Nasopharyngeal carcinoma

A type of cancer originating in the nasopharynx

Diagram showing stage T2 nasopharyngeal cancer.

Micrograph showing nasopharyngeal carcinoma positive for Epstein-Barr virus.

Nasopharyngeal carcinoma (NPC) is a type of cancer that originates in the nasopharynx, which is located behind the nose and above the back of the throat. It is a rare form of cancer in most parts of the world but is more common in certain regions, such as Southeast Asia, North Africa, and the Arctic.

Epidemiology

Nasopharyngeal carcinoma is particularly prevalent in southern China, especially in the Guangdong province, as well as in Hong Kong, Taiwan, and other parts of Southeast Asia. It is also more common among the Inuit populations of Alaska and Canada, and among certain ethnic groups in North Africa and the Middle East. The incidence of NPC is higher in males than in females.

Risk Factors

Several risk factors have been associated with nasopharyngeal carcinoma:

• Epstein-Barr virus (EBV) infection: There is a strong association between EBV and NPC. The virus is found in the cancer cells of most patients with NPC.
• Genetic predisposition: Family history of NPC increases the risk, suggesting a genetic component.
• Dietary factors: Consumption of salt-cured fish and meats, which contain high levels of nitrosamines, is linked to a higher risk of NPC.
• Environmental factors: Exposure to certain chemicals and dusts, such as formaldehyde and wood dust, may increase the risk.

Symptoms

The symptoms of nasopharyngeal carcinoma can vary but often include:

• A lump in the neck due to swollen lymph nodes
• Nasal congestion or blockage
• Nosebleeds
• Hearing loss or ringing in the ears
• Headaches
• Facial pain or numbness

Diagnosis

Diagnosis of nasopharyngeal carcinoma typically involves a combination of:

• Physical examination: Checking for lumps in the neck and other symptoms.
• Endoscopy: Using a thin, flexible tube with a camera to view the nasopharynx.
• Biopsy: Taking a tissue sample from the nasopharynx for examination under a microscope.
• Imaging tests: Such as CT scan, MRI, and PET-CT scan to determine the extent of the cancer.

PET-CT scan showing FDG uptake in nasopharyngeal cancer

Staging

Nasopharyngeal carcinoma is staged based on the size of the tumor, the involvement of lymph nodes, and the presence of metastasis. The stages range from I (localized) to IV (advanced).

Treatment

The treatment of nasopharyngeal carcinoma often involves a combination of therapies:

• Radiation therapy: The primary treatment for NPC, often combined with chemotherapy.
• Chemotherapy: Used in conjunction with radiation therapy, especially for advanced stages.
• Surgery: Rarely used as the primary treatment but may be considered for recurrent cases.

Prognosis

The prognosis for nasopharyngeal carcinoma depends on the stage at diagnosis and the response to treatment. Early-stage NPC has a better prognosis, while advanced stages may have a poorer outcome.

Related pages

• Epstein-Barr virus
• Radiation therapy
• Chemotherapy
• Cancer staging