Nasopharyngeal cancer is a type of head and neck cancer that occurs when cells in the nasopharynx, the upper part of the throat behind the nose and near the base of the skull, grow out of control.
Most nasopharyngeal cancers are nasopharyngeal carcinoma. There are three types of nasopharyngeal cancer:
- Non-keratinizing undifferentiated carcinoma (the most common type in the U.S.)
- Non-keratinizing differentiated carcinoma
- Keratinizing squamous cell carcinoma
What Are Symptoms of Nasopharyngeal Carcinoma?
Symptoms of nasopharyngeal carcinoma include:
- A lump or mass in the neck
- Hearing loss
- Ringing in the ear (tinnitus)
- Ear pain
- Feeling of fullness in the ear (especially on one side only)
- Recurrent ear infections (more common in children)
- Nasal blockage or stuffiness
- Nosebleeds
- Headaches
- Facial pain or numbness
- Trouble opening the mouth
- Blurred or double vision
- Trouble breathing or talking
What Causes Nasopharyngeal Carcinoma?
The cause of most cases of nasopharyngeal carcinoma is unknown.
Risk factors for developing nasopharyngeal carcinoma include:
- Gender
- Occurs about twice as often in males as in females
- Ethnicity and where you live
- Most common in southern China (including Hong Kong), Vietnam, Singapore, Malaysia, the Philippines, Northwest Canada, and Greenland
- In the U.S., it is most common in Asian and Pacific Islanders (particularly Chinese Americans), Native American and Alaskan natives, African Americans, whites, and Hispanics/Latinos
- Diet
- Infection with the Epstein-Barr virus
- Family history
- Smoking
- Heavy alcohol use
- Workplace exposure to formaldehyde (possible; link is not clear)
How Is Nasopharyngeal Carcinoma Diagnosed?
In addition to a medical examination and patient history, tests used to diagnose nasopharyngeal carcinoma include:
- Biopsy
- Endoscopic biopsy
- Fine needle aspiration (FNA) biopsy
- Imaging tests
- Chest X-ray
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI) scan
- Positron emission tomography (PET) scan
- Blood tests
- Complete blood counts (CBC)
- Blood chemistry
- Epstein-Barr virus (EBV) DNA levels
What Is the Treatment for Nasopharyngeal Carcinoma?
Treatment for nasopharyngeal carcinoma includes:
- Surgery
- Surgical removal of the tumor
- Surgical removal of lymph nodes
- Partial or selective neck dissection to remove only lymph nodes closest to the tumor and most likely to have cancer spread
- Modified radical neck dissection to remove lymph nodes on one side of the neck between the jaw bone and collarbone, along with some muscle and nerve tissue
- Radical or comprehensive neck dissection to remove nearly all lymph nodes on one side and even more muscles, nerves, and veins
- Radiation therapy
- External beam radiation therapy (EBRT)
- Intensity-modulated radiation therapy (IMRT)
- Stereotactic radiosurgery
- Brachytherapy (internal radiation) (not often used)
- External beam radiation therapy (EBRT)
- Chemotherapy: may involve one or more of the following
- Cisplatin (Platinol)
- 5-fluorouracil (5-FU)
- Carboplatin (Paraplatin)
- Doxorubicin (Adriamycin)
- Epirubicin (Ellence)
- Paclitaxel (Taxol)
- Docetaxel (Taxotere)
- Gemcitabine (Gemzar)
- Bleomycin (Bleo 15k, Blenoxane)
- Methotrexate (Trexall, Otrexup, Xatmep)
- Targeted therapy
- Cetuximab (Erbitux)
- Immunotherapy
- Immune checkpoint inhibitors
- Pembrolizumab (Keytruda)
- Nivolumab (Opdivo)
- Immune checkpoint inhibitors
What Is the Life Expectancy for Nasopharyngeal Carcinoma?
Life expectancy for nasopharyngeal cancer is often expressed in 5-year survival rates, that is, how many people will be alive 5 years after diagnosis.
Nasopharyngeal cancer 5-year survival rates:
- Localized (no sign the cancer has spread outside the nasopharynx): 82%
- Regional (cancer has spread outside the nasopharynx to nearby structures or lymph nodes): 73%
- Distant (cancer has spread to distant parts of the body, such as the lungs or liver): 48%
