Carcinomas of the nasopharynx are cancers which arise from the lining cells of the nasopharynx (the space at the back of the nose, above the soft palate, leading into the throat).

Nasopharyngeal carcinomas are uncommon in the UK but in some parts of the world they occur much more often. In south China and other areas in South East Asia they can make up as many as 1 in 10 of all cancers.

This great difference in the frequency of these tumours in different places has led to a lot of research to look for possible environmental causes for cancer of the nasopharynx. These studies suggest that very often there is an underlying infection in the lining cells of the nasopharynx with a type of herpes virus, called the Epstein Barr virus. Usually this infection causes no problems and goes completely unnoticed but it seems that in the Far East there are some environmental factors which can trigger this 'latent' infection to turn into a cancer. Eating salted preserved fish from an early age and the chemicals produced by burning certain types of oils in oil lamps have been suggested as things which can trigger the infection to lead to a cancer.

When a carcinoma of the nasopharynx develops it can cause a variety of symptoms depending on its direction of spread. If it involves the back of the nose then it may lead to nose bleeds, a bloody discharge from the nose or nasal obstruction. If it spreads sideways it can interfere with hearing, causing partial deafness, ear infections or ringing in the ears (tinnitus). If it involves the roof of the nasopharynx then various nerves might be damaged leading to symptoms like double vision, numbness of the skin of the face, hoarseness of the voice or headaches.

Nasopharyngeal carcinomas tend to spread to the lymph nodes in the neck and in around half of all cases the first sign of the cancer is swelling in one or both sides of the neck.

The treatment of nasopharyngeal cancer relies mainly on radiotherapy. Because of the need to give quite a high dose of radiation and to focus this on the tumour, avoiding sensitive normal tissues around and about, the treatment is quite complex and can last for some months. The results of radiotherapy for these cancers, however, are generally good with well over half of all the tumours being completely cured. Chemotherapy may also be used in some people with cancer of the nasopharynx and is probably most effective when used together with radiotherapy.

The nasopharynx contains quite a lot of lymphatic tissue and this means that another type of cancer, called a lymphoma, can develop in these tissues. The behaviour and treatment of lymphomas of the nasopharynx is different from carcinomas of the nasopharynx and depends on the particular type of the lymphoma, but they are very sensitive to chemotherapy and radiotherapy and treatment is usually very successful.