Nasopharyngeal Carcinoma: Causes, Symptoms, and Treatment

Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.

What kind of doctor treats Nasopharyngeal Carcinoma?

An oncologist, a doctor who treats cancer, usually oversees care for nasopharyngeal carcinoma. An ear, nose, and throat doctor often does the first exam, and a radiation oncologist gives radiation treatment. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.

What is nasopharyngeal carcinoma?

Nasopharyngeal cancer is a type of head and neck cancer that starts in the tissues of the nasopharynx. The nasopharynx is the upper part of the throat, located behind the nose. The cancer commonly begins in the squamous cells that line the nasopharynx.

This cancer is very rare. It often does not cause noticeable symptoms at first, so it is sometimes found at a later stage.

Symptoms

Most people with this cancer notice a lump or mass in the neck. It is usually not tender or painful. Other possible symptoms include:

  • Hearing loss, ringing in the ear, pain, or a feeling of fullness in the ear, especially on one side only.
  • Ear infections that keep coming back.
  • Nasal blockage or stuffiness, and nosebleeds.
  • Sore throat.
  • Headaches, and facial pain or numbness.
  • Trouble opening your mouth.
  • Blurred or double vision.
  • Trouble breathing or talking.

Causes and who gets it

The exact cause of most nasopharyngeal cancers is not known. Scientists have found risk factors, which are things that raise a person's chance of getting the disease. Having a risk factor does not mean you will get the disease.

Risk factors include:

  • Infection with Epstein-Barr virus (EBV). Most people who get EBV do not develop this cancer.
  • Living in, or having ancestry from, certain parts of Asia, North Africa, and the Arctic.
  • Having a family member with this cancer.
  • Using tobacco or breathing in secondhand smoke.
  • Frequent and heavy alcohol use.
  • A diet high in salt-cured fish and meats, which may contain cancer-causing chemicals such as nitrosamine.

The cancer can occur at any age. Men tend to develop it more often than women.

How doctors diagnose it

Your doctor will ask when your symptoms started and how often you have them. They will also ask about your health and family history and do a physical exam. Tests used to diagnose and stage this cancer include:

  • Nasopharyngoscopy with biopsy. A thin, flexible lighted tube is passed through the nose to the back of the throat, and a sample of tissue may be taken to check for cancer under a microscope.
  • MRI (magnetic resonance imaging), which uses a magnet, radio waves, and a computer to make detailed pictures inside the body.
  • An Epstein-Barr virus (EBV) blood test. An HPV test is usually done if the EBV test is negative.

Treatment

An oncologist oversees treatment. Your care team may also include a head and neck surgeon, a radiation oncologist, a dentist, a dietitian, and a speech therapist. Treatment depends on the stage of the cancer and your overall health, and you may have more than one type.

  • Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells. Treatment of stage I is usually radiation to the tumor and lymph nodes in the neck.
  • Chemotherapy uses drugs to stop the growth of cancer cells. It may be given with radiation therapy. For stages II, III, and IVA, one option is chemotherapy given with radiation, followed by more chemotherapy.
  • Surgery is sometimes used for cancer that does not respond to radiation. If cancer has spread to lymph nodes, the doctor may remove lymph nodes and other tissues in the neck.
  • Immunotherapy uses the patient's immune system to fight cancer. It may be used for cancer that has spread or has come back.

Late effects of treatment can start after treatment ends and last for months or years. They may include chronic dry mouth, hearing loss, and trouble swallowing. After treatment, head and neck exams are important to look for signs that the cancer has come back.

When to see a doctor

If you have any of the symptoms above, see a doctor right away so the cause can be found and treated, if needed. A new infection in one ear in an adult who has not had ear infections before should be checked by a specialist who can examine the nasopharynx.

Call 911 or go to the emergency room if you have sudden or severe breathing problems, or bleeding that will not stop.

How a direct primary care or concierge doctor fits in

A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can look at a lasting neck lump or ear symptoms, order first tests, and refer you to an ear, nose, and throat doctor or an oncologist.

Common questions

What is the first sign of nasopharyngeal carcinoma?

A lump or mass in the neck is the sign that most people notice. Some people have no noticeable symptoms at first.

Does Epstein-Barr virus cause nasopharyngeal carcinoma?

It is linked to it, but infection alone is not enough to cause it. Most people who get EBV do not develop nasopharyngeal cancer.

Can nasopharyngeal carcinoma be prevented?

There is no sure way to prevent it, but some steps might lower your risk. Avoiding tobacco and alcohol might help, and so might eating less salt-cured fish.

How is nasopharyngeal carcinoma treated?

It depends on the stage of the cancer. Stage I is usually treated with radiation therapy to the tumor and lymph nodes in the neck. Later stages may add chemotherapy, and sometimes surgery.

Sources

  1. National Cancer Institute - Nasopharyngeal Cancer Treatment (PDQ) - Patient Version
  2. American Cancer Society - Signs and Symptoms of Nasopharyngeal Cancer
  3. American Cancer Society - Nasopharyngeal Cancer Causes, Risk Factors, and Prevention

Medical Disclaimer

This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.