How is nasopharyngeal cancer diagnosed? 

It is important that your doctor establishes the diagnosis of nasopharyngeal cancer, assesses the size of the cancer and whether it has spread to the lymph nodes in the neck or elsewhere in the body.

To answer these questions your doctor will need to do the following things:

  • talk with you about your medical history. This includes signs you may have noticed, any other health conditions, medications that you are taking, and whether you smoke or drink alcohol

  • perform a physical examination by feeling and looking inside your throat and neck

  • order diagnostic tests, which may include scans. 

Not everyone will need to have every test for nasopharyngeal cancer. Your doctor will recommend tests that are right for you. 

Common tests include:

Nasoendoscopy

Your doctor will use a very thin flexible tube with a tiny light and camera on it to look inside your nose to see your nasopharynx. 

   

Biopsy

This involves taking a small piece (sample) from the cancer. The sample is then examined under a microscope to check for cancer cells. This is often the only sure way to tell if you have cancer. Your doctor may recommend an incision biopsy or a needle biopsy.
  • Incision biopsy: Your doctor will take a small piece of tissue using a surgical knife. This can be done in the clinic using topical anaesthetic (a spray in the nose) or in hospital under general  anaesthetic (medicine to keep you unconscious), so that you don’t feel any pain. In both cases, an endoscope and biopsy forcep is used to go through the nose into the nasopharynx. There may be some bleeding after the biopsy. If you take blood thinners (e.g. warfarin), you may need to stop these for a few days before the biopsy.
  • Needle biopsy (Fine Needle Aspiration or FNA): This is used when there is a lump (enlarged lymph node) in your neck that could have cancer cells in it. During the procedure, your doctor will take some cells from the lump using a needle. Usually this is done with guidance from an ultrasound to make sure the needle is in the right spot. You may feel a bit uncomfortable during the biopsy.
 

CT (Computed Tomography) scan

This uses X-rays to take pictures of the inside of the body. If a person has cancer, a CT scan can help the doctor to see where it is, measure how big it is, and if it has spread into nearby organs or other parts of the body.

 

MRI (Magnetic Resonance Imaging) scan

This uses magnetic fields to take pictures of the inside of the body. This helps your doctor see how far a cancer has grown into the tissue around it.

 

PET (Positron Emission Tomography) scan

This is a whole body scan that uses a radioactive form of sugar which can show if nasopharyngeal cancer has spread to the lymph nodes or elsewhere in the body