Nasopharyngeal Carcinoma

Overview
Symptoms & Diagnosis
Treatment

What is Nasopharyngeal Carcinoma?

Nasopharyngeal carcinoma (NPC) is the most common cancer occurring in the nasopharynx, which is located behind the nose and above the back of the throat.

Nasopharyngeal carcinoma is rare in the United States, although in other parts of the world — specifically southern China — it occurs much more frequently, and is most common in men.

During nasal breathing, air passes through the nose and nasopharynx before reaching the larynx, trachea, and lungs. On each side of the nasopharynx are tubes that connect to the ears known as the Eustachian tubes. These tubes are responsible for equalizing the pressure inside the ears, causing the familiar “pop.”

Nasopharyngeal cancer typically arises in the thin lining of the nasopharynx in the space behind the Eustachian tubes.

At UPMC, the preferred surgical treatment for nasopharyngeal carcinoma is the Endoscopic Endonasal Approach (EEA). This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach or previously inoperable tumors. Benefits of EEA include:

No incisions to heal
No disfigurement
Faster recovery time

Diagnosing Nasopharyngeal Carcinoma (NPC)

If nasopharyngeal carcinoma (NPC) is suspected, your doctor will perform an exam of the nasal and sinus areas and ask about your symptoms. The doctor may request imaging tests to help determine whether the cancer has spread.

Some types of NPC have a high tendency to spread to the cervical lymph nodes, even in early stages. Therefore, a diagnosis of NPC often can be made through a lymph node biopsy.

Nasopharyngeal carcinoma symptoms

Because the cancer grows within air-filled spaces, symptoms of NPC may not arise until the tumor has grown large enough to obstruct airflow or affect the sense of smell or vision.

Other symptoms of NPC include:

A lump in the neck caused by a swollen lymph node
A sensation of fullness or pressure in the ear
Popping noises, hearing loss, and ear infection
Nasal regurgitation of food and liquids
Impaired “hypernasal” speech
Headaches

In advanced cases, infiltration of NPC into the spine can cause:

Stiff neck
Pain
Neck instability

Nasopharyngeal Carcinoma Treatments

Treatment for nasopharyngeal carcinoma may consist of:

Surgery
Radiotherapy
Chemotherapy

Usually a combination of these treatments is offered, depending on several factors, including:

The stage and type of the tumor
Your age
Your pre-existing medical conditions

Most nasal tumors, whether cancerous or not, require surgery.

Surgery

Nasopharyngeal carcinoma may be approached directly using Endoscopic Endonasal Approach (EEA). This state-of-the-art, minimally invasive approach allows surgeons to access the tumor through the natural corridor of the nose, without making an open incision. Surgeons then remove the tumor through the nose and nasal cavities.

EEA offers the benefits of no incisions to heal, no disfigurement, and a faster recovery time.

Radiotherapy

UPMC offers state-of-the-art radiation therapy as a treatment option. This allows doctors to directly target the nasal cavity and treat the cancer effectively — while limiting radiation that might adversely affect areas such as the eyes, optic nerves, brain, and spinal cord.

Chemotherapy

Anti-cancer drugs (chemotherapy) may be used in combination with surgery and radiation therapy treatments.

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