Nasopharyngeal cancer

Nasopharyngeal cancer is sometimes called nasopharyngeal carcinoma or cancer of the post-nasal space. It is a type of head and neck cancer that develops in the nasopharynx.

The nasopharynx is the upper part of the throat (pharynx) at the back of the nose (or nasal cavity). 'Naso' means nose and the 'pharynx' is the throat. The nasopharynx allows air to flow from the nose, through the rest of the pharynx, larynx and trachea (windpipe) and into the lungs.

We have separate information about types of cancer that develops in other areas of the throat such as the oropharynx (oropharyngeal cancer) or hypopharynx.

The exact cause of nasopharyngeal is not known. But there are risk factors that can increase the chances of developing it.

The most common risk factor for nasopharyngeal cancer is a virus called the Epstein-Barr virus (EBV). This virus causes glandular fever. Almost everyone is infected with EBV at some time during their life. The body’s immune system is normally able to get rid of the virus, and usually the infections do not cause any problems.

Only a very small number of people who have had EBV develop nasopharyngeal cancer. Most people with EBV will not develop nasopharyngeal cancer.

As with other cancers, nasopharyngeal cancer is not infectious and cannot be passed on to other people.

We have more information about the causes and risk factors of head and neck cancers.

The results of your tests help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging. The grade of the cancer gives an idea how quickly it may develop.

Knowing the stage and grade of the cancer helps doctors plan the best treatment for you.

The staging systems most often used for nasopharyngeal cancer are the TNM and number staging systems.

TNM staging system

TNM stands for tumour, node and metastases.

Tumour (T)

T describes the size of the tumour and where the tumour is in the nasopharynx, nose and throat. It also describes whether it has grown into nearby tissues, such as bones, nerves or muscles. It is numbered between 0 and 4.

• T0 means there are no signs of a tumour, but there may be abnormal cells that are pre-cancerous. Or, there are lymph nodes in the neck contain cancer cells that test positive for the Epstein Barr virus.
• T1 the tumour is only in the nasopharynx and the nose, or back of the throat (oropharynx).
• T2 the tumour has spread further into the surrounding tissue or muscle.
• T3 the tumour is larger and has spread to structures around the nasopharynx, including the sinuses and bone at the base of the skull.
• T4 the tumour has grown further into nearby nerves, bones, muscles or other areas of the skull.

Nodes (N)

N describes whether the cancer has spread to the lymph nodes.

Metastases (M)

M describes whether the cancer has spread to another part of the body (called metastatic cancer).

The number staging system combines all the information from TNM staging and gives it a number from 1 to 4. You can read more about this in our information about staging and grading of head and neck cancer.

Grading of nasopharyngeal cancer

A doctor looks at a sample of the cancer cells under a microscope to find out the grade of the cancer. Nasopharyngeal cancer is graded 1 to 4. You can read more about this in our information about staging and grading of head and neck cancer.

You will have regular follow-up appointments after treatment. These may continue for several years. You may also have regular follow-up appointments with a speech and language therapist (SLT), dietitian, restorative dentist and dental hygienist.

If you have any problems or notice new symptoms between appointments, let your doctor know as soon as possible.

Some treatment side effects may take a long time to improve after treatment finishes, or they may become permanent. These are called long-term effects. Other side effects can develop months or even years after treatment has finished. These are known as late effects. We have more information about long-term and long-term and late effects of head and neck cancer treatment.

Head and neck cancer and its treatment can sometimes have an effect on your sex life.

If you are worried about this, talk to your doctor or nurse. You can read about things that may help in our information on cancer and sex.

Some cancer treatments can also affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.

We have more information about:

• fertility in women after treatment
• fertility in men after treatment.
• LGBTQ+ people and cancer treatment

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes during and after treatment. For example, if you smoke or drink alcohol, it is best to avoid smoking or reduce the amount of alcohol.

Eating well and keeping active can improve your health and well-being. It can also help your body recover. Your dietitian can help with any difficulties you might have with eating after treatment.

It may take several months to recover from treatment. It can be hard if treatment has changed your appearance, how you eat or drink, or your voice. This may also affect your body image but there are ways to help you to manage any changes.

You may still be coping with difficult feelings. Talking to your family and friends or health professionals about how you feel can help them know how to support your well-being.

There are also national support groups that you may find helpful:

• The Mouth Cancer Foundation
  The Mouth Cancer Foundation gives information and support to people affected by head and neck cancers.
• Changing Faces
  Changing Faces offers advice and information to anyone who is affected by a change in their appearance.
• The Swallows Head and Neck Cancer Support Group
  The Swallows offers a 24-hour support line to anyone affected by head and neck cancer.
• Salivary Gland Cancer UK
  Salivary Gland Cancer UK supports people with rare salivary gland cancers, such as adenoid cystic carcinoma, ACC, and unknown carcinoma.

Macmillan is also here to support you. If you would like to talk, you can:

• Call the Macmillan Support Line on 0808 808 00 00.
• Chat to our specialists online.
• Visit our head and neck cancer forum to talk with people who have been affected by head and neck cancer, share your experience, and ask an expert your questions.