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Cancer of the nasal passages and upper throat (nasopharynx) may occur in people of any age group. Although rare in North America, cancer of the nasopharynx is one of the most common cancers in Asia. This cancer is also more common among Chinese people who immigrated to North America than other Americans. It is less common among American-born Chinese than their immigrant parents or grandparents.
The Epstein-Barr virus, which causes infectious mononucleosis, plays a role in the development of nasopharyngeal cancer. There is also a hereditary predisposition. In addition, children and young adults who eat large amounts of salted fish (especially people with a poor intake of vitamins) are more likely to develop nasopharyngeal cancer.
Often, the first symptom is persistent blockage of the nose or eustachian tubes, which causes a sensation of fullness or pain in the ears and may cause hearing loss, particularly in one ear. If a eustachian tube is blocked, fluid may accumulate in the middle ear. A person also may have a discharge of pus and blood from the nose, swollen lymph nodes, and nosebleeds. Rarely, part of the face or an eye becomes paralyzed. Often, the cancer spreads to lymph nodes in the neck.
A doctor diagnoses the cancer by performing a biopsy of the tumor, in which a sample of tissue is removed and examined under a microscope. Computed tomography (CT) of the base of the skull and magnetic resonance imaging (MRI) of the head and neck are performed to evaluate the extent of the cancer. A positron emission tomography (PET) scan also commonly is done to assess the extent of the cancer.
The tumor is treated with radiation therapy and chemotherapy. If the tumor is large or persists, surgery may be needed, although these tumors are often not amenable to surgical removal. Overall, 35% of the people survive for at least 5 years after diagnosis. Early treatment improves prognosis significantly.
Last full review/revision July 2008 by Richard V. Smith, MD
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