Nose and Throat Cancer (Nasopharyngeal Carcinoma)
What is nasopharyngeal cancer?
Nasopharyngeal carcinoma (NPC) originates from the mucosal lining of the space behind the nasal passages and above the back of the throat. It is strongly associated with the Epstein-Barr virus (EBV) but the exact causal link between EBV and NPC is uncertain. Most adults worldwide have been exposed to EBV, yet only a very small fraction (1/100,000) develops NPC.
Who is most likely to get nasopharyngeal cancer?
People who live in or have ancestors from Southeast Asia, Arctic regions, and Arabs of North Africa have increased risk, especially people from the Guangdong Province in Southern China. Pacific Rim cities, including those in the San Francisco Bay region, have a higher incidence of NPC than the rest of the USA because of the relatively high proportion of people with Southeast Asian ancestry living here.
What Are Commons Signs of Nasopharyngeal Cancer?
Some symptoms of NPC may include nasal congestion, nose bleeds, changes in hearing or changes in vision because structures critical to functions of the eyes, nose and ears are adjacent to the nasopharynx. Another common symptom may be painless swelling of lymph nodes in the neck, especially neck nodes below the ear (rather than below the chin or jaw). It is relatively uncommon but not rare for patients to show evidence of NPC spreading beyond the head and neck regions.
These and other symptoms may be caused by nasopharyngeal cancer. Other conditions may cause the same symptoms.
A doctor should be consulted if any of the following problems occur:
- A lump in the nose or neck
- A sore throat
- Trouble breathing or speaking
- Trouble hearing
- Pain or ringing in the ear
Stage 0 nasopharyngeal cancer
In stage 0, abnormal cells are found in the lining of the nasopharynx. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Stage 1 nasopharyngeal cancer
In stage 1, cancer has formed and the cancer:
- Is found in the nasopharynx only; or
- Has spread from the nasopharynx to the oropharynx and/or to the nasal cavity.
The oropharynx is the middle part of the throat and includes the soft palate, the base of the tongue, and the tonsils.
Stage 2 nasopharyngeal cancer
Stage 3 nasopharyngeal cancer
In stage 3 nasopharyngeal cancer, the cancer:
- Is found in the nasopharynx only or has spread from the nasopharynx to the oropharynx and/or to the nasal cavity. Cancer has spread to one or more lymph nodes on both sides of the neck. The affected lymph nodes are 6 centimeters or smaller; or
- Is found in the parapharyngeal space. Cancer has spread to one or more lymph nodes on both sides of the neck. The affected lymph nodes are 6 centimeters or smaller; or
- Has spread to nearby bones or sinuses. Cancer may have spread to one or more lymph nodes on one or both sides of the neck and/or to lymph nodes behind the pharynx. The affected lymph nodes are 6 centimeters or smaller.
The oropharynx is the middle part of the throat and includes the soft palate, the base of the tongue, and the tonsils. The parapharyngeal space is a fat-filled, triangular area near the pharynx, between the base of the skull and the lower jaw.
Stage 4 nasopharyngeal cancer
Stage 4 nasopharyngeal cancer is divided into stages IVA, IVB, and IVC.
- Stage IVA: Cancer has spread beyond the nasopharynx and may have spread to the cranial nerves, the hypopharynx (bottom part of the throat), areas in and around the side of the skull or jawbone, and/or the bone around the eye. Cancer may also have spread to one or more lymph nodes on one or both sides of the neck and/or to lymph nodes behind the pharynx. The affected lymph nodes are 6 centimeters or smaller.
- Stage IVB: Cancer has spread to lymph nodes between the collarbone and the top of the shoulder and/or the affected lymph nodes are larger than 6 centimeters.
- Stage IVC: Cancer has spread beyond nearby lymph nodes to other parts of the body.
Recurrent nasopharyngeal cancer
Recurrent nasopharyngeal cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the nasopharynx or in other parts of the body.