Nasopharyngeal Cancer

This page provides essential information on nasopharyngeal cancer, a type of head and neck cancer, covering its symptoms, causes, diagnostic methods, and treatment options. The content has been developed with guidance from Dr. Sandeep Nayak, an internationally acclaimed surgical oncologist from India known for pioneering innovative surgical techniques, along with contributions from Dr. Athira Ramakrishan, Dr. Abhilasha Sadhoo, and Dr. Ameenuddin Khan, who are accomplished specialists in the field.

Nasopharyngeal cancer is a rare type of head and neck cancer that develops in the nasopharynx, the upper part of the throat, located behind the nose and above the roof of the mouth. It’s a passageway through which air travels from your nasal passages to your windpipe and lungs. What makes this cancer distinct is its hidden location, which often delays detection until it has already spread to nearby lymph nodes or other areas. Because of this, many patients are diagnosed at an advanced stage, making treatment more complex compared to some other cancers of the head and neck.

Globally, nasopharyngeal cancer represents less than 1% of all cancers, with an incidence of about 1 case per 100,000 people each year. Although uncommon, its clinical behavior and the challenges it poses in diagnosis and treatment make it a subject of growing importance in oncology.

Specialists at MACS Clinic, a trusted centre for nasopharyngeal cancer treatment in Bangalore, emphasize:
 “Early detection combined with advanced surgical techniques can significantly improve outcomes, even for deep-seated or complex tumors.”

Let’s take a look at the different types of nasopharyngeal cancer

Types of Nasopharyngeal Cancer

Nasopharyngeal cancers are generally classified based on their microscopic appearance.

  1. Keratinizing Squamous Cell Carcinoma
  • Rare type, linked to smoking and environmental factors.
  • Less responsive to radiation therapy.
  1. Non-Keratinizing Carcinoma
  • More common and strongly associated with Epstein-Barr Virus (EBV) infection.
  • Subdivided into differentiated and undifferentiated types.
  1. Basaloid Squamous Cell Carcinoma
  •  A rare and aggressive form.
  • Often requires a combination of treatments.
u

Need Assistance?

Experiencing persistent nasal or ear issues? Seek a timely evaluation to rule out severe conditions.

Here are the signs you should not ignore.

Symptoms of Nasopharyngeal Cancer

The symptoms can be subtle in the early stages, often mimicking common ear, nose, or throat issues. Key warning signs include:

  • Persistent nasal congestion or blockage
  • Frequent nosebleeds
  • Hearing loss or a sensation of fullness in one ear
  • Ringing in the ears (tinnitus)
  • Lump in the neck due to enlarged lymph nodes
  • Headaches or facial numbness
  • Difficulty breathing, speaking, or swallowing
What factors increase the risk of nasopharyngeal cancer?

Causes of Nasopharyngeal Cancer

The exact cause remains unclear, but research has identified several contributing factors:

Epstein-Barr Virus (EBV):
Strongly linked with most cases worldwide.

Genetic predisposition:
A family history increases the risk.

Dietary factors:
High consumption of preserved or salted foods containing nitrosamines may contribute to the risk.

Environmental exposure:
Contact with wood dust, formaldehyde, or other chemicals.

Tobacco and alcohol use:
Increases susceptibility, particularly for keratinizing types.

Understanding these risk factors enables better awareness and the implementation of preventive measures.

Here’s how doctors detect nasopharyngeal cancer.

Diagnosis and Tests

Diagnosis usually involves a combination of clinical evaluation, imaging, and laboratory tests:

Nasopharyngoscopy:

A thin flexible scope is inserted through the nose to visualize the nasopharynx.

Imaging studies:

Includes MRI, CT, or PET scans, which help determine tumor size, spread, and lymph node involvement.

Blood tests:

EBV DNA levels may support the diagnosis and help monitor the response to treatment.
Accurate staging is crucial as it guides treatment decisions and predicts prognosis.
u

Need Assistance?

If symptoms persist, do not wait—schedule a consultation to discuss safe and effective care.

Once the diagnosis and stage are confirmed, the treatment plan is designed to control the tumor and preserve vital functions such as speech and swallowing. Here’s an overview of the treatment options available.

Management and Treatment

Treatment for nasopharyngeal cancer is carefully tailored to each individual, taking into account the stage of the disease, the location of the tumor, and the person’s overall health. The main treatment options include:

Radiation Therapy

Radiation is the cornerstone of treatment for nasopharyngeal cancer, particularly effective in non-keratinizing types. Modern methods such as Intensity-Modulated Radiation Therapy (IMRT) allow doctors to target the tumor with high precision while protecting nearby critical structures like the brainstem, spinal cord, and salivary glands.

Chemotherapy

Chemotherapy is often used in combination with radiation (concurrent chemoradiation) to improve effectiveness, especially in advanced stages. It may also be given before radiation (neoadjuvant) to shrink tumors or after (adjuvant) to reduce recurrence risk.

Surgery

Surgery is not usually the first line of treatment, but it may be recommended for residual disease after radiation or for recurrent tumors. Different surgical approaches include:

  • Endoscopic surgery through the nasal passages for smaller tumors.
  • Open surgical procedures are used for larger or more complex cases.
  • Neck dissection if lymph nodes are affected.

In select cases, robotic-assisted techniques are employed to access tumors that lie deep within the skull base or beneath the collarbone. At advanced centres such as MACS Clinic, approaches like Transoral Robotic Surgery (TORS) and the Robotic Infraclavicular Approach (RIA) enable surgeons to operate with precision in areas that are otherwise difficult to reach safely.

As Dr. Sandeep Nayak, senior surgical oncologist, notes, “With robotic technology, we are now able to reach tumors in regions once considered inaccessible, offering patients safer procedures and better functional outcomes.”

Targeted Therapy and Immunotherapy

In some cases, drugs that target specific molecular pathways or therapies that stimulate the immune system are used. These are particularly valuable for advanced or recurrent cancers that do not respond fully to conventional treatments.
u

Need Assistance?

Understanding your treatment options can make a difference. Speak with a specialist to explore what’s possible.

Still have questions? Let’s answer the most common ones people ask.

FAQs

What are the stages of nasopharyngeal cancer?

Nasopharyngeal cancer is staged from Stage I to Stage IV:

  • Stage I: Tumor is small and confined to the nasopharynx.
  • Stage II: Tumor grows slightly and may involve nearby lymph nodes.
  • Stage III: Larger tumor with more extensive local or lymph node involvement.
  • Stage IV: Advanced cancer, spreading to nearby structures or distant organs.
What are the treatment side effects?

Side effects vary depending on therapy:

  • Radiation: dry mouth, difficulty swallowing, skin changes.
  • Chemotherapy: nausea, fatigue, lowered immunity.
  • Surgery: temporary pain, swelling, or speech difficulties.

Most side effects are manageable with supportive care.

Is nasopharyngeal cancer curable?

Yes, especially when detected early. Even in advanced cases, modern treatment techniques can achieve long-term control, reduce the risk of recurrence, and improve survival rates.

u

Need Assistance?

Have questions or concerns about oral health? Adetailed consultation with an expert can provide clarity and peace of mind.

Disclaimer:  The information shared in this content is for educational purposes only. Individual results may vary. Please consult a qualified doctor for personalized advice