Nasopharyngeal cancer

Overview

Nasopharyngeal cancer develops in the nasopharynx, a box-shaped chamber that sits at the top of the throat, behind the nasal passages and above the soft part of the mouth’s roof. Air passes through the nasopharynx before heading down the throat and trachea.

There are three types of nasopharyngeal cancer:

  • Nasopharyngeal Carcinoma (NPC) - The most common type of nasopharyngeal cancer, and starts in the epithelial cells that line the skin and some organs and glands
  • Lymphomas - Develop in immune system cells called lymphocytes
  • Adenocarcinoma and Adenoid Cystic Carcinoma - Occasionally found in the nasopharynx’s salivary glands

Our approach

The multidisciplinary team meets each week to share ideas about cases, bringing together experts in different specialties from across the health system. Doing so ensures that patients receive the most useful, appropriate and up-to-date treatments. While an ear, nose and throat specialist (otolaryngologist, or ENT) will lead care, the multidisciplinary team also includes other Northwell Health experts.

Northwell Health provides the highest level of care without making patients travel too far by offering state-of-the-art diagnostic tools and techniques for nasopharyngeal cancer at several locations throughout New York and Long Island.

Risk factors

While the exact causes of nasopharyngeal cancer remain unknown, several risk factors have been identified:

  • Ethnicity - The disease occurs most frequently in people of Asian (particularly Chinese) or Pacific Islander descent, followed by Native Americans, native Alaskans, African Americans, whites and Hispanics/Latinos.
  • Gender - Twice as many men as women get nasopharyngeal cancer.
  • Heavy drinking
  • Diet - Eating a diet high in salt-cured meat and fish has been tied to the disease overseas.
  • Genetics - Certain inherited tissue types have been linked to nasopharyngeal cancer.

The disease occasionally shows up in several members of the same family, for reasons that aren’t yet clear.

Epstein-Barr Virus (EBV) and Nasopharyngeal Carcinoma

Epstein-Barr Virus (EBV) is a herpes virus that causes mononucleosis (mono). Lingering, dormant infections seem to play an occasional role in the later development of nasopharyngeal carcinoma. The exact link has not yet been determined, though, and the virus is probably not the sole cause of the disease — while the virus is very common, nasopharyngeal cancer is rare.

Symptoms

Nasopharyngeal cancer symptoms overlap with other conditions and should lead to caution, not alarm. A physician can diagnose the cause of any of these symptoms:

  • 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

Specialists use exams and tests to diagnose nasopharyngeal cancer, including:  

  • Head and neck exam - Feeling for swollen lymph nodes
  • Hearing test - Checking for ability to hear soft and loud sounds, as well as low and high pitches
  • Speaking and swallowing tests 
  • Neurological exam - Asking questions and running tests to check brain, spinal cord and nerve function, as well as mental status, muscles, coordination, walking, five senses and reflexes
  • Complete blood count - Drawing blood to check number of platelets, white and red blood cells, and hemoglobin
  • Biopsy - Inserting a scope through the nose or mouth, then removing cells or tissue for examination with a microscope
  • CT (CAT) scan - Putting together X-rays from different angles, with dye sometimes injected into veins or swallowed
  • PET scan - Injecting glucose (sugar) into the veins and using a rotating scanner to look for malignant cells
  • MRI - Using a magnet, radio waves and a computer to take detailed pictures of the inside of the body
  • Epstein-Barr virus (EBV) test - Checking for infection by looking for antibodies to the virus and virus DNA markers, including Epstein-Barr virus and other risk factors.

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