Nasopharyngeal Cancer Overview

Nasopharyngeal cancer originates in the nasopharynx, a hollow canal that begins at the back of the nose and ends at the esophagus. Although cancer can form in several cell types, it most often occurs in the squamous and epithelial cells that line the nasopharynx. Although some nasopharyngeal tumors are benign (noncancerous), most are cancerous and can spread to nearby lymph nodes and metastasize to other parts of the body.

Nasopharyngeal cancer is relatively uncommon in the United States, accounting for less than 1% of all cancer diagnoses. This specific type of head and neck cancer is more prevalent in other regions, including southeast Asia, southern China and parts of northern Africa.

What causes nasopharyngeal cancer?

The exact cause of nasopharyngeal cancer is not fully understood. Scientists believe it results from cellular DNA changes that disrupt normal cellular function and promote uncontrolled cell growth, leading to tumor formation.

What are the risk factors for nasopharyngeal cancer?

Known risk factors for nasopharyngeal cancer include:

• Epstein-Barr virus (EBV) infection – EBV can cause genetic changes in the cells of the nasopharynx and is strongly associated with nasopharyngeal cancer.
• Family history – A family history of nasopharyngeal cancer can increase the risk, which suggests a genetic predisposition.
• Gender and age – Nasopharyngeal cancer is most frequently diagnosed in men between the ages of 40 and 60.
• Unhealthy diet – Excessive consumption of preserved foods, such as salted meats and fish, has been linked to a higher risk of developing nasopharyngeal cancer, possibly due to the carcinogenic substances found in these foods.
• Tobacco and alcohol use – Smoking and heavy drinking significantly increase the risk of nasopharyngeal cancer, especially when combined.
• Occupational exposures – Prolonged exposure to certain chemicals or dust, commonly encountered in the wood, textile and rubber industries, can increase the risk of developing nasopharyngeal cancer.

What are the signs and symptoms of nasopharyngeal cancer?

The warning signs of nasopharyngeal cancer can vary and may initially resemble those of a less serious respiratory illness, such as the common cold or flu, making early detection challenging. Possible symptoms include:

• Neck lump – Lymph node swelling or a painless mass that can be felt in the neck
• Nasal symptoms – Persistent nasal congestion or recurrent nosebleeds
• Throat symptoms – Sore throat, difficulty swallowing or a sensation of something stuck in the throat
• Ear symptoms – Hearing loss, ringing in the ears (tinnitus) or a feeling of fullness in the ear
• Headache – Recurrent or persistent headaches, sometimes with facial pain or numbness
• Vision changes – Double vision or other visual disturbances caused by the tumor pressing on a nerve
• Fatigue and weight loss – General fatigue and unexplained weight loss, especially in advanced cases

How is nasopharyngeal cancer diagnosed?

The diagnostic process for nasopharyngeal cancer usually involves a combination of clinical evaluation, imaging and tissue sampling. After reviewing the patient’s medical history, risk factors and symptoms, the physician will examine the neck, throat and nasal passages to check for swollen lymph nodes, masses and other abnormalities. The physician may also perform a nasopharyngoscopy, which involves inserting a flexible, lighted scope through the nose to visualize the interior of the nose, throat and voice box.

If any abnormalities are found, the physician will typically order follow-up imaging tests, such as:

• Computed tomography (CT) – A CT scan can create detailed images of the nasopharynx and surrounding areas, which can help the physician identify tumors, assess their size and determine if the cancer has spread.
• Magnetic resonance imaging (MRI) – An MRI scan can provide detailed images of the soft tissues in the nasopharynx, helping the physician evaluate the location, size and spread of a tumor.
• Positron emission tomography (PET) – A PET scan can detect areas of increased metabolic activity in the body, such as tumor sites, which can help the physician identify the spread of nasopharyngeal cancer to lymph nodes and distant organs.

A definitive diagnosis of nasopharyngeal cancer requires a biopsy, which involves taking a sample of suspicious tissue from the nasopharynx or affected lymph nodes. The sample will be sent to a laboratory for microscopic examination by a pathologist, who can identify cancerous cells.

Blood testing may also be used during the diagnostic process for nasopharyngeal cancer, which may be associated with elevated levels of EBV antibodies in the bloodstream. General blood work can also help the physician assess the patient’s overall health and plan treatment.

How is nasopharyngeal cancer treated?

Treatment for nasopharyngeal cancer typically involves a combination of therapies tailored to the stage of the tumor and the overall health of the patient. Options may include:

• Radiation therapy – Often the primary treatment for early-stage nasopharyngeal cancer, intensity-modulated radiation therapy (IMRT) can precisely target the tumor while minimizing exposure to surrounding healthy tissues.
• Chemotherapy – Chemo may be used in combination with radiation therapy (chemoradiation) for heightened effectiveness in treating advanced nasopharyngeal cancer. Alternatively, it may be administered before or after radiation therapy to shrink the tumor or reduce the risk of recurrence.
• Targeted therapy – Medications such as cetuximab may be used to block specific proteins that promote nasopharyngeal cancer growth.
• Surgery – Because the nasopharynx is a difficult area for a surgeon to access, surgical treatment is typically reserved for cases in which radiation therapy and chemotherapy are insufficient.
• Supportive care – Pain management, nutritional support and rehabilitative therapy are integral to maintaining the patient’s quality of life during and after nasopharyngeal cancer treatment.

Benefit from world-class care at Moffitt Cancer Center

Whether you have nasopharyngeal cancer symptoms or a confirmed diagnosis, you can confidently entrust your care to Moffitt. A nationally recognized leader in cancer treatment, Moffitt offers cutting-edge therapies and a robust portfolio of clinical trials. The multispecialty team in our Head and Neck Cancer Program collaboratively develops an individualized plan for each patient, incorporating advanced treatment techniques with comprehensive support services. Additionally, our focus on innovative research ensures that our patients receive the most effective and up-to-date care in a compassionate environment.

If you would like to learn more about nasopharyngeal cancer, you can request an appointment with a specialist in our Head and Neck Cancer Program by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.