Nasopharyngeal Cancer
About
Cancer of the nasopharynx is also called nasopharyngeal cancer. The nasopharynx is the upper portion of the pharynx and it lies just above the soft palate in the mouth. The nasopharynx is an important passageway that allows air to travel from the nose to the windpipe and food to travel into the foodpipe. This type of cancer can also occur in the pharyngeal tonsils, commonly called the adenoids, which are located on the back wall of the nasopharynx.
People typically notice a problem because of nosebleeds, hearing loss associated with problems in the Eustacian tubes, or a lump in the nose or neck. There are also a number of other symptoms associated with this type of cancer. Remember that the symptoms you experience might also be caused by other medical conditions so it important for you to consult a physician to confirm a diagnosis.
It’s normal for you to wonder how you got cancer of the nasopharynx. Although we still don’t have all the answers, we do know that there are risk factors associated with people developing this cancer, especially infection by Epstein Barr Virus, ancestry or ethnicity, sex, diet, personal history, tobacco use and certain environmental exposures. Remember that there is no single cause for developing this type of cancer.
Nasopharyngeal cancers are different from other head and neck cancers in that they occur most often in people of particular ethnicity, such as Orientals from Southern China, Aboriginals, and Mediterraneans from Portugal or Italy. Nasopharyngeal cancers represent 20% of all cancers seen in Hong Kong, but only amount to about 70 tumors/year in North America.
Screening and Diagnosis
You may need to undergo a number of tests for the screening and diagnosis, which will help your team to assess the stage, or severity of the cancer. Your head and neck specialist will first perform a physical examination to look for signs and symptoms of cancer, and then may order one or more of the most commonly used tests such endoscopy, panendoscopy, and x-rays.
Learn about some of the other tests commonly used for head and neck cancers
Treatment
Small Tumors
Because nasopharyngeal cancers grow in a location that is very difficult to reach by surgery, they are almost exclusively treated using chemotherapy and radiation. This approach effectively destroys small nasopharyngeal cancers that have not yet spread to the lymph nodes and at the same time preserves the role of the nasopharynx in speaking, swallowing, and breathing.
Large Tumors
When nasopharyngeal tumors are large or when multiple lymph nodes are also involved, a combination of chemotherapy and radiation is given first. Following that treatment, post-adjuvant chemotherapy (a second dose after the first treatment) is given to help eliminate any residual tumor and minimize its spread.
Because surgery is potentially debilitating, it is a treatment reserved for recurrent nasopharyngeal cancer. In such cases, surgery is used to remove the tumors and diseased lymph nodes that have not responded to prior chemotherapy or radiation treatment.
If nasopharyngeal cancer returns, the majority of patients are retreated with a combination of chemotherapy and radiation. A small subset of patients may also be offered surgery to treat limited tumor recurrences.
Follow-Up Care
Follow-up care for cancer of the nasopharynx is critical and you will need to see your physician on a regular basis. You may also need ongoing therapy for speaking and swallowing problems.
Many members of the multidisciplinary treatment team will work with you through this challenging process, and can offer continuing care and guidance about the services and resources that may be of assistance during your recovery or palliative care.