Skip to main content
 

What is Nasopharyngeal Cancer?

The Nasopharynx

The nasopharynx is the upper part of the throat (pharynx) that lies behind the nose. It is a box-like chamber about one and a half inches on each edge. It lies just above the soft part of the roof of the mouth (soft palate) and just in back of the entrance into the nasal passages.

Several types of tumors can develop in the nasopharynx. Some of these tumors are benign but others are malignant. Benign tumors of the nasopharynx are fairly rare and tend to occur in children and young adults. They include tumors or malformations of the vascular (blood-carrying) system, such as angiofibromas and hemangiomas, and benign tumors of the minor salivary glands that are found within the nasopharynx. Treatment of these tumors (if it is needed) is different from that for cancerous nasopharyngeal tumors.

Malignant Nasopharyngeal Tumors

Malignant tumors can invade surrounding tissue and spread to other parts of the body.

Following are the most common malignant nasopharyngeal tumors:

Nasopharyngeal Carcinoma - This is the most common malignant tumor of the nasopharynx. A carcinoma is a cancer that starts in epithelial cells -- the cells lining the internal and external surfaces of the body. This tumor has three types: The Keratinizing Squamous Cell Carcinoma, the Non-Keratinizing Differentiated Carcinoma and the Undifferentiated Carcinoma.

These types all start from the same cell type – the epithelial cells that cover the surface lining of the nasopharynx. The treatment is also usually the same for all types of nasopharyngeal cancer.

Lymphoma - Lymphomas can sometimes start in the nasopharynx. They are cancers of immune system cells called lymphocytes, cells that are normally found in the nasopharynx.

Adenocarcinoma and Adenoid Cystic Carcinoma - These are cancers that can develop in the minor salivary glands found in the nasopharynx.

Risk Factors

Research is increasing regarding what we know about nasopharyngeal cancer. Scientists are learning more about its causes. Following are common risk factors for the disease:

  • Chinese or Asian ancestry
  • Exposure to the Epstein-Barr virus (The Epstein-Barr virus has been associated with certain cancers, including nasopharyngeal cancer and some lymphomas.)
  • Drinking large amounts of alcohol

Signs and Symptoms

These and other symptoms may be caused by nasopharyngeal cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

  • A lump in the nose or neck
  • A sore throat
  • Trouble breathing or speaking
  • Nosebleeds
  • Trouble hearing
  • Pain or ringing in the ear
  • Headaches 

Diagnosis

If a patient has symptoms that could be nasopharyngeal cancer, the doctor will test for fever and high blood pressure and check general signs of health. The patient will likely have one or more of the following tests:

Physical Exam

An exam in which the doctor feels for swollen lymph nodes in the neck and looks down the throat with a small, long-handled mirror to check for abnormal areas.

Nasoscopy

A procedure to look inside the nose for abnormal areas. A nasoscope is inserted through the nose. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.

Neurological Exam

A procedure to look inside the nose for abnormal areas. A nasoscope is inserted through the nose. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.

X-Rays

An x-ray of the skull and organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

MRI

A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called Nuclear Magnetic Resonance Imaging (NMRI).

CT Scan

A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

PET Scan

A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. PET scans may be used to find nasopharyngeal cancers that have spread to the bone.

Laboratory Tests

Medical procedures that test samples of tissue, blood, urine, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or monitor the disease over time.

Biopsy

The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.

Stages

If nasophyaryngeal cancer is diagnosed, the doctor needs to know the stage, or extent, of the disease to plan the best treatment. Staging is a careful attempt to find out whether the cancer has spread, and if so, to what parts of the body.

Stage 0 (Carcinoma in Situ) - In stage 0, abnormal cells are found in the lining of the nasopharynx. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage I - In stage I, cancer has formed and is found in the nasopharynx only or has spread from the nasopharynx to the oropharynx and/or to the nasal cavity.

Stage II - In stage II, the cancer is found in the nasopharynx only or has spread from the nasopharynx to the oropharynx and/or to the nasal cavity. Cancer has spread to one or more lymph nodes on one side of the neck and/or to lymph nodes behind the pharynx. The affected lymph nodes are six centimeters or smaller. Or, the cancer is found in the parapharyngeal space. Cancer may have spread to one or more lymph nodes on one side of the neck and/or to lymph nodes behind the pharynx. The affected lymph nodes are six centimeters or smaller.

Stage III - In stage III, the cancer is found in the nasopharynx only or has spread from the nasopharynx to the oropharynx and/or to the nasal cavity. Cancer has spread to one or more lymph nodes on both sides of the neck. The affected lymph nodes are six centimeters or smaller or found in the parapharyngeal space. Cancer has spread to one or more lymph nodes on both sides of the neck. The affected lymph nodes are six centimeters or smaller or it has spread to nearby bones or sinuses. Cancer may have spread to one or more lymph nodes on one or both sides of the neck and/or to lymph nodes behind the pharynx. The affected lymph nodes are six centimeters or smaller.

Stage IV - Stage IV nasopharyngeal cancer is divided into stages IVA, IVB, and IVC.

  • Stage IVA: Cancer has spread beyond the nasopharynx and may have spread to the cranial nerves, the hypopharynx (bottom part of the throat), areas in and around the side of the skull or jawbone, and/or the bone around the eye. Cancer may also have spread to one or more lymph nodes on one or both sides of the neck and/or to lymph nodes behind the pharynx. The affected lymph nodes are six centimeters or smaller. 
  • Stage IVB: Cancer has spread to lymph nodes between the collarbone and the top of the shoulder and/or the affected lymph nodes are larger than six centimeters. 
  • Stage IVC: Cancer has spread beyond nearby lymph nodes to other parts of the body. 

Knowing the stage assists the doctor in determining a prognosis. It also better helps you understand the care and treatment that will be required.

Treatment and Side Effects Management

Different types of treatment are available for patients with nasopharngeal cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. (A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer)

Your treatment options depend on the stage of cancer, your overall health and your preferences about treatment. In metastatic disease, the location and extent of the cancer is also an important consideration.

You do not have to rush to make a decision, so consider the options carefully. Ask questions if you do not understand any aspect of treatment or the terms your doctors are using. Research shows that cancer survivors of all educational levels and backgrounds can have a hard time communicating with their health care team. One of the best ways to improve communication with your health care team is to prepare your visits so that you can best make use of the time.

A treatment plan is a way to deal with both the short and long term goals of managing your nasopharyngeal cancer. There are several treatment options, depending on the cancer stage and the patient’s age and general health. Patients have time for second opinions and to talk through all of their options with their doctors and develop a treatment plan that best fits their needs.

Learn More About Treatment & Side Effects Management