Referral to a specialist for possible nasopharyngeal cancer

Your GP should arrange for you to see a specialist if you have symptoms that could be due to nasopharyngeal cancer. Depending on your symptoms and other factors, this might be an urgent referral.

You will see a specialist as soon as possible. Ask your GP when this is likely to be. 

Seeing your GP

It can be hard for GPs to decide who may have cancer and who might have a more minor condition. For some symptoms, your doctor may ask you to wait to see if the symptoms get better or respond to treatment, such as antibiotics.

UK referral guidelines

There are guidelines for GPs to help them decide who needs a referral. These vary slightly between the different UK nations. Your GP will use these guidelines as well as their own experience and judgement. 

The guidelines below are from Scotland. 

GPs in England and Wales follow the National Institute for Health and Care Excellence (NICE) guidelines. NICE don’t have specific guidelines for nasopharyngeal cancer. Specialists in Northern Ireland are updating their head and neck guidelines. We will add these when they are available.

Scotland

The Scottish guidelines are general head and neck guidelines.

You should have an emergency referral if you have symptoms caused by a blockage or narrowing of the airway. This includes noisy breathing (stridor Open a glossary item). 

Your GP or dentist should refer you to a specialist if you have any of the following that last for more than 3 weeks:

  • an unexplained lump in the head or neck area

  • an unexplained swelling or break (ulceration) on your lips or in your mouth

  • unexplained red or red and white patches in your mouth

  • a hoarse voice that is there all the time and doesn’t go away

  • painful swallowing or a painful throat that is there all the time

Neck lump clinic

A lump or growth in your neck is a common symptom of nasopharyngeal cancer and may be the only symptom you have. Your GP might refer you to a neck lump clinic if your hospital has this service. 

The neck lump clinic is a one stop clinic. You see a specialist and have one or more tests on the same day. Your specialist asks you about your symptoms and examines your lump. They may examine the inside of your nose and throat using a small flexible camera called a nasoendoscope.

You then have tests to check for cancer, such as an ultrasound scan Open a glossary item. The doctor may take a sample of cells from the lump (fine needle aspiration Open a glossary item) or a biopsy Open a glossary item.

Many neck lumps are not cancer, but it is important to be sure.

You usually have a follow up appointment about a week later to get the results. Or in some clinics, you might get some results on the same day.

Other symptoms

Your GP will consider any other symptoms you have, so do mention these.

Risk factors

Your GP might also take into account whether you have any risk factors that affect your chances of developing nasopharyngeal cancer.

If you're still worried

Sometimes you might feel that your GP is not concerned enough about your symptoms. it’s worth remembering that nasopharyngeal cancers are rare. 

If you think your GP should be more concerned, print this page and the symptoms page and ask them to talk it through with you. You can also ask your GP to explain why they don’t think you need a referral. Then you might be able to decide together whether you need to see a specialist.

What should I do if I don’t get an appointment?

If your GP has referred you, ask them when you should get your appointment. Contact them again if you don’t get one. Or some hospitals have a referral service you could try contacting if you know which hospital you are going to. Explain that you are waiting for an urgent suspected cancer referral.

Waiting times

Your hospital is working towards waiting time targets. For example, a target to find out whether you have cancer or not. And there are targets to start treatment if you are diagnosed with cancer. These are slightly different depending on where you live in the UK.

  • Scottish guidelines for suspected cancer
    The Scottish Government, 2019 (accessed March 2024)

  • Suspected cancer: recognition and referral
    National Institute for Health and Care Excellence (NICE), June 2015 (updated 2023)

  • Nasopharyngeal carcinoma: United Kingdom National Multidisciplinary Guidelines
    R Simo and others
    The Journal of Laryngology and Otology, 2016. Volume 130, Supplement 2, Pages 97-103

  • Nasopharyngeal carcinoma: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow up
    P Bossi and others
    Annals of Oncology, 2021. Volume 32, Issue 4, Pages 452-465

  • Head and neck cancer explained: an overview of management pathways

    D Owens, V Paleri  and A V Jones

    British Dental Journal, 2022 volume 233, pages 721–725

Last reviewed: 
14 Mar 2024
Next review due: 
12 Mar 2027

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