The causes

There are three major known risk factors for NPC.

• Genetic factors: Studies have found that people with certain inherited tissue types have an increased risk of developing NPC.

• Infection by the Epstein-Barr virus (EVB): The virus (which causes glandular fever) has been linked to an increased risk of developing cancers of the nasopharynx and the lymphatic system (lymphoma). But not all people infected with the EVB virus, and who have the specific genetic make-up, develop NPC.

• Environmental factors: living and eating habits – for example, heavy alcohol consumption for an extended period is believed to increase the risk of NPC. Studies have found that smoking and an excessive intake of salted fish may also increase the risk of nasal cancers.

The symptoms

Early symptoms of NPC are not obvious, and so may be easily ignored. They include the following:

• Blood-stained nasal discharge

• Hearing loss, ringing in the ear or weeping in the external auditory canal

• Post-nasal drip

• Nasal obstruction

Swollen lymph nodes in the neck

• Recurring headaches, especially at night

• Lockjaw, malaise and weight loss

As the nasopharynx has a strong lymphatic link to the neck, the first sign that NPC is spreading may be a lump in the neck. Most of these secondary tumours in the neck glands can be removed if immediate medical attention is sought.
In areas where chronic rhinitis and sinusitis are common because of air quality, the symptoms of NPC may be treated as simple nasal problems for months until there is a lump on the neck.