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.

Nasopharyngeal carcinoma (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.

Read on to learn more about the symptoms and causes of NPC. This article also looks at diagnosis, treatment options, outlook, and more.

NPC can cause several nonspecific symptoms.

Early symptoms a person with NPC may experience include:

  • nosebleeds
  • nasal congestion
  • lump in the throat
  • sore throat
  • difficulty hearing
  • pain, pulsing, or ringing in the ears

As the condition develops, symptoms may include:

  • headaches
  • facial weakness or numbness
  • double vision
  • strabismus, or misalignment of the eyes

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.

The exact cause of NPC is not always clear.

Epstein-Barr virus

Scientists have been studying how the Epstein-Barr virus (EBV) may contribute to the formation of the cancer.

The virus is responsible for several illnesses, including mononucleosis (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.

Other factors

Other factors may play a role in affecting how the body reacts to an EBV infection. These can include:

  • a diet rich in salt-cured meats and fish
  • tobacco use
  • being assigned male at birth
  • family history of the cancer
  • human papillomavirus (HPV)
  • occupational exposure to wood dust
  • living in areas where NPC is more common, such as parts of Asia, North Africa, and the Middle East.

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

A doctor may find NPC when searching for the cause of a person’s symptoms.

They may begin by asking questions about a person’s symptoms and performing a physical exam. If they suspect cancer, they may order various tests to help determine whether NPC cancer is the underlying cause.

Some diagnostic tests a doctor may order include:

  • neurological exam
  • nasal endoscopy
  • biopsy
  • imaging studies such as:
    • MRI
    • PET-CT scan
    • chest X-ray
  • complete blood count
  • EBV test
  • HPV test
  • blood chemistry study

A person’s doctor can advise on which tests they order and what they involve.

Once a person receives a diagnosis of NPC, a doctor will stage the cancer and then help them create a suitable treatment plan. 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 therapy
  • 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: Treatment typically includes radiation therapy to shrink the tumor.
  • Stage 2: Treatment may be a combination of radiation and chemotherapy (chemoradiation).
  • Stage 3: A doctor may start with chemotherapy followed by chemoradiation. Alternatively, they may begin with 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: Treatment typically starts with chemotherapy and may be followed by radiation therapy, chemoradiation, or other therapies. A doctor may recommend surgery after radiation.

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 following table shows the 5-year relative 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 nasopharynx.82%
Regional: The tumor has spread outside the nasopharynx to nearby structures or lymph nodes.72%
Distant: The cancer has spread to distant parts of the body, such as the lungs or liver.49%
All stages combined63%

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

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

A person’s doctor can provide them with more information about their outlook based on their individual circumstances.

A relative survival rate helps give an idea of how long a person with a particular condition will live after receiving a diagnosis compared with those without the condition.

For example, if the 5-year relative survival rate is 70%, it means that a person with the condition is 70% as likely to live for 5 years as someone without the condition.

It is important to remember that these figures are estimates. A person can consult a healthcare professional about how their condition is going to affect them.

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NPC is a rare cancer, with only 1 case per 100,000 people in the United States and most parts of the world each year.

However, regional rates in parts of South Asia, the Middle East, and North Africa are higher.

Here are some frequently asked questions about NPC.

What are the first symptoms of nasopharyngeal cancer?

Some of the first symptoms of NPC can include nasal congestion, nosebleeds, a lump or pain in the throat, hearing problems, and pain in the ears.

What is the most common cause of nasopharyngeal cancer?

Although the exact causes of NPC are unclear, Epstein-Barr virus infection may increase a person’s risk. However, more research into this and other risk factors of NPC is necessary.

How curable is nasopharyngeal carcinoma?

Whether NPC is curable can depend on the stage of the condition, as well as other factors such as a person’s overall health. Radiation therapy may cure early stage NPC. Chemoradiation may help cure NPC in advanced stages, particularly if the cancer has not spread beyond the neck and head.

A person’s doctor can provide them with more information about how curable they believe their condition is.

Nasopharyngeal carcinoma (NPC) is a type of head and neck cancer. It is rare in the United States.

The exact cause is not always clear, 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 therapy or chemotherapy combined with surgery. Alternatively, they may recommend a combination of radiation and chemotherapy.