Nasopharyngeal carcinoma (NPC) is the most common cancer occurring in the nasopharynx, which is located behind
the nose and above the back of the throat. Nasopharyngeal carcinoma is rare in the United States, although in other
parts of the world — specifically southern China — it occurs much more frequently, and is most common in males.
During nasal breathing, air passes through the nose and nasopharynx before reaching the larynx, trachea, and
lungs. On each side of the nasopharynx are tubes that connect to the ears known as the Eustachian tubes. These
tubes are responsible for equalizing the pressure inside the ears, causing the familiar “pop”. Nasopharyngeal
cancer typically arises in the thin lining of the nasopharynx in the space behind these tubes.
The preferred treatment at UPMC for NPC is surgery using the endoscopic endonasal approach (EEA). This
innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access
hard-to-reach areas in the back of the throat and nasal cavity. EEA offers the benefits of no incisions to heal,
no disfigurement to the patient, and a faster recovery time. Complementary treatments, such as radiotherapy and
chemotherapy, are often used in addition to surgical treatment.
If NPC is suspected, the patient will receive an exam of the nasal and sinus areas. The doctor may request
imaging tests to help determine whether the cancer has spread. Some types of NPC have a high tendency to spread
to the cervical lymph nodes, even in early stages. Therefore, a diagnosis of NPC can often be made through a
lymph node biopsy.
Because the cancer grows within air-filled spaces, symptoms may not arise until the tumor has grown large
enough to obstruct airflow or affect the sense of smell or vision. Other symptoms of NPC include:
- A lump in the neck caused by a swollen lymph node
- A sensation of fullness or pressure in the ear
- Popping noises, hearing loss, and ear infection
- Nasal regurgitation of food and liquids
- Impaired “hypernasal” speech
In advanced cases, infiltration of NPC into the spine can cause a stiff neck, pain, and neck instability.
Treatment at UPMC may consist of surgery, radiotherapy, and chemotherapy. Usually a combination of these
treatments is offered, depending on the stage and type of the tumor, patient age, and pre-existing medical
conditions. Most nasal tumors, whether cancerous or not, require surgery.
The preferred surgical procedure at UPMC for nasopharyngeal carcinoma is the EEA approach. This
state-of-the-art, minimally invasive surgical procedure provides excellent access and visualization to the
structures of the nasal cavity and uses the nose as a natural corridor to reach the tumors, without the
need for facial incisions.
UPMC offers state-of-the-art radiation therapy. This allows UPMC physicians to directly target the nasal
cavity and treat the cancer effectively while limiting radiation that might adversely affect areas such as
the eyes, optic nerves, brain, and spinal cord.
Anti-cancer drugs (chemotherapy) may be used in combination with surgery and radiation therapy.