Nasopharyngeal Cancer

Overview 

The nasopharynx is located at the very back of the nose, above the back of the throat. Nasopharyngeal cancer is a type of head and neck cancer that begins in the nasopharynx. Cancer occurs when abnormal cells start to grow out of control.

There are three types of cancers that can develop in the nasopharynx:

• Nasopharyngeal carcinoma – most nasopharyngeal cancers are carcinomas. A carcinoma is cancer that starts in the epithelial cells (cells that line the internal and external surfaces of the body). There are three kinds of nasopharyngeal carcinoma, also called NPC – non-keratinizing undifferentiated, non-keratinizing differentiated and keratinizing squamous cell carcinomas.
• Lymphoma – cancers of lymphocytes (immune system cells), lymphomas can occur throughout the body, including the nasopharynx.
• Adenocarcinoma or adenoid cystic carcinoma – cancers that can start in the minor glands in the nasopharynx but are more commonly found in the nose or mouth.

Nasopharyngeal cancer causes 

In many cases, the Epstein-Barr virus causes nasopharyngeal cancer. In other cases, the cause of nasopharyngeal cancer is unknown.

Nasopharyngeal cancer risk factors

Factors that can increase your risk for developing nasopharyngeal cancer are:

• Being of Southeast Asia descent
• Having the Epstein-Barr virus (EBV)

Nasopharyngeal cancer symptoms

Signs and symptoms of nasopharyngeal cancer may include:

• Bleeding from your mouth or nose
• Swollen lymph node in your neck that you can feel from outside
• Trouble breathing through your nose
• Trouble popping your ears

Nasopharyngeal cancer diagnosis

Your doctor may use one or more of the following tests to diagnose this condition:

• Physical exam - your doctor will perform a complete physical exam – including asking questions about your health history, your symptoms and related risk factors.
• Biopsy - during this test, your doctor removes a biopsy (small sample of tissue) from your nasopharynx. This biopsy is sent to the laboratory for close analysis and to determine if there are any abnormalities.
• Computerized tomography (CT) scan - your doctor may order a CT scan of your head and neck. This specialized imaging test uses a series of X-ray images to create detailed images of the inside of your body. This can help your doctor determine if the cancer has spread beyond your nasopharynx.
• Ultrasound - your doctor may order an ultrasound, an imaging test that uses sound waves to create detailed images of your head and neck. This can help your doctor determine if the cancer has spread beyond your nasopharynx.

Nasopharyngeal cancer treatment

Depending on your personal health history, stage of the nasopharyngeal cancer and other factors, the doctor may recommend one or more of the following treatment options:

• Chemotherapy - this treatment uses medications taken orally (by mouth) or intravenously (by vein) to destroy cancerous cells.
• Radiation therapy - during this treatment, your oncologist uses high-energy beams or rays to destroy cancerous cells. Radiation therapy may be used after you’ve undergone surgery to remove any cancerous cells that couldn’t be removed during surgery.
• Surgery - your oncologist may recommend a surgical procedure to remove the cancerous cells, along with a margin of healthy tissue. Depending on the extent of your nasopharyngeal cancer and the surgery needed to remove it, you may need to undergo reconstructive surgery.
• Targeted drug therapy - this treatment uses medications to attack specific abnormalities within cancerous cells, with the goal of destroying them.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.