Tests for nasopharyngeal cancer
Nasopharyngeal cancer is when abnormal cells in the nasopharynx start to grow and divide uncontrollably. The nasopharynx is at the top of your throat. It connects the back of your nose to the back of your mouth.
You have tests if you have symptoms that could be due to nasopharyngeal cancer. These tests will find out what is causing them and whether it is cancer or not.
If you have been diagnosed with nasopharyngeal cancer, you have further tests to find out its size and whether it has spread. This tells you the stage of your cancer. The stage helps your doctor to decide the best treatment for you.
Tests your GP might do
Most people with symptoms start by contacting their GP. The first appointment with your GP is often a telephone appointment. Your GP then might arrange for you to go in and see them.
Your GP can do some tests to help them decide if you need to see a specialist. This usually includes:
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an examination of your nose, mouth, throat and neck
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blood tests
Examining your nose, throat, mouth and neck
Your doctor looks inside your nose and mouth and feels around your neck. They feel for any areas that might be swollen or do not feel normal.
Your GP might listen and feel other areas of your body such as your chest and tummy to find out if they sound normal.
Do also let your doctor know if you have pain anywhere in your body.
Blood tests
Blood tests can check your general health including:
- how well your liver and kidneys are working
- check the number of blood cells such as
platelets 
and red blood cells
Tests your specialist might do
Depending on the examination by your GP and the results of your tests, your GP might refer you to a specialist doctor at the hospital. This is usually a head and neck doctor or an ENT specialist. ENT stands for ear, nose, and throat.
Your specialist doctor usually does more tests. These might include:
- a test to look inside your nose, mouth, and throat (called a nasoendoscopy)
- an ultrasound scan of your neck
lymph nodes or a lump in your neck to check for cancer. You might also have a tissue sample taken (a biopsy) of the lymph nodes or neck lump - a test using a larger endoscope to have a closer look at your upper airway and to take biopsies of any abnormal areas (a panendoscopy)
- a CT scan
- an MRI scan
- a PET-CT scan
Nasoendoscopy
A nasoendoscopy is often the first test you have at the hospital. You usually have this in the outpatient clinic.
Your doctor passes a thin and flexible tube called a nasoendoscope through your nose and into your throat. The tube has a camera and a light at the end. This test can be uncomfortable but doesn’t usually hurt. It only lasts a few minutes.
If your doctor sees an abnormal area, you may need to go into the hospital for a day to have a sample of tissue (biopsy) taken under a short . Or you might have a biopsy using a in a minor operation unit. This depends on where exactly the abnormal area is and how big it is.
Checking your neck lymph nodes or neck lump
You might have an ultrasound scan to check the lymph nodes or a lump in your neck.
Ultrasound scans use high frequency sound waves to create a picture of a part of the body. The ultrasound scanner has a microphone that gives off sound waves. The sound waves bounce off the organs inside your body and are picked up by the microphone. The microphone links to a computer that turns the sound waves into a picture.
If your doctor sees an abnormal area, you might have a (FNA) or a core biopsy at the same time as your ultrasound scan. Your doctor uses a special needle or syringe to take the cells. A can then look at the cells under a microscope.
Your doctor numbs the area with a local anaesthetic before taking the sample of cells.
Panendoscopy
A panendoscopy is a test to look at your upper airway. This includes your:
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mouth
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nose
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throat
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voice box (larynx)
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top of your food pipe (oesophagus)
You usually have a panendoscopy if:
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other tests have shown an abnormal area in your mouth, throat or nose and your doctor wants to see this more clearly
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your doctor wants to take a biopsy from an abnormal area
A specialist doctor does the test using a panendoscope. This is a series of connected telescopes. You have a panendoscopy under general anaesthetic in the operating theatre. This means that you are asleep and won’t feel anything. Your doctor looks through one end of the endoscope and there is a camera and light at the other.
MRI scan
MRI stands for magnetic resonance imaging. It uses magnetism and radio waves to take pictures of the inside of the body.
You might have an MRI scan of your head and neck if your doctor thinks the cancer has spread to the nearby lymph nodes.
CT scan
A CT (or CAT) scan stands for computer (axial) tomography. It is a test that uses x-rays and a computer to create detailed pictures of the inside of your body. The computer puts them together to make a 3 dimensional (3D) image.
You might have a CT scan of your head and neck to show the size of the nasopharyngeal cancer and any enlarged lymph nodes in your neck.
You might also have a CT scan of your chest or abdomen. This can show whether the cancer has spread.
PET-CT scan
A PET-CT scan combines a CT scan and a PET scan. It gives detailed information about your cancer.
You usually have a PET-CT scan in the radiology department. It usually takes between 30 and 60 minutes. You might have a PET-CT scan if your doctor finds cancer cells in the lymph nodes in your neck, but they don’t know where the cancer started. The PET-CT scan can help to show a cancer that other scans have not been able to find.
Other tests for nasopharyngeal cancer
Depending on your symptoms you might have other tests. These may include:
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a hearing test – if your symptoms include hearing problems
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a dental examination
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an eye test if your symptoms include problems with your eyes
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a barium swallow test - you might have this if you are having difficulty swallowing solid food
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a blood tests to look for levels of a virus called Epstein Barr virus (EBV). This can help your doctor plan your treatment.
You might also have a chest x-ray. This uses small amounts of radiation to take pictures of the inside of your body. Your GP or hospital doctor might request a chest x-ray if you have shortness of breath or a change in your voice (hoarseness) that doesn’t go away.
Treatment
The tests you have help your doctor find out if you have nasopharyngeal cancer and how far it has grown. This is the stage of the cancer.
This is important because doctors recommend your treatment according to the stage of the cancer.
Getting your results
You should get your results within 1 or 2 weeks.
Waiting for results can make you anxious. Ask your doctor or nurse how long it will take to get them. Contact the doctor who arranged the test if you haven’t heard anything after a couple of weeks.
You might have contact details for a specialist nurse who you can contact for information if you need to. It may help to talk to a close friend or relative about how you feel. You may want them to go with you to get the results for support.
Coping
Coping with a diagnosis of nasopharyngeal cancer can be difficult. There is help and support for you and your family.
