Nasopharyngeal cancer is a disease in which malignant (cancer) cells form in the lining of the nasal cavity (inside of the nose) and throat. It is rare in children younger than 10 and more common in teenagers.
Risk Factors, Symptoms, and Diagnostic and Staging Tests
The risk of nasopharyngeal cancer is greatly increased by having an infection with the Epstein-Barr virus (EBV), which infects cells of the immune system.
Nasopharyngeal cancer may cause any of the following signs and symptoms. Check with your child's doctor if you see any of the following problems in your child:
- Painless lumps in the neck.
- Blocked or stuffy nose.
- Ear infection.
- Problems moving the jaw.
- Hearing loss.
- Double vision.
Other conditions that are not nasopharyngeal cancer may cause these same symptoms.
When nasopharyngeal is diagnosed, it usually has already spread to lymph nodes in the neck and bones of the skull. It may also spread to the nose, mouth, throat, bones, lung, and/or liver.
Tests to diagnose and stage nasopharyngeal cancer may include the following:
- Physical exam and history.
- MRI of the head and neck.
- CT scan of the chest and abdomen .
- Bone scan.
See the General Information section for a description of these tests and procedures.
Other tests used to diagnose or stage nasopharyngeal cancer include the following:
- Nasoscopy: A procedure in which a doctor inserts a nasoscope (a thin, lighted tube) into the patient's nose to look for abnormal areas.
- 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.
- Epstein-Barr virus (EBV) tests: Blood tests to check for antibodies to the Epstein-Barr virus and DNA markers of the Epstein-Barr virus. These are found in the blood of patients who have been infected with EBV.
The prognosis (chance of recovery) for most young patients with nasopharyngeal cancer is very good. The prognosis and treatment options depend on the following:
- The size of the tumor at diagnosis.
- Whether the tumor has spread to nearby tissues, lymph nodes, or distant parts of the body.
- How the cancer responds to the initial treatment.
Treatment of nasopharyngeal cancer in children may include the following:
- Radiation therapy.
- Chemotherapy given before and at the same time as radiation therapy.
- Chemotherapy and radiation therapy given with interferon-beta.
- Chemotherapy and radiation therapy given with brachytherapy.
- Surgery, in certain cases.
- Biologic therapy using EBV-specific cytotoxic T-lymphocytes.
Young patients are more likely than adults to have problems caused by treatment, including second cancers.
See the PDQ summary on adult Nasopharyngeal Cancer Treatment for more information.