Understanding Nasopharyngeal Cancer & Clinical Trials
- Legendary baseball player Babe Ruth, passed away from a rare type of head and neck cancer called nasopharyngeal carcinoma on August 16, 1948—and aside from his impressive pitching career, many don’t know that he played an influential role in the study of cancer treatments.
- Ruth took part in one of the first chemotherapy clinical trials, taking the drug teropterin (a precursor to methotrexate, a chemotherapy drug still used today).
- A clinical trial is a research study involving volunteers that looks into using new drugs or therapies. The goal of these studies is to test if new treatments are safe and effective. These trials can give patients access to incredible new therapies, or what some would call “tomorrow’s medicine,” today.
- Clinical trials can be an option for people with cancer at many points during the treatment process. Your doctor may have spoken with you about possibly enrolling in a trial if you have advanced disease or if there’s a drug that’s currently considered investigational that may work better than the standard for you.
- If you’re looking for a clinical trial, check out our SurvivorNet Clinical Trial Finder.
Patient advocate and creator of the nonprofit organization My Faulty Gene, Kathy Bates brought up Babe Ruth’s role in the evolution of chemotherapy in a recent LinkedIn post, reminding many of Ruths “unfamiliar” story during Oral, Head and Neck Cancer Awareness Week.
Read MoreThe disease was caught at a later stage, as it spread to his lymph nodes. Despite undergoing radiotherapy and surgery, the tumor he had never went away. He later lost weight and has a significant decrease in muscle mass.
In 1947, Dr. Richard Lewisohn and researchers at New York City’s Mount Sinai Hospital advised Ruth to take part in a clinical trial testing out a drug called Teropterin, which had never been used on humans.
Despite Ruth choosing not to be told what drug he would be taking, he underwent treatment every day for six weeks.
Ruth, who didn’t want to know what drug he was receiving or why, agreed and underwent six weeks of daily treatment—making him one of the first patients anywhere to receive chemotherapy.
Mayo Clinic Proceedings explains further, “Remarkably, Ruth had a dramatic clinical response with regression of adenopathy and symptomatic improvement, and his case was presented (anonymously) at a research conference in St Louis in September 1947.
“The Wall Street Journal and Time reported the following week that scientists were on the verge of a ‘cure for cancer,’ but the drug was quickly discarded in favor of a more potent agent, aminopterin. Unfortunately, Ruth’s cancer recurred, and despite additional radiotherapy, he died of pneumonia and metastatic cancer at Memorial Hospital in New York City in August 1948, at the age of 53 years.”
Ruth wrote in his autobiography “The Babe Ruth Story,” referring to getting the new treatment, “It wasn’t an easy decision.
“I realized that if anything was learned about that type of treatment whether good or bad, it would be of use in the future to the medical profession and maybe to a lot of people with my same trouble. So I took the shot.”
The History of Chemotherapy
Chemotherapy originated after a tragic World War II naval event. MD Anderson Cancer Center explains, “On the night of Dec. 2, 1943, Germany launched a devastating air attack on the Italian port of Bari, sinking or damaging 40 ships, One of these, the U.S. ship SS John Harvey, was carrying a secret cargo of mustard gas shells that exploded on impact.
“Military personnel forced to swim through the resulting toxic mess ended up with severe and fatal burns. Autopsies revealed that the mustard gas killed the soldiers’ rapidly dividing white blood cells, prompting doctors to wonder if it could do the same for cancer cells, which also divide and grow quickly.”
It was that event that led the military to employ pharmacologists to study the use of mustard gas chemicals to fight cancer, resulting in the first chemotherapy drug, mechlorethamine, being created and ultimately treating lymphoma, and later more drugs would be developed.
Understanding Nasopharyngeal Carcinoma – A Type of Head & Neck Cancer
According to the National Cancer Institute (NCI) nasopharyngeal cancer is a type of head and neck cancer that develops in the tissues of the nasopharynx.
The NCI explains that the pharynx is “a hollow tube in the neck about 5 inches long that is made up of three parts.”
The three parts are the upper part of the pharynx, known as the nasopharynx, which is the located behind the nose. “The nostrils are connected to the nasopharynx. Openings on each side of the nasopharynx lead to the ears,” the NCI adds.
Expert Resources On Head & Neck Cancers
- New Evidence Suggests Benefit Of Keytruda Immunotherapy For Some Head And Neck Cancer Patients
- HPV Vaccine Gardasil Approved For Prevention of Head And Neck Cancers– Could Help Millions Of Men Avoid The Cancers That Struck Val Kilmer & Michael Douglas
- Remembering Superstar Sammy Davis Jr. Who Died From Throat Cancer at 64; Head and Neck Cancer Treatment Has Advanced With Proton Therapy
- Get the Facts: What Do We Know About HPV-Linked Throat Cancer?
- The HPV Vaccine Gardasil Now Approved For Prevention of Head & Neck Cancers– As Cases Rise in Men
The middle part, which is under the nasopharynx, is the oropharynx. And the lowest part of the pharynx is called the hypopharynx, which opens up to the trachea (windpipe) and esophagus.
“When we breathe or swallow, the pharynx acts as a passageway for air to reach the lungs and food to reach the stomach. Nasopharyngeal cancer commonly begins in the squamous cells that line the nasopharynx,” the NCI says.
RELATED: What You Need to Know About Squamous Cell Carcinoma
Symptoms of this type of cancer may include difficulty speaking, breathing, or hearing, however signs and symptoms can vary depending on the person.
Other symptoms may include:
- a lump in the neck
- pain, pulsing, or ringing in the ear
- trouble hearing
- a sore throat
- stuffy nose
- nosebleeds
Symptoms of this nasopharyngeal cancer in an advanced state may consist of:
- misalignment of the eyes (strabismus)
- double vision
- headaches
- facial numbness
- facial weakness
“Nasopharyngeal carcinoma is diagnosed by biopsy of the tumor, which is often performed in clinic with a use of a small endoscope. This allows the head and neck surgeon to visualize the tumor and its extent,” according to John Hopkins Medicine.
“Imaging techniques (MRI and/or CT scan) may also help determine the extent of the tumor. Testing of the tumor for EBV is also recommended.”
What Is a Clinical Trial?
A clinical trial is a research study involving volunteers that looks into using new drugs or therapies. The goal of these studies is to test if new treatments are safe and effective.
Why I’d Choose a Clinical Trial For Myself
Clinical trials can be an option for people with cancer at many points during the treatment process. Your doctor may have spoken with you about possibly enrolling in a trial if you have advanced disease or if there’s a drug that’s currently considered investigational that may work better than the standard for you.
A lot of patients may feel uncomfortable about the thought of participating in a trial, but the trials can provide amazing opportunities for patients. For one thing, they give patients access to a bevy of new drugs that are currently being developed by pharmaceutical companies.
Things to Consider
In the U.S., all new drugs have to go through clinical trials before the FDA will approve them. In addition to being potentially live-saving for patients, these trials are also necessary to advance science and cancer treatments.
However, participating in a trial comes with risks as well, and it’s important to talk to your doctor about this before getting involved in one. Some risks to consider are:
- The risk of harm and/or side effects due to experimental treatments
- Researchers may be unaware of some potential side effects for experimental treatments
- The treatment may not work for you, even if it has worked for others
Clinical Trials Can be Life-Saving for Some
Still, joining a clinical trial comes with benefits as well. You will be given access to treatments that could be life-saving, but simply haven’t made it through the approval process yet.
If participating in a clinical trial is something you think you may be interested in, the government has a list of trials that are currently ongoing. SurvivorNet also has a tool to help you find trials for your particular disease.
Exceptional Responders: Why Do Some People Respond Better to Treatment?
Who Can Sign Up for Clinical Trials?
If you’re interested in taking part in a clinical trial, the first thing to do is to speak to your doctor about the possibility of a trial. Blindly searching trials on the internet might not be the best advice available; using either the government’s clinical trials database or SurvivorNet’s resources specifically for cancer patients is your best option.
Dr. Nina Shah says if you’re interested in a new treatment, don’t be afraid to ask questions.
However, just because you’re willing to take part in a clinical trial doesn’t necessarily mean you will be able to join. These trials have specific criteria that patients need to meet in order to take part. At the end of the day, even though these trials can have incredible results and provide you with access to cutting-edge therapies, these are controlled experiments.
For each trial, there will be certain inclusion and exclusion criteria.
Sometimes, patients may be excluded from certain trials if their cancer has spread to their brain. If the metastases aren’t under control, the patient may be unable to participate because researchers are concerned that they won’t be able to complete the whole study.
There are options for people who may not be eligible for the clinical trials they wish to participate in, but still want to try the therapies. A few years ago, the U.S. passed something called “Right to Try” legislation. This gives terminally ill people access to highly experimental drugs that are in “phase one” of the clinical trial process.
The ‘Right to Try’ Controversy: When Should People be Given Experimental Drugs?
Your doctor may also request access to a single patient IND (investigational new drug) on your behalf, which can also give access to treatments that the FDA has not yet approved.
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.