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UT Southwestern Medical Center’s cancer specialists have extensive experience and training in nasopharyngeal cancer and other complex head and neck cancers. Our cancer care teams provide compassionate, expert care to diagnose and treat the disease, with supportive services to guide patients and their families through the treatment journey.

As the only National Cancer Institute (NCI)-designated comprehensive cancer center in North Texas, we deliver the best cancer care available today and push to discover new treatments. NCI designation means we offer patients the ability to participate in the broadest possible range of clinical trials, with access to potential therapies not available at other facilities.

Expert Care for Nasopharyngeal Cancer

The nasopharynx is located just behind the nose, above the soft palate (roof of the mouth), and forms the upper part of the throat. Cancer that develops in the nasopharynx is called nasopharyngeal cancer, a type of head and neck cancer.

Most nasopharyngeal cancers begin in the squamous cells, which are thin, flat cells that line the nasopharynx. These types of cells also form the top layer of skin and make up other parts of the body such as the lungs and esophagus.

At the Harold C. Simmons Comprehensive Cancer Center, we have teams of surgeons, doctors, nurses, and other providers who specialize in treating cancers of the head and neck. Our team for nasopharyngeal cancer care includes otolaryngologists (ear, nose, and throat specialists), radiation and medical oncologists, oral and reconstructive surgeons, physical and occupational therapists, and speech pathologists.

Causes and Risk Factors of Nasopharyngeal Cancer

The causes of nasopharyngeal cancer are not fully known, but certain factors can increase the chance of developing it. 

Keep in mind that not everyone with risk factors will develop nasopharyngeal cancer. Also, people without known risk factors can develop the disease. Factors that can increase the risk of nasopharyngeal cancer include:

  • Gender: Nasopharyngeal cancer affects men twice as much as women.
  • Race and ethnicity: Asian and Pacific Islanders, especially Chinese Americans, have a higher risk of the disease.
  • Geography: People in southern China, Hong Kong, Malaysia, the Philippines, Singapore, Vietnam, northwest Canada, and Greenland are at a higher risk.
  • Diet: Eating a large quantity of salt-cured meats and fish is associated with a higher risk of nasopharyngeal cancer.
  • Epstein-Barr virus: Infection with this virus, which usually occurs in childhood, is associated with nasopharyngeal cancer later in life.
  • Genes: People with certain tissue types, which affect the immune system’s ability to fight cancer, can be more susceptible to nasopharyngeal cancer.
  • Alcohol and tobacco use
  • Extensive exposure to smoke or dust

Patients can help prevent some types of cancer by avoiding certain risk factors. Learn more about head and neck cancer awareness and prevention.

Symptoms of Nasopharyngeal Cancer

Some symptoms can occur with other conditions, and some people do not experience any symptoms. Patients should see their doctor if they experience any of these symptoms and they don’t go away:

  • One or more lumps in the neck, usually not painful
  • Feeling of fullness in the ear, especially on only one side
  • Hearing loss, pain, or ringing in the ear
  • Frequent ear infections, especially in adults who have not previously had them
  • Difficulty opening the mouth
  • Nasal stuffiness or blockage
  • Headache
  • Nosebleed
  • Facial pain or numbness
  • Blurred or double vision

Stages of Nasopharyngeal Cancer

Cancer staging is the process doctors use to determine how large a tumor is, whether cancer has spread, and, if so, how far. The stages of nasopharyngeal cancer include:

Stage 0 (Carcinoma in Situ)

The lining of the nasopharynx contains abnormal cells, which might become cancer and spread into nearby normal tissue. 

Stage I: Cancer has formed

The cancer: 

  • Is found in the nasopharynx only; or 
  • Has spread from the nasopharynx to the oropharynx and/or to the nasal cavity. 

The oropharynx is the middle part of the throat and includes the soft palate, the base of the tongue, and the tonsils. 

Stage II

The cancer:

  • Is found in only the nasopharynx or has spread from the nasopharynx to the oropharynx and/or to the nasal cavity. Cancer has spread to one or more lymph nodes on one side of the neck and/or to lymph nodes behind the pharynx. The affected lymph nodes are 6 centimeters or smaller; or 
  • Is found in the parapharyngeal space (the space near the pharynx, between the base of the skull and the lower jaw). Cancer might have spread to one or more lymph nodes on one side of the neck and/or to lymph nodes behind the pharynx. The affected lymph nodes are 6 centimeters or smaller. 

Stage III

The cancer: 

  • Is found in only the nasopharynx or has spread from the nasopharynx to the oropharynx and/or to the nasal cavity. Cancer has spread to one or more lymph nodes on both sides of the neck. The affected lymph nodes are 6 centimeters or smaller; or 
  • Is found in the parapharyngeal space. Cancer has spread to one or more lymph nodes on both sides of the neck. The affected lymph nodes are 6 centimeters or smaller; or 
  • Has spread to nearby bones or sinuses. Cancer might have spread to one or more lymph nodes on one or both sides of the neck and/or to lymph nodes behind the pharynx. The affected lymph nodes are 6 centimeters or smaller. 


Stage IV: Divided into substages IVA, IVB, and IVC

  • Stage IVA: Cancer has spread beyond the nasopharynx and might have spread to the cranial nerves, the hypopharynx (the bottom part of the throat), areas in and around the side of the skull or jawbone, and/or the bone around the eye. Cancer might also have spread to one or more lymph nodes on one or both sides of the neck and/or to lymph nodes behind the pharynx. The affected lymph nodes are 6 centimeters or smaller. 
  • Stage IVB: Cancer has spread to lymph nodes between the collarbone and the top of the shoulder, and/or the affected lymph nodes are larger than 6 centimeters. 
  • Stage IVC: Cancer has spread beyond nearby lymph nodes to other parts of the body. 

Diagnosis of Nasopharyngeal Cancer

Our cancer doctors conduct a thorough evaluation, which includes a:

  • Physical exam
  • Discussion of personal and family medical history
  • Discussion of symptoms and risk factors 

To confirm a diagnosis, our doctors might recommend one or more tests, such as:

  • Nasopharyngoscopy: Because the nasopharynx is deep inside the head, we use special tools and techniques to examine it. We look inside the nose and throat with a thin, flexible tube with a lighted camera known as a nasopharyngoscope.
  • Computed tomography (CT) scan: CT uses specialized X-rays with or without a contrast agent to produce cross-sectional, 3D images of the throat.
  • Magnetic resonance imaging (MRI) scan: MRI uses radio waves and a strong magnet, with or without a contrast agent, to produce detailed images of the throat. MRI can also show whether cancer has spread to lymph nodes in the neck.
  • Positron emission tomography (PET) scan: Using small amounts of radioactive materials and a special camera, PET scans produce highly detailed images that can detect cancerous cells.
  • Biopsy: Our doctors take a small tissue sample that a pathologist analyzes under a microscope for the presence of cancer. We perform biopsies using a needle or during a nasopharyngoscopy, using a special tool on the scope.
  • Neurological exam: Patients might need this test to evaluate nerve function in the face, neck, and head areas.
  • Hearing test: If we suspect fluid in the middle ear, we might perform a hearing test.
  • Blood tests: We might order blood tests to check for signs of Epstein-Barr infection.

Treatment for Nasopharyngeal Cancer

Treatment options vary based on the stage of cancer, which includes its size, location, and whether it has spread. The main treatment for nasopharyngeal cancer is radiation therapy, often combined with chemotherapy.

Our treatment options for nasopharyngeal cancer include:

  • Radiation therapyOur doctors often use radiation, treatment with high-energy waves such as X-rays or gamma rays, for nasopharyngeal cancer because it is very sensitive to radiation.
  • Chemotherapy: Anticancer medications work to destroy cancer cells and prevent them from spreading. We often use chemotherapy along with radiation therapy to destroy as many cancer cells as possible.
  • Chemoradiation: We often combine radiation therapy with chemotherapy, known as chemoradiation. This combination makes cancer cells more sensitive to radiation.
  • Targeted therapy: Certain anticancer medications target specific characteristics within cancer cells, which can be detected through specialized testing. People whose cancers have these characteristics can be treated with targeted therapy, usually in combination with radiation or chemotherapy.
  • Surgery: We sometimes perform surgery if nasopharyngeal tumors do not respond to radiation therapy. Surgery is also effective if cancer has spread to nearby lymph nodes or other tissues in the neck. 

For patients who are having radiation therapy for nasopharyngeal cancer, we recommend having any necessary dental work done before treatment. Radiation treatment slows healing and can cause other side effects. Learn more about cancer and transplant dental care

At UT Southwestern’s Harold C. Simmons Comprehensive Cancer Center, patients have access to every available treatment option, delivered by the most experienced head and neck cancer specialists in Dallas. Find out more about all the options we offer for head and neck cancer treatment.

Support Services

We offer a variety of head and neck cancer support services for patients and their families, such as:

Clinical Trials

As a medical research institution, UT Southwestern frequently conducts head and neck cancer clinical trials, giving our patients access to the newest treatments. Patients should speak with their doctors about the availability of clinical trials.

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We have a wide range of clinical trials open to patients with all stages of cancer. Search for opportunities to participate in a cancer study.

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