I would like to know what nasopharyngoscopy biopsy is. What is being looked for when doing this test? What are they taking a piece of? I'm very confused. Is cancer one of the things that they may be checking for?

B.V.

Nasopharyngoscopy with biopsy is a procedure in which your doctor examines your nasopharynx with a flexible fiberoptic telescope and biopsies (removes a piece of) any unusual lesions. Yes, cancer is certainly one of the things for which your doctor is checking.
The nasopharynx is an anatomic crossroads, the space where your throat (pharynx) meets your nasal cavity. The nasal cavity, by the way, is much bigger than most people realize. The nose on your face is just the tip of the iceberg. The nasal cavity extends behind the nose, the full length of the roof of the mouth.

When you look into a mirror and say, "ah," you are peering into your oropharynx. This is not the top of your throat. The space above this is the nasopharynx.

Let's return to your fears regarding cancer. Just about any tissue can give rise to cancer, and the nasopharynx is no exception. But many noncancerous tissues may grow in the nasopharynx (such as the adenoids), so please do not assume you have cancer.

The two most common symptoms of nasopharyngeal cancer are a neck lump and hearing loss. Neck lumps may represent spread of the cancer to one or more of the lymph nodes of the neck (although, once again, there are MANY possible explanations for a neck lump!). Hearing loss may occur if the cancer obstructs the eustachian tube, which is a muscular tube that extends from the nasopharynx to the middle ear. Eustachian tube obstruction can cause hearing loss because it can lead to a middle ear infection or an accumulation of middle ear fluid.

Other symptoms of nasopharyngeal cancer are nasal airway obstruction, nasal bleeding, double vision, weight loss, and unexplained pain in the ear, neck or head. As you can see, these are all very common symptoms, but nasopharyngeal cancer is a fairly uncommon problem. It is certainly not the first thing most doctors think of when they see a patient with these symptoms.

Nasopharyngeal cancer can only be diagnosed by biopsy. Even if a doctor has discovered cancer within a neck lymph node, nasopharyngeal biopsy is still important so that the doctor may be certain that the cancer arose from the nasopharynx.

Radiation therapy is the primary treatment for nasopharyngeal cancer. Only rarely are such cancers amenable to surgical removal. Chemotherapy may be helpful in some patients, depending upon the type of cancer. In the future, immunologic therapy may play a role in treatment.

It is impossible to quote survival statistics in your case. The first (and most obvious) problem is the fact that you may very well NOT HAVE CANCER. Second, your doctor certainly does not know the type of cancer. (That's one of the purposes of the biopsy.) Finally, your doctor may not know the extent of the cancer. For this, further studies (such as a CT or MRI scan) may be necessary.

By the way, why haven't you asked your doctor these questions? Your doctor has an obligation to you to tell you WHY you are having this procedure, the expected benefits of the procedure, alternatives (if any) and the risks of the procedure. This type of discussion is known as informed consent, and it is an essential prelude to any significant procedure -- such as a biopsy.