Nasopharynx

Head and Neck Cancer Introduction Page
oral cavity
oropharynx
(soft palate, tonsil, base of tongue)
larynx (voice box)
hypopharynx (pyriform sinus, posterior phanryngeal wall, post-cricoid region)
nasal cavity/paranasal sinuses
nasopharynx
salivary glands
paragangliomas (glomus tumors)
thyroid


Nasopharynx

Background
Signs and Symptoms
Clinical Evaluation
Treatment
Follow-Up

Background


Illustration courtesy of Lippincott Williams & Wilkins © 2004

The nasopharynx is the air cavity behind the nose, just under the base of skull and at the upper aspect of the aerodigestive tract. It is behind the soft palate.

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Signs and Symptoms

Most patients see their doctor because of a lump in the neck. A stuffy nose, bleeding through the nose, headache, earache, decreased hearing, recurrent ear infections, sinus congestion, and other symptoms in the nasal region, can alse be symptoms.

There are several areas of the world, including many Asian countries, the Mediterranean region, the Middle East, and Northern Africa, in which there is a particularly prominent risk of nasopharyngeal cancer. All ages are affected, including children. The causes of this cancer are not completely understood, however researchers believe that viruses may play a role.

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Clinical evaluation

As with all head and neck cancers, a proper evaluation begins with a history and physical. A careful and detailed head and neck examination is required, which includes the use of a flexible fibre-optic endoscopy. An endoscopy, often done in the doctor’s office, involves placing a small, flexible instrument through the nose in order to see all the structures of the head and neck. The procedure is painless. A biopsy is performed, and if a diagnosis of cancer is made, an evaluation to determine the extent of disease must be done. This includes a complete physical examination, a CT scan (which uses X-rays to create a two-dimensional image of the area), an an MRI scan (which uses a magnetic field and pulses of radio wave energy to visualize the detailed anatomy), and a PET scan (which creates computerized images of the metabolic changes that occur in tissue). A chest X-ray, and sometimes a chest CT scan may also be used.

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Treatment

Radiation therapy is the primary treatment for nasopharyngeal carcinoma. Early-stage cancers are treated by radiation therapy alone. More advanced cancers are treated by a combination of chemotherapy and radiation. For patients with more advanced cancers, additional chemotherapy is usually given after the completion of the combined chemotherapy/radiotherapy program.

The technical planning and delivery of radiation therapy is an essential part of the success of treatment. At Continuum Cancer Centers of New York, we use all modern technological advances to treat nasopharyngeal cancer. Three-dimensional conformal external beam radiation therapy, intensity modulated radiation therapy, and stereotactic radiotherapy may be a key component of treatment. Our physicians are highly experienced with these techniques.

As is true with all other head and neck cancers, the multidisciplinary team approach is essential. In addition to the radiation oncologist, medical oncologist, and surgeon, participation of diagnostic radiologists, pathologists, dental oncologists, nurses, cancer support services, and others, are optimal. Continuum Cancer Centers employ this multidisciplinary, team approach in order to maximize the outcome for our patients.

Click Here for more information about radiation oncology treatments for head and neck cancer.

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Follow-up

After treatment is completed, the patient enters the follow-up phase. Usually, all of the treating physicians are involved in follow-up evaluations. For the first year, patients are usually seen every one to two months. During the second year, they are often seen every two to three months. After the second year, patients are usually seen every three to six months. Of course, the follow-up schedule is individualized for each patient.

Imaging procedures like CT scans, PET scans, or fused PET/CT scans, are done according to a routine that is individualized for each patient. Not all patients require these studies. A chest X-ray is usually done on an annual basis. Regular dental evaluation is done, because good dental care is essential to the head and neck health.

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