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Table of Contents General Information About Nasopharyngeal Cancer
Stages of Nasopharyngeal Cancer
Recurrent Nasopharyngeal Cancer
Treatment Option Overview
Treatment Options by Stage
Treatment Options for Recurrent Nasopharyngeal Cancer
To Learn More About Nasopharyngeal Cancer
Get More Information From NCI
Changes to This Summary (07/09/2008)
About PDQ
General Information About Nasopharyngeal Cancer
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Nasopharyngeal cancer is a disease in which malignant (cancer)
cells form in the tissues of the nasopharynx.
The nasopharynx is the
upper part of the pharynx (throat)
behind the nose. The pharynx is a hollow tube about 5 inches long that starts
behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes from the throat to
the stomach). Air and food pass
through the pharynx on the way to the trachea or the esophagus. The nostrils
lead into the nasopharynx. An opening on each side of the nasopharynx leads
into an ear. Nasopharyngeal cancer most commonly
starts in the squamous cells that
line the oropharynx (the part of the
throat behind the mouth).
Ethnic background and exposure to the Epstein-Barr virus can
affect the risk of developing nasopharyngeal cancer.
Anything that increases your risk of getting a disease is called a risk factor. Risk factors may include
the following:
- Chinese or Asian ancestry.
- Exposure to the Epstein-Barr
virus: The Epstein-Barr virus has been associated with certain
cancers, including nasopharyngeal cancer and some lymphomas.
Possible signs of nasopharyngeal cancer include trouble
breathing, speaking, or hearing.
These and other symptoms may be caused by nasopharyngeal cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following
problems occur:
- A lump in the nose or neck.
- A sore throat.
- Trouble breathing or speaking.
- Nosebleeds.
- Trouble hearing.
- Pain or ringing in the ear.
- Headaches.
Tests that examine the nose and throat are used to detect
(find) and diagnose nasopharyngeal cancer.
The following tests and procedures may be used:
- Physical exam of the throat: An exam in which
the doctor feels for swollen lymph
nodes in the neck and looks down the throat with a small,
long-handled mirror to check for abnormal areas.
- Nasoscopy: A procedure to look inside the nose for abnormal areas. A nasoscope is inserted through the nose. A nasoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
- Neurological exam: A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person’s mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam.
- Head and chest x-rays: An x-ray of the skull and organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- MRI (magnetic
resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
- CT scan (CAT scan):
A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. PET scans may be used to find nasopharyngeal cancers that have spread to the bone.
- Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or monitor the disease over time.
- Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on
the following:
- The stage of the cancer (whether it affects part of
the nasopharynx, involves the whole nasopharynx, or has spread to other places
in the body).
- The type of nasopharyngeal cancer.
- The size of the tumor.
- The patient’s age and
general health.
Back to Top Stages of Nasopharyngeal Cancer
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After nasopharyngeal cancer has been diagnosed, tests
are done to find out if cancer cells have spread within the nasopharynx or to
other parts of the body.
The process used to find out whether cancer has spread within the nasopharynx or to other parts of the
body is called staging. The information gathered from the
staging process determines the stage of the disease. It is
important to know the stage in order to plan treatment. The results of the tests used to diagnose nasopharyngeal cancer are often also used to stage the disease.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
- Through tissue. Cancer invades the surrounding normal tissue.
- Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
- Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The following stages are used for nasopharyngeal
cancer:
Stage 0 (Carcinoma in Situ)
In stage 0, abnormal cells are found in the lining
of the nasopharynx. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Stage I
In stage I, cancer has formed and is found in the nasopharynx only.
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Stage II
Stage II nasopharyngeal
cancer is divided into stage IIA and stage IIB as
follows:
Stage III
In stage III nasopharyngeal
cancer, the cancer:
- is found in the nasopharynx and has spread to lymph
nodes on both sides of the neck and the lymph nodes are 6 centimeters or smaller; or
- has spread into the soft tissues (oropharynx and/or nasal cavity)
and to lymph nodes on both sides of the neck and the lymph nodes are 6 centimeters or smaller; or
- has spread beyond the soft tissues into areas around the pharynx and to lymph nodes on both sides of the neck and the lymph nodes are 6 centimeters or smaller; or
- has spread to nearby bones or sinuses and may have spread to lymph nodes on one or both sides of the neck and the involved lymph nodes are 6 centimeters or smaller.
Stage IV
Stage IV nasopharyngeal
cancer is divided into stage IVA, stage IVB, and stage IVC as
follows:
Back to Top Recurrent Nasopharyngeal Cancer
Recurrent nasopharyngeal cancer is cancer that has recurred
(come back) after it has been treated. The cancer may come
back in the nasopharynx or in other
parts of the body.
Back to Top Treatment Option Overview
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There are different types of treatment for patients with nasopharyngeal
cancer.
Different types of treatment are available for patients with nasopharyngeal cancer. Some treatments are standard (the currently used treatment), and some
are being tested in clinical trials.
A treatment clinical trial is a research study meant to help
improve current treatments or obtain information on new treatments for patients
with cancer. When clinical trials show that a new treatment is better than the
standard treatment, the new
treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Three types of standard treatment are used:
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
External radiation therapy to the thyroid or the pituitary gland may change the way the thyroid gland works. The doctor may test the thyroid gland before and after
therapy to make sure it is working properly. It is also important that a dentist check the patient’s teeth, gums, and mouth, and fix any existing problems before radiation therapy begins.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Surgery
Surgery is a procedure to find out whether cancer is present, to remove cancer from the body, or to repair a body part. Also called an operation. Surgery is
sometimes used for nasopharyngeal cancer that does not respond to radiation
therapy. If cancer has spread to the lymph
nodes, the doctor may remove lymph nodes and other tissues in
the neck.
New types of treatment are being tested in clinical
trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site.
Biologic therapy
Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
Intensity-modulated radiation therapy
Intensity-modulated radiation therapy (IMRT) is a type of 3-dimensional radiation therapy that uses computer-generated images to show the size and shape of the tumor. Compared to standard radiation therapy, intensity-modulated radiation therapy may be less likely to cause xerostomia (dry mouth). This may improve quality of life.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Back to Top Treatment Options by Stage
A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.
Stage I Nasopharyngeal Cancer
Treatment of stage I nasopharyngeal
cancer is usually radiation
therapy to the tumor and lymph nodes in the neck.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I nasopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Stage II Nasopharyngeal Cancer
Treatment of stage II nasopharyngeal
cancer may include the following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II nasopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Stage III Nasopharyngeal Cancer
Treatment of stage III nasopharyngeal
cancer may include the following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III nasopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Stage IV Nasopharyngeal Cancer
Treatment of stage IV nasopharyngeal
cancer may include the following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV nasopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Back to Top Treatment Options for Recurrent Nasopharyngeal Cancer
Treatment of recurrent nasopharyngeal cancer may include the
following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent nasopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Back to Top To Learn More About Nasopharyngeal Cancer
For more information from the National Cancer Institute about nasopharyngeal cancer, see the following:
For more childhood cancer information and other general cancer resources from the National Cancer Institute, see the following:
Back to Top Get More Information From NCI
Call 1-800-4-CANCER
For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.
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Search the NCI Web site
The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use our “Best Bets” search box in the upper right hand corner of each Web page. The results that are most closely related to your search term will be listed as Best Bets at the top of the list of search results.
There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.
Find Publications
The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
Back to Top Changes to This Summary (07/09/2008)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Changes have been made to this summary to match those made to the health professional version.
Back to Top About PDQ
PDQ is a comprehensive cancer database available on NCI's Web site.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.
PDQ also contains information on clinical trials.
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
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