Nasopharyngeal Cancer

Nasopharyngeal carcinoma (NPC) is a type of head and neck cancer. It begins in the nasopharynx, which is in the upper part of your throat, behind your nose. The nasopharynx connects your nostrils and throat, and allows the air you breath to pass freely from your nose and into your lungs. 

NPC is a rare form of cancer. It affects fewer than one in every 100,000 people in North America. It is most common in Southeast Asia. 

There are three types of NPC: 

  • Squamous cell carcinoma, which is the most common type in the U.S.
  • Non-keratinizing differentiated carcinoma
  • Undifferentiated carcinoma

Researchers aren’t completely sure what causes NPC. There are some risk factors, which include: 

  • Male
  • Under age 35
  • Diet high in salt-cured fish and meats
  • Family history of nasopharyngeal cancer
  • Exposure to Epstein-Barr Virus (EBV)

Treatment

There are many treatment options for nasopharyngeal cancer. Those may include:

  • Radiation therapy
  • Surgery
  • Chemotherapy
  • Biologic drugs

Your Penn State Cancer Institute doctor will discuss the best way to treat your cancer. Your plan will depend on the type and stage of your NPC. Family and personal medical history will also impact your treatment.

Radiation Therapy

High-energy radiation therapy kills cancer cells and stops new ones from growing. It is an effective treatment option for early stage NPC. Radiation is often used with other treatments, including chemotherapy. Side effects may include:

  • Fatigue
  • Skin changes
  • Dry mouth
  • Inflammation of mouth or throat lining

More serious complications are rare, but include:

  • Blindness
  • Brain stem injury
  • Death of healthy tissue

Recently, there have been advances in radiation therapy. Intensity-modulated radiotherapy (IMRT) targets the precise location of the tumor with high-dose radiation. This treatment limits damage to nearby tissue and has fewer side effects than traditional radiation. 

Surgery

Surgery may be an option if cancer has recurred or has spread to the neck lymph nodes. If all the cells are removed, surgery may cure NPC cancer. Not all patients with nasopharyngeal cancer will need surgery. The location, size and stage of the tumor will also determine if a patient is a good candidate for surgery. 

After nasopharyngeal surgery, patients may need reconstructive surgery. Your doctor will discuss your options with you. 

Chemotherapy

Chemotherapy is often as part of a treatment plan that also includes radiation, surgery or biologic drugs. Chemotherapy kills cancer cells with powerful drugs given through an IV. Cisplatin is the most common drug used for NPC. Side effects of Cisplatin may include:

  • Temporary hair loss
  • Nausea and vomiting
  • Diarrhea
  • Hiccups
  • Inability to taste food
  • Dry mouth

Your doctor will discuss which medications are best for your treatment and the side effects you may experience. 

Biologic Drugs

Biologic drugs, when used in combination with other treatments, can help your body fight and kill cancer cells. They target specific proteins that may encourage cancer cell growth. This is a newer area of treatment, and research is still being conducted. 
 

Care Team

You may see one or more of the following specialists for your cancer treatment.
Salah Almokadem, DO, MBChB Salah Almokadem, DO, MBChB Medical Oncologist View Researcher Profile
Melissa Boltz, DO Melissa Boltz, DO Surgeon View Researcher Profile
Karen Choi, MD Karen Choi, MD Surgeon View Researcher Profile
David Goldenberg, MD David Goldenberg, MD Surgeon View Researcher Profile
Neerav Goyal, MD, MPH Neerav Goyal, MD, MPH Surgeon View Researcher Profile
Diane Hershock, MD, PhD Diane Hershock, MD, PhD Medical Oncologist View Researcher Profile
Jessyka Lighthall, MD Jessyka Lighthall, MD Surgeon View Researcher Profile
Heath Mackley, MD Heath Mackley, MD Radiation Oncologist View Researcher Profile
Marc Rovito, MD Marc Rovito, MD Hematology/Oncologist View Researcher Profile
Brian Saunders, MD Brian Saunders, MD Surgeon View Researcher Profile
Guy Slonimsky Guy Slonimsky Surgeon
Leila Tchelebi, MD Leila Tchelebi, MD Radiation Oncologist View Researcher Profile

Locations

Penn State Cancer Institute

Penn State Cancer Institute

400 University Dr
Hershey, PA 17033

Phone: 717-531-6585
Penn State Health Medical Group - Nyes Road Specialties

Penn State Health Medical Group - Nyes Road Specialties

121 N Nyes Rd
Suite C
Harrisburg, PA 17112

Phone: 717-657-4045
Penn State Health Medical Group Camp Hill - Specialties

Penn State Health Medical Group Camp Hill - Specialties

3025 Market St
Entrance A
Camp Hill, PA 17011

Phone: 717-761-8900
Penn State Health Otolaryngology - Head and Neck Surgery/Pediatric Surgery

Penn State Health Otolaryngology - Head and Neck Surgery/Pediatric Surgery

200 Campus Dr
Suite 400 | Entrance 2
Hershey, PA 17033

Phone: 717-531-6822

Clinical Trials

Groups, Classes and Support

Support groups offer an opportunity to connect with other patients, caregivers and families. Learn more about support groups offered at Penn State Cancer Institute.

Prevention and Screening

There are no recommended screenings for nasopharyngeal cancer because it is a rare type of cancer. However, you should visit your primary provider at least once a year for a well visit and see a doctor immediately if you have any concerns about your overall health. 

You can also take steps to lower your risk of developing nasopharyngeal cancer:

  • Avoid tobacco.
  • Limit alcohol consumption.
  • Eat a well-balanced diet rich in fruits and vegetables.
  • Limit salt-cured fish and meats. This includes popular foods such as beef jerky, bacon, corned beef, ceviche, anchovies or dried cod.

Symptoms and Diagnosis

Nasopharyngeal cancer is a rare type of head and neck cancer. It starts in the upper part of your throat, behind the nose. This area is called the nasopharynx. The nasopharynx is precariously placed at the base of your skull, above the roof of your mouth. Your nostrils open into the nasopharynx.

Symptoms

Nasopharyngeal Cancer Symptoms

Common symptoms of NPC may include:

  • Stuffy nose
  • Sore throat
  • Recurring ear infections
  • Face pain or numbness
  • Difficulty speaking
  • Headache
  • Hearing loss
  • Ringing in the ears
  • Lump in neck or throat

Diagnosis

Diagnosing Nasopharyngeal Cancer

If you experience any of those symptoms or are concerned about your health, schedule an appointment with your primary care provider. Your provider will conduct a complete physical exam and check for swollen lymph nodes. After your exam, your provider may refer you to a head and neck specialist, called an otolaryngologist.

At that appointment, you will answer in-depth questions about your personal and family medical history and describe the severity of your symptoms, including how long you have been experiencing them.

Your doctor may also perform a nasopharyngoscopy during your visit. A local anesthesia will be used, usually a spray in your nostrils, to numb the feeling in your nose. Then, your doctor will insert a small, flexible and lighted tube into your nose or mouth. This allows your doctor to view the nasopharynx and identify any abnormalities.

A biopsy will be ordered if abnormalities are found. The biopsy may take place in the office or it may be done in an operating room under general anesthesia.

Imaging tests may also be used to help identify if the cancer has spread. Your doctor may order:

  • CT scan: CT stands for computed tomography. This test is also called a CAT scan. It takes detailed images of internal organs, bones, soft tissue and blood vessels. Your physician is able to use the cross-sectional images to confirm the presence, size and location of a tumor. 
  • MRI: A magnetic resonance imaging diagnostic test takes detailed pictures of inside your body. It is used to help diagnose cancer and to monitor the effectiveness of treatments. 
  • PET: The positron emission tomography is generally only used in later stage cancers to determine if cancer has spread to other organs. PET scans are sometimes combined with CT scans to provide a more precise and accurate diagnosis. 

Your doctor may also order a complete blood count (CBC) or EBV testing to confirm cancer.

Stages of Nasopharyngeal Cancer

Diagnostic tests and exams will identify if you have nasopharyngeal cancer. Test results will also give your doctor a clear picture of the type of cancer you have. Cancer is often described in stages. Stages describe the severity of cancer and help your doctor determine the best treatment plan for you.

There are four stages of cancer. Later stages (stages 3 and 4) indicate cancer has spread to other organs. Within each stage of cancer, there are often other classifications that describe the type of cancer you have.

Generally, stages of NPC include:

  • Stage 1: Early-stage nasopharyngeal cancer
  • Stage 2: Intermediate-stage nasopharyngeal cancer
  • Stage 3 and 4A: Advanced nasopharyngeal cancer
  • Stage 4B: Late-stage nasopharyngeal cancer, indicating cancer has spread throughout your body

Outlook & Prognosis

In general, patients do well with treatment. Individuals with stage 1 or stage 2 nasopharyngeal cancer show long-term survival rates of 90 percent. Stage 3 and 4A patients have a somewhat lower long-term survival rate, 83 percent and 71 percent, respectively. (Source)

The most severe stage of NPC is stage 4B. This stage indicates that cancer has spread to other body organs. Treatment focuses on quality of life and lifespan. This stage of cancer is not usually curable.

Nasopharyngeal Cancer

Nasopharyngeal carcinoma (NPC) is a type of head and neck cancer. It begins in the nasopharynx, which is in the upper part of your throat, behind your nose. The nasopharynx connects your nostrils and throat, and allows the air you breath to pass freely from your nose and into your lungs. 

NPC is a rare form of cancer. It affects fewer than one in every 100,000 people in North America. It is most common in Southeast Asia. 

There are three types of NPC: 

  • Squamous cell carcinoma, which is the most common type in the U.S.
  • Non-keratinizing differentiated carcinoma
  • Undifferentiated carcinoma

Researchers aren’t completely sure what causes NPC. There are some risk factors, which include: 

  • Male
  • Under age 35
  • Diet high in salt-cured fish and meats
  • Family history of nasopharyngeal cancer
  • Exposure to Epstein-Barr Virus (EBV)

There are many treatment options for nasopharyngeal cancer. Those may include:

  • Radiation therapy
  • Surgery
  • Chemotherapy
  • Biologic drugs

Your Penn State Cancer Institute doctor will discuss the best way to treat your cancer. Your plan will depend on the type and stage of your NPC. Family and personal medical history will also impact your treatment.

Radiation Therapy

High-energy radiation therapy kills cancer cells and stops new ones from growing. It is an effective treatment option for early stage NPC. Radiation is often used with other treatments, including chemotherapy. Side effects may include:

  • Fatigue
  • Skin changes
  • Dry mouth
  • Inflammation of mouth or throat lining

More serious complications are rare, but include:

  • Blindness
  • Brain stem injury
  • Death of healthy tissue

Recently, there have been advances in radiation therapy. Intensity-modulated radiotherapy (IMRT) targets the precise location of the tumor with high-dose radiation. This treatment limits damage to nearby tissue and has fewer side effects than traditional radiation. 

Surgery

Surgery may be an option if cancer has recurred or has spread to the neck lymph nodes. If all the cells are removed, surgery may cure NPC cancer. Not all patients with nasopharyngeal cancer will need surgery. The location, size and stage of the tumor will also determine if a patient is a good candidate for surgery. 

After nasopharyngeal surgery, patients may need reconstructive surgery. Your doctor will discuss your options with you. 

Chemotherapy

Chemotherapy is often as part of a treatment plan that also includes radiation, surgery or biologic drugs. Chemotherapy kills cancer cells with powerful drugs given through an IV. Cisplatin is the most common drug used for NPC. Side effects of Cisplatin may include:

  • Temporary hair loss
  • Nausea and vomiting
  • Diarrhea
  • Hiccups
  • Inability to taste food
  • Dry mouth

Your doctor will discuss which medications are best for your treatment and the side effects you may experience. 

Biologic Drugs

Biologic drugs, when used in combination with other treatments, can help your body fight and kill cancer cells. They target specific proteins that may encourage cancer cell growth. This is a newer area of treatment, and research is still being conducted. 
 

You may see one or more of the following specialists for your cancer treatment.
Salah Almokadem, DO, MBChB Salah Almokadem, DO, MBChB Medical Oncologist View Researcher Profile
Melissa Boltz, DO Melissa Boltz, DO Surgeon View Researcher Profile
Karen Choi, MD Karen Choi, MD Surgeon View Researcher Profile
David Goldenberg, MD David Goldenberg, MD Surgeon View Researcher Profile
Neerav Goyal, MD, MPH Neerav Goyal, MD, MPH Surgeon View Researcher Profile
Diane Hershock, MD, PhD Diane Hershock, MD, PhD Medical Oncologist View Researcher Profile
Jessyka Lighthall, MD Jessyka Lighthall, MD Surgeon View Researcher Profile
Heath Mackley, MD Heath Mackley, MD Radiation Oncologist View Researcher Profile
Marc Rovito, MD Marc Rovito, MD Hematology/Oncologist View Researcher Profile
Brian Saunders, MD Brian Saunders, MD Surgeon View Researcher Profile
Guy Slonimsky Guy Slonimsky Surgeon
Leila Tchelebi, MD Leila Tchelebi, MD Radiation Oncologist View Researcher Profile
Penn State Cancer Institute

Penn State Cancer Institute

400 University Dr
Hershey, PA 17033

Phone: 717-531-6585
Penn State Health Medical Group - Nyes Road Specialties

Penn State Health Medical Group - Nyes Road Specialties

121 N Nyes Rd
Suite C
Harrisburg, PA 17112

Phone: 717-657-4045
Penn State Health Medical Group Camp Hill - Specialties

Penn State Health Medical Group Camp Hill - Specialties

3025 Market St
Entrance A
Camp Hill, PA 17011

Phone: 717-761-8900
Penn State Health Otolaryngology - Head and Neck Surgery/Pediatric Surgery

Penn State Health Otolaryngology - Head and Neck Surgery/Pediatric Surgery

200 Campus Dr
Suite 400 | Entrance 2
Hershey, PA 17033

Phone: 717-531-6822
Support groups offer an opportunity to connect with other patients, caregivers and families. Learn more about support groups offered at Penn State Cancer Institute.

There are no recommended screenings for nasopharyngeal cancer because it is a rare type of cancer. However, you should visit your primary provider at least once a year for a well visit and see a doctor immediately if you have any concerns about your overall health. 

You can also take steps to lower your risk of developing nasopharyngeal cancer:

  • Avoid tobacco.
  • Limit alcohol consumption.
  • Eat a well-balanced diet rich in fruits and vegetables.
  • Limit salt-cured fish and meats. This includes popular foods such as beef jerky, bacon, corned beef, ceviche, anchovies or dried cod.

Nasopharyngeal cancer is a rare type of head and neck cancer. It starts in the upper part of your throat, behind the nose. This area is called the nasopharynx. The nasopharynx is precariously placed at the base of your skull, above the roof of your mouth. Your nostrils open into the nasopharynx.

Symptoms

Nasopharyngeal Cancer Symptoms

Common symptoms of NPC may include:

  • Stuffy nose
  • Sore throat
  • Recurring ear infections
  • Face pain or numbness
  • Difficulty speaking
  • Headache
  • Hearing loss
  • Ringing in the ears
  • Lump in neck or throat

Diagnosis

Diagnosing Nasopharyngeal Cancer

If you experience any of those symptoms or are concerned about your health, schedule an appointment with your primary care provider. Your provider will conduct a complete physical exam and check for swollen lymph nodes. After your exam, your provider may refer you to a head and neck specialist, called an otolaryngologist.

At that appointment, you will answer in-depth questions about your personal and family medical history and describe the severity of your symptoms, including how long you have been experiencing them.

Your doctor may also perform a nasopharyngoscopy during your visit. A local anesthesia will be used, usually a spray in your nostrils, to numb the feeling in your nose. Then, your doctor will insert a small, flexible and lighted tube into your nose or mouth. This allows your doctor to view the nasopharynx and identify any abnormalities.

A biopsy will be ordered if abnormalities are found. The biopsy may take place in the office or it may be done in an operating room under general anesthesia.

Imaging tests may also be used to help identify if the cancer has spread. Your doctor may order:

  • CT scan: CT stands for computed tomography. This test is also called a CAT scan. It takes detailed images of internal organs, bones, soft tissue and blood vessels. Your physician is able to use the cross-sectional images to confirm the presence, size and location of a tumor. 
  • MRI: A magnetic resonance imaging diagnostic test takes detailed pictures of inside your body. It is used to help diagnose cancer and to monitor the effectiveness of treatments. 
  • PET: The positron emission tomography is generally only used in later stage cancers to determine if cancer has spread to other organs. PET scans are sometimes combined with CT scans to provide a more precise and accurate diagnosis. 

Your doctor may also order a complete blood count (CBC) or EBV testing to confirm cancer.

Stages of Nasopharyngeal Cancer

Diagnostic tests and exams will identify if you have nasopharyngeal cancer. Test results will also give your doctor a clear picture of the type of cancer you have. Cancer is often described in stages. Stages describe the severity of cancer and help your doctor determine the best treatment plan for you.

There are four stages of cancer. Later stages (stages 3 and 4) indicate cancer has spread to other organs. Within each stage of cancer, there are often other classifications that describe the type of cancer you have.

Generally, stages of NPC include:

  • Stage 1: Early-stage nasopharyngeal cancer
  • Stage 2: Intermediate-stage nasopharyngeal cancer
  • Stage 3 and 4A: Advanced nasopharyngeal cancer
  • Stage 4B: Late-stage nasopharyngeal cancer, indicating cancer has spread throughout your body

Outlook & Prognosis

In general, patients do well with treatment. Individuals with stage 1 or stage 2 nasopharyngeal cancer show long-term survival rates of 90 percent. Stage 3 and 4A patients have a somewhat lower long-term survival rate, 83 percent and 71 percent, respectively. (Source)

The most severe stage of NPC is stage 4B. This stage indicates that cancer has spread to other body organs. Treatment focuses on quality of life and lifespan. This stage of cancer is not usually curable.