Cancer Types
Common cancer types: symptoms, diagnostic methods and current treatment options.
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Nasopharyngeal Cancer: Symptoms, Diagnosis and Treatment
Sources reviewed by: Assoc. Prof. Dr. Ali OğulLast updated: October 2026
Nasopharyngeal cancer symptoms, EBV association, MRI staging, chemoradiotherapy and immunotherapy options. Medical oncology assessment in Mersin.
Key information
| Definition | A malignant tumour arising from the nasopharynx behind the nasal cavity |
|---|---|
| Main risks | EBV infection, salted and smoked foods, smoking |
| Common symptoms | Painless lump in the neck, ear blockage, nosebleeds |
| Diagnosis | Endoscopy and biopsy, MRI, PET-CT, blood EBV DNA |
| Treatment | Radiotherapy, chemoradiotherapy, chemotherapy, immunotherapy |
What is nasopharyngeal cancer?
Nasopharyngeal cancer develops from the area behind the nasal cavity, at the top of the throat (nasopharynx). Unlike other head and neck cancers, it is closely associated with the Epstein-Barr virus (EBV) and is highly sensitive to radiotherapy and chemotherapy. Because of the anatomy of the region, radiotherapy rather than surgery is the basis of treatment [1][2].
Risk factors
EBV infection, frequent consumption of salted and smoked foods, smoking and genetic predisposition are risk factors. It is more common in populations of South-East Asian and North African origin [2][3].
What are the symptoms?
A painless enlarged lymph node in the neck is the most common reason for seeking care. One-sided ear blockage or hearing loss, nasal congestion, nosebleeds, double vision, facial numbness and headache may occur. In adults, fluid in the middle ear on one side requires examination of the nasopharynx [1][3].
Most of these complaints can also be caused by other conditions; complaints that persist or get worse need to be assessed by a doctor.
How is it diagnosed?
Diagnosis is made by endoscopic examination of the nasopharynx and biopsy. MRI of the nasopharynx and neck and PET-CT are used to assess spread. Blood EBV DNA levels can be used for prognosis and follow-up. Dental, hearing and nutritional assessment is recommended before treatment [1][4].
Staging
Staging follows the AJCC/UICC TNM (8th edition) system; extension of the tumour to the skull base and cranial nerves and involvement of neck lymph nodes determine the stage [1][4].
Treatment options
- Early stage: In stage I disease, intensity-modulated radiotherapy (IMRT) is used alone.
- Locally advanced stage: Chemoradiotherapy with concurrent cisplatin is standard. Induction chemotherapy (e.g. gemcitabine + cisplatin) before chemoradiotherapy is an approach recommended in guidelines.
- Recurrent or metastatic disease: Adding PD-1 inhibitors (e.g. toripalimab, camrelizumab, tislelizumab) to gemcitabine + cisplatin chemotherapy has entered guidelines as a new standard in advanced disease; availability of these drugs in Türkiye varies. Re-irradiation or surgery is considered for local recurrence in selected patients [4][5].
- Support: Support for dry mouth, swallowing difficulty, hearing and dental health is important before and after treatment.
Treatment is planned individually, taking into account the stage, tumour characteristics, general condition and the patient’s preferences. Not every option listed here is suitable for every patient.
Recent developments
Induction chemotherapy and immunotherapy in advanced disease are developments that have changed treatment in recent years. The use of blood EBV DNA measurement to personalise treatment intensity is being investigated [4][5].
Support and follow-up during treatment
During treatment, not only the anti-cancer drugs but also the patient’s general condition is monitored. Nausea, fatigue, loss of appetite, pain, infection risk and changes in mood are asked about at every visit; when needed, preventive medication, nutritional support, physiotherapy and psychosocial support are planned. In situations such as fever, shortness of breath, uncontrollable diarrhoea or vomiting, or new severe pain, it is advisable to contact the treatment team without waiting for the scheduled visit. Herbal products and supplements can interact with some cancer drugs, so the treatment team should be consulted before using them.
Response is assessed with MRI 3 months after treatment, followed by examination, endoscopy and imaging at regular intervals. Late effects of radiotherapy (thyroid and pituitary function, hearing, dry mouth) should be monitored.
Frequently asked questions
Because of the location of the region, the main treatment is radiotherapy and chemotherapy; surgery is generally considered for selected recurrences.
Blood EBV DNA levels can give information about disease burden and recurrence monitoring after treatment; on its own it does not establish the diagnosis.
IMRT protects the salivary glands better; nevertheless, dry mouth can persist for a long time in some patients and is managed with supportive treatment.
A painless lump in the neck lasting more than two to three weeks should be assessed by an ENT specialist.
Call +90 530 250 54 85 or write to the same number via WhatsApp. The outpatient clinic is open Monday to Friday, 08:00–16:00.
At the medical oncology outpatient clinic of Mersin University Faculty of Medicine Oncology Hospital, Çiftlikköy Campus, 33110 Yenişehir/Mersin, Türkiye. The assessment is done in person.
When needed, yes. The multidisciplinary tumour board meets every Friday from 09:00 to 13:00, and the sequence of surgery, radiotherapy and drug treatment is planned jointly.
Yes. A second opinion is a common way to clarify a treatment plan. Bring your pathology, imaging and discharge reports to the clinic for the assessment.
Pathology report, imaging reports and, if possible, the image CDs, discharge summary, recent blood tests and a list of the medicines you take. Translated copies are helpful if your documents are not in Turkish or English.
Medical oncology consultation for nasopharyngeal cancer in Mersin
If you have been diagnosed with nasopharyngeal cancer, or your diagnostic work-up is ongoing, you can apply for a medical oncology consultation with Assoc. Prof. Dr. Ali Oğul at Mersin University Faculty of Medicine Oncology Hospital (Çiftlikköy Campus, 33110 Yenişehir/Mersin, Türkiye). Medical oncology covers the planning of drug treatments such as chemotherapy, targeted therapy, immunotherapy and hormone therapy, the monitoring of side effects and follow-up after treatment. The hospital has a day treatment unit where drug treatments are given.
Treatment decisions are made by a team. When needed, patient files are discussed at the multidisciplinary tumour board, which meets every Friday from 09:00 to 13:00 with specialists from the relevant departments.
For appointments, call +90 530 250 54 85 or send a WhatsApp message to the same number with your name, diagnosis and reason for the request; you can also send your reports. The outpatient clinic is open Monday to Friday, 08:00–16:00. No diagnosis or treatment recommendation is given via WhatsApp; the assessment takes place in person at the clinic. Consultations are held in Turkish.
Appointment
Evaluation and second opinion
If you have been diagnosed with nasopharyngeal cancer or would like a second opinion on your current treatment plan, you can contact Assoc. Prof. Dr. Ali Oğul with your pathology report and imaging results.
This content is for information only; please consult your physician for diagnosis and treatment.
References
- EURACAN-ESMO Clinical Practice Guidelines – Nasopharyngeal carcinoma. Accessed: October 2026. https://www.esmo.org/guidelines/guidelines-by-topic/head-and-neck-cancers
- NCI – Nasopharyngeal Cancer Treatment (PDQ). Accessed: October 2026. https://www.cancer.gov/types/head-and-neck/patient/adult/nasopharyngeal-treatment-pdq
- WHO/IARC – Global Cancer Observatory. Accessed: October 2026. https://gco.iarc.who.int/
- NCCN Guidelines – Head and Neck Cancers. Accessed: October 2026. https://www.nccn.org/guidelines/category_1
- ASCO Guideline – Chemotherapy and Radiotherapy in Nasopharyngeal Carcinoma. Accessed: October 2026. https://www.asco.org/practice-patients/guidelines
Links open external sources. The references were accessible as of October 2026.