Cancer That Begins Above the Back of the Throat Behind the Soft Palate

Nasopharyngeal is a rare type of head and neck cancer. It begins in the nasopharynx, which is in the most upper part of your throat, behind the nasal cavity. The nasopharynx connects nasal cavity and the throat, and allows the air you breathe to pass freely from your nose and into your lungs. 

Nasopharyngeal cancer originates from the mucosal lining of the nasopharynx.  

Nasopharyngeal cancer affects less than one in every 100,000 people in North America but is more common in Southeast Asia North Africa and among the Inuits in Alaska. Researchers aren’t completely sure what causes nasopharyngeal cancer, but it is more common in males and between the age of 30-50. Other risk factors include: 

  • Consuming a diet rich in  salt-cured fish, meats and vegetables (this includes popular foods such as beef jerky, bacon, corned beef, ceviche, anchovies or dried cod)
  • Family history of nasopharyngeal cancer
  • Exposure to the Epstein-Barr virus. A common virus that usually produces symptoms of a common cold. It is unclear why some nasopharyngeal cancers are associated with Epstein-Barr virus, and the vast majority of people affected with that virus will not develop nasopharyngeal cancer.
  • Having a relative with nasopharyngeal cancer
  • Tobacco products and alcohol consumption

There is no recommended screening for nasopharyngeal cancer because it is very rare in the United States. However, you should visit your primary provider at least once a year for a well visit and see a doctor immediately if you have any concerns about your overall health or experience the following symptoms: 

Possible Symptoms, Diagnosis & Outlook

During the early stages of nasopharyngeal cancer, most individuals will not experience symptoms. However, as disease progresses, the following symptoms may appear:

  • Lump in your neck or throat
  • Nose bleeds or blood in the saliva
  • Stuffy nose
  • Sore throat
  • Recurring ear infections
  • Face pain or numbness
  • Headaches
  • Hearing loss or ear fullness
  • Ringing in the ears

If you experience any of those symptoms or are concerned about your health, schedule an appointment with your primary care provider. Your provider will conduct a complete physical exam and check for possible neck masses. After your exam, according to the symptoms and findings, your provider may refer you to a head and neck specialist, called an otolaryngologist.

At that appointment, you will answer in-depth questions about your personal and family medical history and describe the severity of your symptoms, including how long you have been experiencing them. Your otolaryngologist may also perform in office flexible endoscopic evaluation of the nasopharynx under local anesthesia.

If abnormalities are found, you will have a biopsy, in which a small tissue sample is taken from the area to confirm the diagnosis and check for the extent of the cancer. In some cases, biopsies can be performed in the office, but your specialist may want a more thorough evaluation by performing a biopsy in the operating room under general anesthesia.

Your doctor may also order the following tests:

  • Computed tomography (CT or CAT) scan: takes detailed images of internal organs, bones, soft tissue and blood vessels. Your physician is able to use the cross-sectional images to confirm the presence, size and location of a tumor. 
  • Magnetic resonance imaging (MRI) scan: provides the highest resolution of soft tissues, and less of the bony structures.  
  • Positron emission tomography (PET) scan: generally used in advanced-stage cancers to determine if cancer has spread to other organs. PET scans are sometimes combined with CT scans to provide a more precise and accurate anatomic localization.  

Diagnostic tests and exams will identify if you have nasopharyngeal cancer and will enable your physician to determine the stage.

Cancer’s stage is used to determine prognosis and treatment options. Stages describe the severity of cancer and help your doctor determine the best treatment plan for you. An early stage 1 cancer indicates a smaller cancer confined to one area. Stage 4 indicates advanced cancer that invaded other head structures, spread to the neck or other distant areas of the body.

In general, patients with an early stage of nasopharyngeal cancer have a more favorable prognosis compared to patients with advanced stage of disease.

Meet the Team

Your Penn State Cancer Institute physicians will discuss the best way to treat your cancer, depending on its type and stage. Our multidisciplinary team of Head and Neck surgeons, radiation and medical oncologists, and pathologists reviews all treatment options before making a recommendation. Not all patients with nasopharyngeal cancer will need surgery. The location, size and stage of the tumor will also determine if a patient is a good candidate for surgery.

Treatment options may include:

  • Radiation therapy alone: an effective treatment option for early-stage nasopharyngeal cancer. High-energy radiation therapy kills cancer cells, stops new ones from growing and is often used with other treatments, including chemotherapy.
    • Intensity-modulated radiotherapy (IMRT) targets the precise location of the tumor with high-dose radiation. This treatment limits damage to nearby tissues and has fewer side effects than traditional radiation.
  • Chemotherapy: uses drugs to kill cancer cells and stop them from growing. In most cases, radiation therapy will be combined with chemotherapy.
  • Biologic drugs: when used in combination with other treatments, can help your body fight and kill cancer cells. They target specific proteins that may encourage cancer cell growth. This is a newer area of treatment, and research is still being conducted.
  • Surgery: most cases of nasopharyngeal cancer will be treated with radiation and chemotherapy. Some cases will be amendable for surgery that can combine endoscopic and open approaches to remove the cancer from the nasopharynx and affected lymph nodes in the neck.  

Side effects of nasopharyngeal cancer treatment depend upon the type of treatment used and can include:

  • Difficulty breathing
  • Infection
  • Bleeding
  • Pain
  • Swallowing problems
  • Change in speech and articulation
  • Fatigue
  • Skin changes
  • Dry mouth
  • Temporary hair loss
  • Nausea and vomiting
  • Inability to taste food

Why Choose Penn State Health for Care

Comprehensive, Compassionate Care

Penn State Health provides specialized testing, treatment and management for nasopharyngeal cancers. Our medical team is consistently recognized nationally through Best Doctors in America and America’s Top Doctors awards. Our specialists also participate in worldwide conferences and speaking engagements in countries including India, Korea, Germany, Japan and others.

Leading-Edge Clinical Trials

The cancer experts at Penn State Health Milton S. Hershey Medical Center and Penn State Cancer Institute are committed to offering their patients the latest treatment options, including access to leading-edge clinical trials. Our superb clinical research team includes dedicated research nurses, clinical trial coordinators and data analysts and gives patients the opportunity to participate in the latest clinical trials. Learn more about new Penn State Health clinical trials at StudyFinder.

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