Definition

What is nasopharyngeal carcinoma?

Nasopharyngeal carcinoma is cancer that occurs in the nasopharynx, which is located behind your nose and above the back of your throat.

Nasopharyngeal carcinoma is difficult to detect early. That’s probably because the nasopharynx isn’t easy to examine and symptoms of nasopharyngeal carcinoma mimic those of other, more-common conditions.

How common is nasopharyngeal carcinoma?

Nasopharyngeal carcinoma is not common. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of nasopharyngeal carcinoma?

The common symptoms of nasopharyngeal carcinoma are:

  • A lump in your neck caused by a swollen lymph node
  • Blood in your saliva
  • Bloody discharge from your nose
  • Nasal congestion
  • Hearing loss
  • Frequent ear infections
  • Headaches

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes nasopharyngeal carcinoma?

Cancer begins when one or more genetic mutations cause normal cells to grow out of control, invade surrounding structures and eventually spread (metastasize) to other parts of the body. In nasopharyngeal carcinomas, this process begins in the squamous cells that line the surface of the nasopharynx.

Exactly what causes the gene mutations that lead to nasopharyngeal carcinoma isn’t known, though factors, such as the Epstein-Barr virus, that increase the risk of this cancer have been identified. However, it isn’t clear why some people with all the risk factors never develop cancer, while others who have no apparent risk factors do.

Risk factors

What increases my risk for nasopharyngeal carcinoma?

There are many risk factors for nasopharyngeal carcinoma, such as:

  • Nasopharyngeal carcinoma is more common in men than it is in women.
  • This type of cancer more commonly affects people in parts of China, Southeast Asia and northern Africa. In the United States, Asian immigrants have a higher risk of this type of cancer than do American-born Asians. Inuits in Alaska also have an increased risk of nasopharyngeal cancer.
  • Nasopharyngeal cancer can occur at any age, but it’s most commonly diagnosed in adults between the ages of 30 and 50.
  • Salt-cured foods. Chemicals released in steam when cooking salt-cured foods, such as fish and preserved vegetables, may enter the nasal cavity, increasing the risk of nasopharyngeal carcinoma. Being exposed to these chemicals at an early age may increase the risk even more.
  • Epstein-Barr virus. This common virus usually produces mild signs and symptoms, such as those of a cold. Sometimes it can cause infectious mononucleosis. Epstein-Barr virus is also linked to several rare cancers, including nasopharyngeal carcinoma.
  • Family history. Having a family member with nasopharyngeal carcinoma increases your risk of the disease.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is nasopharyngeal carcinoma diagnosed?

Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as swollen lymph nodes in the neck or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

Neurological exam: A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person’s mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam.

Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The tissue sample is removed during one of the following procedures:

Nasoscop : A procedure to look inside the nose for abnormal areas. A nasoscope is inserted through the nose. A nasoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.

Upper endoscopy: A procedure to look at the inside of the nose, throat, esophagus, stomach, and duodenum (first part of the small intestine, near the stomach). An endoscope is inserted through the mouth and into the esophagus, stomach, and duodenum. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples. The tissue samples are checked under a microscope for signs of cancer.

MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. PET scans may be used to find nasopharyngeal cancers that have spread to the bone. Sometimes a PET scan and a CT scan are done at the same time. If there is any cancer, this increases the chance that it will be found.

Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.

Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:

The number of red blood cells, white blood cells, and platelets.

The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.

The portion of the blood sample made up of red blood cells.

Epstein-Barr virus (EBV) test: A blood test to check for antibodies to the Epstein-Barr virus and DNA markers of the Epstein-Barr virus. These are found in the blood of patients who have been infected with EBV.

Hearing test: A procedure to check whether soft and loud sounds and low- and high-pitched sounds can be heard. Each ear is checked separately.

How is nasopharyngeal carcinoma treated?

You and your doctor work together to devise a treatment plan based on several factors, such as the stage of your cancer, your treatment goals, your overall health and the side effects you’re willing to tolerate.

Treatment for nasopharyngeal carcinoma usually begins with radiation therapy or a combination of radiation and chemotherapy.

Radiation therapy

Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer cells.

Radiation therapy for nasopharyngeal carcinoma is usually administered in a procedure called external beam radiation. During this procedure, you’re positioned on a table and a large machine is maneuvered around you, directing radiation to the precise spot where it can target your cancer.

For small nasopharyngeal tumors, radiation therapy may be the only treatment necessary. In other situations, radiation therapy may be combined with chemotherapy.

Radiation therapy carries a risk of side effects, including temporary skin redness, hearing loss and dry mouth.

Another type of radiation therapy, an internal form of radiation (brachytherapy), is sometimes used in recurrent nasopharyngeal carcinoma. With this treatment, radioactive seeds or wires are positioned in the tumor or very close to it.

Radiation therapy to the head and neck, especially when combined with chemotherapy, often causes severe sores in the throat and mouth. Sometimes these sores make it difficult to eat or drink. If this occurs, your doctor may recommend inserting a tube into your throat or stomach. Food and water are delivered through the tube until your mouth and throat recover.

Chemotherapy

Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy drugs can be given in pill form, administered through a vein or both. Chemotherapy may be used to treat nasopharyngeal carcinoma in three ways:

Chemotherapy at the same time as radiation therapy. When the two treatments are combined, chemotherapy enhances the effectiveness of radiation therapy. This combined treatment is called concomitant therapy or chemoradiation.

However, side effects of chemotherapy are added to the side effects of radiation therapy, making concomitant therapy more difficult to tolerate.

  • Chemotherapy after radiation therapy. Your doctor might recommend chemotherapy after radiation therapy or after concomitant therapy. Chemotherapy is used to attack any remaining cancer cells in your body, including those that may have broken off from the original tumor and spread elsewhere. Some controversy exists as to whether additional chemotherapy actually improves survival in people with nasopharyngeal carcinoma. Many people who undergo chemotherapy after concomitant therapy are unable to tolerate the side effects and must discontinue treatment.
  • Chemotherapy before radiation therapy. Neoadjuvant chemotherapy is chemotherapy treatment administered before radiation therapy alone or before concomitant therapy. More research is needed to determine whether neoadjuvant chemotherapy can improve survival rates in people with nasopharyngeal carcinoma. What chemotherapy drugs you receive and how often will be determined by your doctor. The side effects you’re likely to experience will depend on which drugs you receive.

Surgery

Surgery is not often used as a treatment for nasopharyngeal carcinoma. Surgery may be used to remove cancerous lymph nodes in the neck.

In certain cases, surgery may be used to remove a tumor from the nasopharynx. This usually requires surgeons to make an incision in the roof of your mouth to access the area to remove the cancerous tissue.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage nasopharyngeal carcinoma?

Radiation therapy for nasopharyngeal carcinoma often causes dry mouth (xerostomia).

Having a dry mouth can be uncomfortable. It can also lead to frequent infections in your mouth and difficulty eating, swallowing and speaking, and can increase problems with health of your teeth. Ask your doctor whether you should see a dentist if you experience dry mouth complications.

You may find some relief from dry mouth and its complications if you:

  • Brush your teeth several times each day. Use a soft-bristled toothbrush and gently brush your teeth several times each day. Tell your doctor if your mouth becomes too sensitive to tolerate gentle brushing.
  • Rinse your mouth with a warm saltwater solution after meals. Make a mild solution of warm water, salt and baking soda. Rinse your mouth with this solution after each meal.
  • Keep your mouth moistened with water or sugarless candies. Drink water throughout the day to keep your mouth moistened. Also try sugarless gum or sugarless candies to stimulate your mouth to produce saliva.
  • Choose moist foods. Avoid dry foods. Moisten dry food with sauce, gravy, broth, butter or milk.
  • Avoid acidic or spicy foods and drinks. Choose foods and drinks that won’t irritate your mouth. Avoid caffeinated and alcoholic beverages.

Tell your doctor if you have dry mouth. He or she may provide treatments to help you cope with more-severe signs and symptoms of dry mouth. Your doctor may also refer you to a dietitian who can help you find foods that are easier to eat if you’re experiencing dry mouth.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: November 24, 2017 | Last Modified: November 24, 2017

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