also retained his speech and swallowing functions, saying he had expected severe dry mouth but can still eat and talk with his family.

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I originally thought my mouth would be so dry after treatment that I would be unable to eat, but it turned out much better than I expected. I can still eat and chat with my family.