Nasopharyngeal cancer occurs when cancer cells grow in the nasopharynx. This is the portion of your throat that’s just behind your nose and above the oropharynx, where food and drinks pass on their way to your stomach.

This type of head and neck cancer is rare and is less common in the United States compared to other parts of the world.

Keep reading to find out more about nasopharyngeal cancer, its symptoms, diagnosis, and treatments.

An infographic depicting a typical location for nasopharyngeal cancer.Share on Pinterest
Illustration by Jason Hoffman

Nasopharyngeal cancer is an atypical cancer type because it occurs at higher rates in Southeast Asia than compared to the rest of the world.

For example, doctors make an estimated 129,000 nasopharyngeal cancer diagnoses. Of those diagnosed, more than 70 percent live in South China and Southeast Asia.

Researchers have tried to pinpoint exactly why nasopharyngeal cancer occurs at higher rates in this geographic location. They’ve studied factors like diet, lifestyle habits, and genetics. Here are some of their current conclusions:

  • Diet. Nasopharyngeal cancer diagnosis rates have decreased over the past 3 decades. One possible explanation is a reduction in consumption of salted fish, which have compounds that may cause cancer.
  • Genetics. Studies regarding genetic variants have identified a connection between variations in the HLA gene grouping and risks for nasopharyngeal cancer.

Increasing age and a history of heavy drinking are other risk factors for nasopharyngeal cancer. However, about 50 percent of people with nasopharyngeal cancer in the United States are younger than age 55.

Rarely, the human papillomavirus (HPV) can also be a cause of nasopharyngeal cancer.

Nasopharyngeal cancer and the Epstein-Barr virus

Researchers have also found a connection between the Epstein-Barr virus (EBV) and increased nasopharyngeal cancer risk. EBV is a common human virus that can cause infectious mononucleosis (mono).

Latent, or nonactive, EBV may cause expansion or replication of tumor cells, which could initiate or worsen nasopharyngeal cancer risk.

EBV is a common virus, but nasopharyngeal cancer is not a common cancer. Even though there is a connection between the two conditions, it’s very difficult to avoid getting EBV, especially in childhood.

Researchers will likely continue to study how or why there is a connection between the two conditions.

Is nasopharyngeal cancer rare?

Nasopharyngeal cancer is very rare in the United States. According to the American Cancer Society (ACS), there is less than 1 person per 100,000 people who receive a diagnosis of nasopharyngeal cancer in the United States annually.

However, nasopharyngeal cancer is more common in those who live in South Asia, the Middle East, and North Africa. Diagnosis rates may be as high as 21 per 100,000 people in some areas of China.

Research is ongoing, but this appears to be due to the presence of certain gene combinations.

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Nasopharyngeal cancer can cause symptoms that include:

  • difficulty speaking
  • frequent nosebleeds
  • headaches
  • lump in the nose or neck
  • problems breathing
  • problems hearing
  • ringing in the ears
  • sore throat that does not seem to go away

If you experience these or other symptoms, talk with a doctor. They’ll be able to discuss treatments for your symptoms and run any needed tests for a diagnosis.

If a doctor diagnoses nasopharyngeal cancer, they will likely describe your cancer type by stage. Staging is a way that a doctor can describe your cancer that helps you and other members of your treatment team understand your cancer outlook.

The stages generally depend on a tumor’s size as well as if it has spread to surrounding tissues. The following is a brief explanation of nasopharyngeal cancer stages:

  • Stage 0. Doctors also call this stage “carcinoma in situ,” and it signifies when atypical cells occur in the nasopharynx lining. These cells could become cancerous but are not currently.
  • Stage 1. Stage 1 cancer is located in the nasopharynx only or could have potentially spread to the oropharynx or nasal cavity.
  • Stage 2. Stage 2 nasopharyngeal cancer means the cancer has spread to one or more lymph nodes on one or both sides of the neck.
  • Stage 3. Cancer has spread to one or more lymph nodes on both sides of the neck. The cancer may have also spread to the oropharynx or nasal cavity, the parapharyngeal space or nearby muscles, or the bones at the bottom of the skull. As a general rule, the lymph nodes are 6 centimeters (cm) or smaller at this stage.
  • Stage 4. Doctors divide stage 4 into stage 4A and stage 4B.
    • In stage 4A, the cancer has spread to the brain, cranial nerves, hypopharynx, salivary gland in front of the ear, or other locations in the face. The lymph nodes may now be larger than 6 cm in size.
    • In stage 4B, the cancer has spread beyond the lymph nodes in the neck to lymph nodes that are farther away, such as those in the lungs, armpit, or groin.

The later stages of nasopharyngeal cancer tend to be the most severe because they signify the cancer has progressed to other parts of the body as well.

Nasopharyngeal cancer symptoms can closely resemble other conditions, including viruses. However, if a doctor suspects your symptoms could be nasopharyngeal cancer, they’ll do some of the following to diagnose it:

  • Physical exam. A doctor will examine your head and neck, feeling for any enlarged lymph nodes in your neck or atypical characteristics of your mouth or tongue.
  • Blood samples. A doctor may order blood sample testing, which includes a complete blood count or blood chemistry study.
  • Imaging. A doctor may order an imaging scan, such as an MRI or CT scan. These will allow a doctor to visualize your head and neck to see if there are any tumors or atypical characteristics.
  • Biopsy. A doctor may take a tissue sample from your nasopharynx and test it for the presence of cancerous cells.

Other possible testing options for diagnosis include a hearing test or tests for the presence of EBV or HPV.

A doctor will consider multiple factors when determining treatments for nasopharyngeal cancer. These factors may include:

  • cancer’s staging, especially if the cancer has spread
  • tumor size
  • presence of EBV antibodies in the blood

The three most common nasopharyngeal cancer treatments include radiation, chemotherapy, and surgery.

When doctors treat stage 1 nasopharyngeal cancer, they may recommend radiation therapy as a treatment alone. Stage 2 cancers and higher usually involve the use of radiation therapy and chemotherapy.

Nasopharyngeal cancer treatments can have effects that impact a person’s quality of life. These include:

It’s important to talk with a doctor about ways to minimize these side effects.

As with many cancer types, the survival rate for nasopharyngeal cancer depends on the stage of your cancer. One way doctors describe this is by a 5-year relative survival rate. This is the rate of people with the cancer type who live 5 years after receiving their diagnosis.

According to the ACS, the 5-year relative survival rates for nasopharyngeal cancer are:

  • Localized: 81 percent
  • Regional: 73 percent
  • Distant: 48 percent
  • All stages combined: 62 percent

The outlook for nasopharyngeal cancer has improved with time. These rates do not take into account the other factors that can affect your recovery, such as your age and overall health.

Living with nasopharyngeal cancer

Getting a nasopharyngeal cancer diagnosis can be life changing. It’s important to seek support whenever possible. Some of the ways you can enhance your quality of life if you have nasopharyngeal cancer include the following:

  • Consider attending a support group. Support groups can help you find others with cancer and share your concerns, joys, and coping methods. In addition to talking with your doctor about support groups in your area, you can view the National Cancer Institute’s list of organizations nationwide that offer support from an emotional as well as a financial perspective.
  • Learn about clinical trials. There are typically a number of clinical trials testing medications, treatment protocols, and other therapies related to nasopharyngeal cancer. Some common places to start looking include and the National Cancer Institute.
  • Ask about support services. Physical, occupational, and speech therapy services, among others, may help you cope with the side effects that can occur after nasopharyngeal cancer treatments. Ask your doctor if any of these services could benefit you.
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Nasopharyngeal cancer is a rare cancer type with unique risk factors, which include having a history of EBV or HPV.

If you have symptoms that could be indicative of nasopharyngeal cancer, talk with a doctor about diagnostic studies that may help confirm or rule out a diagnosis.

It’s best not to ignore signs and symptoms. Getting a diagnosis as early as possible can help improve your outlook.