What is nasopharyngeal cancer?

Nasopharyngeal cancer (or nasopharyngeal carcinoma) is a type of head and neck cancer that develops in the nasopharynx. This is the part of the throat at the back of the nose (or nasal cavity). 'Naso' means nose and the 'pharynx' is the throat. 

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

Symptoms of nasopharyngeal cancer

Often the first symptom of nasopharyngeal cancer is a painless swelling or lump in the upper neck.

If you are worried about nasopharyngeal cancer, we have more information about the signs and symptoms.

Causes of nasopharyngeal cancer

The most common risk factor for nasopharyngeal cancer is an infection called Epstein-Barr virus (EBV), which causes glandular fever. As with other cancers, nasopharyngeal cancer is not infectious and cannot be passed on to other people.

EBV is very common. 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 infections do not cause any problems.

Most people with EBV will not develop nasopharyngeal cancer.

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

Diagnosis of nasopharyngeal cancer

If you have symptoms, you usually begin by seeing your GP.

They will refer you to a specialist doctor if:

  • they think that your symptoms could be caused by cancer
  • they are not sure what the problem is.

The specialist doctor will ask about your symptoms and general health.

If your only symptom is a lump in your neck, you may be referred to a hospital that has a neck lump clinic.

You may have some of the following tests:

  • Nasendoscopy

    A nasendoscopy is used to look at the inside of your nose and throat.

  • Biopsy

    The doctor collects samples (biopsies) of cells or tissue from the area that looks abnormal. A doctor who specialises in analysing cells (called a pathologist) looks at the sample under a microscope for cancer cells. You usually have a general anaesthetic for this. You may need to spend the night in hospital.

  • Ultrasound scan of the neck

    An ultrasound scan of the neck uses soundwaves to produce a picture of your neck and lymph nodes on a computer screen.

  • Fine needle aspiration (FNA) of the lymph nodes

    You may have a fine needle aspiration (FNA) of the lymph nodes if the lymph nodes in your neck do not feel or look normal on a scan. It is done to see whether there are any cancer cells in the lymph nodes.

Waiting for test results can be a difficult time, we have more information that can help.

Further tests for nasopharyngeal cancer

Your specialist may arrange further tests. These may help diagnose nasopharyngeal cancer or be used to check whether it has spread:

  • CT scan

    A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of your body.

  • MRI scan

    An MRI scan uses magnetism to build up a detailed picture of areas of your body.

  • PET-CT scan

    A PET-CT scan gives more detailed information about the part of the body being scanned.

  • Testing for viruses

    If you have nasopharyngeal cancer, your doctor may do a test to see if it is linked to the Epstein-Barr virus (EBV).

Staging and grading of nasopharyngeal cancer

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.

A doctor decides the grade of the cancer by how the cancer cells look under the microscope. This gives an idea of how quickly the cancer might grow or spread.

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

Treatment for nasopharyngeal cancer

A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).

Your cancer doctor or specialist nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions.

Treatment for nasopharyngeal cancer may include:

  • Radiotherapy

    Radiotherapy uses high-energy rays to destroy cancer cells. This is usually the main treatment for nasopharyngeal cancer.

  • Chemotherapy

    Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It can be used on its own but is often given in combination with radiotherapy to treat nasopharyngeal cancer. This is called chemoradiation.

  • Chemoradiation

    Chemoradiation is when you have chemotherapy and radiotherapy together. Chemotherapy can make the cancer cells more sensitive to radiotherapy treatment.

  • Surgery

    Sometimes surgery is used to remove cancer that comes back or that is left behind after the radiotherapy or chemoradiation.

We have more information about:

You may have some treatments as part of a clinical trial.

After nasopharyngeal cancer treatment

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.

Sex life and fertility

Head and neck cancer and its treatment can sometimes affect your sex life and fertility.

If you are worried about this, it is important to talk with your doctor before you start treatment.

We have more information about:

Late effects

Some side effects that develop during treatment may take a long time to improve, or may sometimes become permanent. These are called long-term effects. Other 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 late effects of head and neck cancer treatment.

Well-being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes to the way you live such as eating well and keeping active can improve your health and well-being and help your body recover.

It can be difficult to eat well after treatment for head and neck cancer, but your dietitian can help you.

Your feelings after nasopharyngeal cancer treatment

For some people, it takes several months to recover from treatment. It can be hard to cope if treatment has changed your appearance, voice or how you eat and drink. It is common to feel overwhelmed by different feelings.

There are 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.

You may also want to talk to our cancer support specialists. Call the Macmillan Support Line free on 0808 808 00 00. If you are finding it difficult to talk, our Online Community is also a good place to meet people who may be in a similar situation.

About our information

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Chris Alcock, Consultant Clinical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

Reviewed: 31 July 2018
Reviewed: 31/07/2018
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Next review: 01 January 2021
Next review: 01/01/2021