Nasopharyngeal Cancer

The nasopharynx is situated behind the nose and below the brain, connecting the nose to the windpipe. On its sidewall, a tube connects it to the ear. The nasopharynx is made up four areas:
1. Nose and sinuses 2. Mouth (oral cavity) 3. Throat (pharynx) 4. Voice box (larynx)
What are the risks?
  • Age – more common in people aged 55 and above
  • Chewing betel nut
  • Diet: A recent study in Singapore identified salted soy beans, canned pickled vegetables, Szechuan vegetables and salted vegetables as high–risk foods. The cooking of such foods releases toxic substances called nitrosamines into the fumes that we breathe.
  • Epstein Barr Virus (EB virus) – This virus has been found to be associated with NPC.
  • Geography and race: NPC incidence among Chinese and other Southeast Asians are 10 -50X higher than other countries. Moderately elevated numbers are associated in Malays.
  • Genetic factors may play an important role in NPC. Blood tests can identify certain people at risk from NPC. At present, these tests are not commercially available.
  • Human Papillomavirus (HPV)
  • Inhalation of sulphuric acid mist, asbestos fibers, dry–cleaning solvents, some types of paint or nickel
  • Smoking
  • Sex – men are 3 times more likely to develop the cancer
What are the symptoms? NPC often does not present any symptoms at the early stage. However, there are a few indications:
  • The most common presentation (90%) is a lump in the neck. That is a swollen lymph node penetrated by cancer cells.
  • Nose bleed, blocked nostrils, mucus secretion.
  • Loss of hearing, pain and buzzing in the ear and noise discharge.
  • Hoarseness of voice and difficulty in swallowing.
  • Paralysis on one side of the face.


  • Mouth pain
  • White or red patch on gums, tongue or lining
  • A change in speech or difficulty pronouncing words
  • Difficulty swallowing food or feeling that food is ‘stuck’
  • A lump in the neck
  • Loose teeth or dentures that no longer fit well


  • Throat pain
  • Sore throat or cough that won’t go away
  • Coughing up phlegm with blood
  • Difficulty swallowing
  • A change in the sound of voice or hoarseness
  • Feeling that air supply is blocked
  • Dull pain around the breastbone
  • Lump in the neck
  • An earachewell


  • Swelling in the neck or throat
  • A change in the sound of voice or hoarseness
  • Lump in the neck
  • Difficulty swallowing
  • A persistent sore throat


  • Persistent blocked nose, particularly in one nostril
  • Decreased sense of smell
  • Nosebleeds
  • Mucus drainage in the back of nose or throat
  • Frequent headaches or feeling of sinus pressure
  • A bulging or watery eye
  • Complete or partial loss of eyesight
  • Double vision
  • A lump on the face, in the nose or mouth
  • Loose or painful teeth
  • Pressure or pain in the ears