Nasopharyngeal carcinoma (NPC) is a rare type of head and neck cancer. Potential risk factors include certain lifestyle factors and exposure to Epstein-Barr virus. Symptoms and treatment vary, but the outlook is often favorable.

NPC starts in the cells of the small, hollow space known as the nasopharynx. This space allows air to travel from the nose to the throat. It makes up part of the upper portion of the throat and lies just behind the nasal cavity and above the soft palate of the mouth.

NPC is a rare cancer, affecting less than 1 in 100,000 people in the United States and most parts of the world each year. However, regional rates in South Asia, the Middle East, and North Africa are higher.

This article reviews the possible symptoms, causes, diagnosis, treatment, and outlook associated with NPC.

NPC can cause several nonspecific symptoms. Having one or more symptoms associated with the cancer does not necessarily mean a person has the cancer. This is because a large number of other possible causes exist.

Some common symptoms a person with NPC may experience include:

  • nosebleeds
  • lump in throat or nose
  • sore throat
  • difficulty hearing
  • headaches
  • difficulty breathing or talking
  • pain or ringing in ears

Other symptoms may include:

  • numbness in the face
  • frequent ear infections
  • blurry or double vision
  • difficulty opening the mouth

The exact cause of NPC is not always known. Scientists have been studying how the Epstein-Barr virus (EBV) may have contributed to the formation of the cancer.

The virus is responsible for several illnesses, including mononucleosis, also known as mono, and may alter the cells in the nasopharynx and cause them to become cancerous.

The link between EBV and NPC is complex and requires further studies.

Infection with EBV alone is not enough to cause the cancer. Other factors may play a role in affecting how the body reacts to an EBV infection. Potential risk factors include:

  • Chinese or Asian ancestry
  • a diet rich in salt-cured meats and fish
  • tobacco use
  • being male
  • older or advanced age
  • family history of the cancer
  • human papillomavirus (HPV)

In addition, occupational exposure to wood dust is also a risk factor.

Having risk factors associated with NPC does not mean a person will necessarily develop the cancer. They are circumstances that can increase the risk a person will develop it.

A person concerned about developing NPC can consider ways to reduce their risk, such as:

  • avoiding smoking
  • avoiding excessive alcohol intake
  • avoiding salt-cured meats and fish
  • taking steps to help avoid exposure to EBV, such as not kissing or sharing personal items with someone who has the infection
  • taking steps to help prevent exposure to HPV, such as getting vaccinated and using barrier methods during sex

Many people who experience the symptoms associated with this rare cancer will find another, more benign underlying cause.

A doctor may find NPC when searching for the cause of a person’s symptoms. If they suspect cancer, various tests can help them determine whether cancer is the underlying cause and what type it is.

Some common diagnostic tests a doctor may order include:

  • physical exam and review of health history
  • neurological exam
  • biopsy
  • flexible fiberoptic laryngoscopy
  • imaging studies such as MRI, CT scan, ultrasound, chest X-ray, or PET scan
  • complete blood count
  • EBV test
  • HPV test
  • blood chemistry test

Once a person receives a diagnosis of NPC, a doctor will help stage the cancer. Staging involves determining the tumor size and whether it affects local tissue or has spread — metastasized — to distant parts of the body.

Currently, the standard treatment options for people with NPC include:

  • radiation, which may involve several different methods based on the stage of the cancer and the doctor’s recommendation
  • chemotherapy
  • surgery, which may involve removing the tumor and reconstructing the affected area

Doctors will use these treatment methods based on the stage of the cancer. Some common treatments based on stage include:

  • Stage 0 and 1: Radiation to shrink the tumor.
  • Stage 2: Combination of radiation and chemotherapy (chemoradiation).
  • Stage 3: A doctor may start with chemotherapy, followed by chemoradiation or chemoradiation aimed at the nasopharynx and neck lymph nodes with or without following this with chemotherapy alone. Surgery after radiation is also an option.
  • Stage 4: Typically starts with chemotherapy and may be followed by radiation or chemoradiation, immunotherapy, or other targeted therapies. A doctor may recommend surgery after radiation.

Researchers are continuing to investigate new treatment methods and combinations of therapy. A person may be able to participate in a clinical trial to help test new treatment methods that may provide more effective care for people with NPC in the future.

The outlook for NPC is generally favorable.

The following table shows the 5-year survival rates of NPC based on the Surveillance, Epidemiology, and End Results (SEER) database:

SEER stage5-year relative survival rate
localized — isolated mass that remains inside the nasopharynx82%
regional — tumor has spread outside the nasopharynx to nearby structures or lymph nodes72%
distant — cancer has spread to distant parts of the body, such as the lungs or liver49%
all stages combined63%

The SEER database tracks 5-year relative survival rates for NPC in the United States based on how far the cancer has spread. Five-year survival rates provide an estimate of the cancer’s severity and the likelihood a person will still be alive 5 years following diagnosis.

A person’s chances of survival will vary based on several factors including:

  • age
  • overall health
  • stage of the cancer
  • response to treatment

Nasopharyngeal carcinoma (NPC) is a type of head and neck cancer. It is rare in the United States and more common in other parts of the world, such as South Asia.

The exact cause is not always known, but Epstein-Barr virus exposure, genetics, and some dietary and lifestyle choices may increase a person’s risk of developing the cancer.

Once a person receives a diagnosis, doctors typically treat NPC with radiation or chemotherapy combined with surgery. Alternatively, they may recommend a combination of radiation and chemotherapy. Outlook is generally positive and improves with early detection and treatment.