Nasopharyngeal cancer is relatively rare and accounts for about 2 percent of all head and neck cancers in the United States. It begins in the nasopharynx, the area just behind the nose where the adenoids are located. Different types of tumors can develop because the nasopharynx contains several types of tissue containing many types of cells. Nasopharyngeal carcinoma is the most common, but there are three subtypes: keratinizing squamous cell carcinoma, non-keratinizing squamous cell carcinoma, and undifferentiated carcinoma. Cancers found in the various tissues of the nasopharynx also include lymphoma and adenocarcinoma.
The Cancer Center's Division of Head and Neck Oncology comprises board-certified otoaryngologists who are highly skilled in the diagnosis, treatment, and management of all types of cancers that affect the head and neck. They work closely with medical oncologists, radiation oncologists and other specialists to provide optimal care for patients with nasopharyngeal cancer.
Your doctor may use several different approaches to diagnose nasopharyngeal cancer. The Cancer Center offers the following:
- nasopharyngoscopy (a test using mirrors, light, and fiberoptic scopes inserted through the mouth and nose)
- CT scan
- chest X-ray (to see if the cancer has spread into the lungs)
- radionuclide bone scan (to see if the cancer has spread into the bones)
- fine needle aspiration
- bone marrow aspiration
A major risk factor for all head and neck cancers is cigarette smoking. Nasopharyngeal cancer most often affects people between the ages of 30 and 50 and is found in twice as many men as women. Research suggests that Epstein-Barr virus infection, which causes infectious mononucleosis, could be linked to nasopharyngeal cancer. Studies have found that genetic factors, such as inherited tissue type, can be a risk factor. Another risk factor is a diet high in salt-cured fish and meat, which is common in Asia, northern Africa, and the Arctic, where nasopharyngeal cancer is more common.
Symptoms of nasopharyngeal cancer include a lump or mass in the neck area; hearing loss, especially on one side; ear pain; nasal blockage; nosebleeds; difficulty opening the mouth; and blurred vision.
Three-dimensional conformal radiation therapy is the main form of treatment for nasopharyngeal cancer. It may be combined with high-dose-rate brachytherapy (the insertion of small rice-like tubes containing radiation into the tumor). Surgery is not usually recommended because the area is not easy to reach and is close to vital blood vessels and nerves. A neck dissection (to remove lymph glands in the neck if the cancer has spread to them) may be part of the treatment plan. Chemotherapy may be used in combination with three-dimensional conformal radiation therapy for patients with cancer that has metastasized.