Nasopharyngeal Cancer in Children

Nasopharyngeal cancer is a disease in which malignant (cancer) cells form in the lining of the nasal cavity (inside of the nose) and throat. It is rare in children younger than 10 and more common in adolescents.

The risk of nasopharyngeal cancer is greatly increased by having an infection with the Epstein-Barr virus (EBV), which infects cells of the immune system. The risk of nasopharyngeal cancer is also increased by having a certain marker on cells.

Nasopharyngeal cancer may cause any of the following signs and symptoms. Check with your child’s doctor if your child has any of the following:

• Painless lumps in the neck
• Nosebleeds
• Blocked or stuffy nose
• Headache
• Pain in the ear
• Ear infection
• Problems moving the jaw
• Hearing loss
• Double vision

Other conditions that are not nasopharyngeal cancer may cause these same signs and symptoms.

When nasopharyngeal is diagnosed, it usually has already spread to lymph nodes in the neck and bones of the skull. It may also spread to the nose, mouth, throat, bones, lung, and/or liver.

Tests to diagnose and stage nasopharyngeal cancer may include the following:

• Physical exam and history
• MRI of the head and neck
• CT scan of the chest and abdomen
• Sometimes a PET scan and a CT scan are done at the same time. If there is any cancer, this increases the chance that it will be found.
• Endoscopy
• Bone scan
• Biopsy

Other tests used to diagnose or stage nasopharyngeal cancer include the following:

• Neurological exam: A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person’s mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam.
• Nasoscopy: A procedure in which a doctor inserts a nasoscope (a thin, lighted tube) into the patient’s nose to look for abnormal areas.
• Epstein-Barr virus (EBV) tests: Blood tests to check for antibodies to the Epstein-Barr virus and DNA markers of the Epstein-Barr virus. These are found in the blood of patients who have been infected with EBV.

Treatment of nasopharyngeal cancer in children may include the following:

• Chemotherapy given before or at the same time as external radiation therapy
• Interferon given with external radiation therapy alone or with chemotherapy and external radiation therapy
• Chemotherapy and external radiation therapy givExternal radiation therapy
• Surgery
• A clinical trial of chemotherapy followed by immunotherapy (EBV-specific cytotoxic T-lymphocytes)

Young patients are more likely than adults to have problems caused by treatment, including second cancers.en with internal radiation therapy.

The prognosis (chance of recovery) for most young patients with nasopharyngeal cancer is very good.