Nasopharyngeal Cancer

Nasopharyngeal cancer (NPC) is a type of head and neck cancer where malignant cancer cells form in the tissues of the nasopharynx. The nasopharynx is the upper part of the pharynx (throat) behind the nose.

What is Nasopharyngeal cancer?

NPC is a common cancer among Malaysians and highly affects Malaysian men. In comparison to the rest of the world, the Malaysian Chinese male has the second highest incidence; the local Chinese women have the highest incidence in the world. In East Malaysia, the Bidayuhs and the Orang Ulus have the highest incidence of NPC.

Types of Carcinogenic

There are 3 main types of squamous cell cancers:

  • Keratinising squamous cell carcinoma (WHO type 1)
  • Non-keratinising-carcinoma, differentiated (WHO type 2)
  • Non-keratinising carcinoma, undifferentiated (WHO type 3)


Once you have been diagnosed positive for NPC after a biopsy test, the condition will be given a stage. This vital information will help you and your healthcare team to choose the best treatment for you. The cancer stage will describe the size of the tumour and how far it has spread.

There are 4 stages for nasopharyngeal cancer:

Stage 1 Stage 2
  • The cancer begins in the nasopharynx and may have spread into the nasal cavity or oropharynx. The cancer has not spread to nearby tissues, lymph nodes or other organs.
  • The cancer may have spread into the oropharynx or even the nasal cavity. It is also found in the lymph nodes on any side of the neck or behind the throat.
  • The cancer has reached the parts next to the nasopharynx. It might have begun from the lymph nodes on one side of the neck or behind the throat.
Stage 3 Stage 4
  • The cancer has spread to nearby bones and air cavities (sinuses). It might have also reached lymph nodes on one or both sides of the neck or behind the throat, but not anywhere else.
  • The cancer may have begun in the oropharynx, nasal cavity or surrounding area (parapharyngeal space) and has spread into the lymph nodes on both sides of the neck.
  • The cancer is advanced and is broken into 3 groups:
    • 4A means the cancer has grown within the skull. It might be in the cranial (skull) nerves, eye or nearby tissues, or the lower part of the throat. There might be cancer cells in the lymph nodes on one or both sides of the neck. These nodes are smaller than 6cm and above the collarbone area. The cancer has not spread anywhere else.
    • 4B means the cancer may have reached into nearby tissues or bones. It has spread to at least one lymph node that is bigger than 6cm across, or a lymph node in the collarbone area, or both. The cancer has not spread anywhere else.
    • 4C means the cancer has spread to other parts of the body, such as the lungs.

Warning signs

  • Hearing loss, ringing in the ear, or feeling of fullness in the ear (especially on one side only)
  • Ear infections that keep coming back
  • Nasal blockage or stuffiness
  • Nosebleeds
  • Headaches
  • Facial pain or numbness
  • Trouble opening the mouth
  • Blurred or double vision

Am I at risk?

Yes, even more so with these factors:

  • Tobacco and alcohol abuse
  • A certain kind of diet; salt-cured fish and meal
  • Infection with the Epstein-Barr virus (EBV)

Unavoidable risk factors:

  • Gender: It is found twice as often in males as it is in females
  • Ethnicity: more common in Southeast China and Hong Kong
  • Genetic factors
  • Family history

What can I do?

You cut your risk by taking these steps:

  • Stop the use of tobacco products
  • Stop or limit alcohol intake
  • Have a healthy diet
  • Schedule for screening

Nasopharyngeal Cancer Myths vs. Facts

Myth Fact
NPC is only linked to certain parts of the world, mainly Southeast China. NPC is only linked to certain parts of the world, mainly Southeast China.
Nasal congestion (blocked nose) or neck swelling is a common side effect for flu or fever. There is no need to check for NPC.

It is important to be aware of your nasopharyngeal health, especially if the flu-like symptoms are ongoing. Early screening increases the chances of curing the disease.

Survival Rates for Nasopharyngeal Cancer

According to the National Cancer Registry Report 2012 -2016, nasopharyngeal cancer is the fifth most common cancer among males, affecting 1 in 175 males. However, by the time cases were diagnosed, 69.3% of cases were already at the late stage (Stages 3 & 4), which makes the cancer challenging to treat. With this concerning finding, Sunway Cancer Centre has successfully achieved high success rates in the treatment of Nasopharyngeal Cancer (NPC), boasting 100% 5 years survival rates for Stage 1 and 2 NPC and 94.7% in Stage III and 50% in Stage IV, respectively.