Nasopharyngeal Carcinoma

Diagnosis

Nasopharyngeal carcinoma diagnosis usually begins with an exam by a healthcare professional. A special scope may be used to inspect the nasopharynx for signs of cancer, and a tissue sample might be taken to confirm the diagnosis.

Physical exam

A healthcare professional may examine your nose, throat, and neck to look for signs of cancer, such as swelling in the lymph nodes. They will also ask about symptoms and personal habits that could be relevant.

Endoscopy

A nasal endoscopy may be performed using a thin, flexible tube with a tiny camera, called an endoscope. The endoscope can be inserted through the nose or the back of the throat to view the nasopharynx.

Biopsy

A biopsy involves removing a tissue sample for lab testing. This is often done during a nasal endoscopy using special tools. If lymph nodes are swollen, a needle may be used to collect cells for testing.

Tests to find the extent of the cancer

After diagnosis, imaging tests help determine the stage of the cancer. These tests may include:

• CT scan
• MRI scan
• Positron emission tomography (PET) scan
• X-ray

Nasopharyngeal carcinoma stages range from 0 to 4. Lower stages indicate a smaller tumor confined to the nasopharynx. Stage 4 indicates larger tumors that may have spread to nearby structures, lymph nodes, or other parts of the body. The stage helps your healthcare team plan treatment and predict prognosis.

Treatment

Treatment for nasopharyngeal carcinoma often begins with radiation therapy, chemotherapy, or a combination of both. The treatment plan is based on the cancer stage, overall health, treatment goals, and tolerance for side effects.

Radiation therapy

Radiation therapy uses high-energy beams, such as X-rays or protons, to kill cancer cells. External beam radiation is commonly used, where a machine directs radiation precisely at the tumor. For small tumors, radiation may be the only treatment. Larger tumors are often treated with radiation plus chemotherapy. Brachytherapy, or internal radiation, may be used if cancer returns.

Chemotherapy

Chemotherapy uses strong medicines to destroy cancer cells. It can be given through a vein or as pills. Chemotherapy may be combined with radiation or used before or after radiation therapy.

Immunotherapy

Immunotherapy helps the immune system identify and kill cancer cells. It may be an option for cancer that has recurred or spread to other areas.

Surgery

Surgery is rarely the first treatment. It may be used to remove cancerous lymph nodes in the neck or, in some cases, to remove cancer from the nasopharynx. Access may be through the roof of the mouth, the face near the nose, or via specialized surgical tools inserted through the nose.