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The nasopharynx is present behind our nose and back of the throat. Cancer of the Nasopharynx is called nasopharyngeal carcinoma.
Signs and symptoms of nasopharyngeal carcinoma
At the starting time or early stages of this type of cancer, no symptoms are detected. The most common signs and symptoms are given below.
- Blood in saliva
- Loss of hearing
- Sore throats
- Headaches
- Frequent infections of the ear
- Nasal congestion
- Ringing in ear
- Bloody discharge from nose
- A lump in the neck
Early symptoms are not very common and may not require a doctor’s visit. It is advisable to pay a visit to the doctor if an unusual lump in the neck or unusual nasal congestion is observed.
Cause of nasopharyngeal carcinoma
This type of cancer begins with some genetic mutations leading to abnormal and abrupt growth of the cells of the nasopharyngeal area. These cells invade surrounding areas first and then spread to other parts of the body. In this type of cancer, the process of abnormal cell multiplications starts in the squamous cells of the Nasopharynx. The exact cause of gene mutation is not known. It has also been identified that the Epstein Burr virus increases the risk of this cancer.
There are many other things still unknown. It is still not clear that many people have all risk factors but never develop this type of cancer. But some people develop this type of cancer without any risk factor.
Risk factors of nasopharyngeal carcinoma
Following are some factors that can be associated with this type of cancer.
1. Age
This cancer can occur at any age but is most commonly found in people 30-50 years of age.
2. Sex
More common in men than women
3. Race
This type of cancer is more common in China, Southeast Asia, and northern Africa. In the U.S.A, this cancer is more common in Asian immigrants. Inuit in Alaska have also a high risk of nasopharyngeal cancer.
4. Salt cured food
When salt-cured foods are cook, they release a chemical in the steam which may enter the nasal cavity. These chemicals increase the risk of this type of cancer. This risk is increased if exposed to these chemicals at an early age.
5. Family History
If any of the family members has this cancer then your chances of having this cancer are also high.
6. Use of alcohol and Tobacco
Heavy use and alcohol increases your risk of having this cancer
7. Epstein Burr Virus
This virus is also supposed to be linked with any type of cancer including nasopharyngeal.
Complications of nasopharyngeal cancer
This type of cancer can complications if invades the surrounding body parts. Complications may become worse if they spread to other parts of the body.
Prevention
There is no confirmed way of avoiding or preventing this cancer but cut down the habits which can cause this type of cancer. For example, reduce the use of salt-cured food.
Diagnosis
- Physical exam: it includes a general examination like asking about symptoms and pressing a lump near the neck.
- Nasal Endoscopy: A camera is used to see the nasopharyngeal area
- Biopsy: A small tissue is obtained from the nasopharyngeal area to investigate further
- Radiological Tests: This includes Ct scan, MRI, PET scan, and X rays
- Blood test: As this type of cancer is rare, only routine blood tests to know blood chemistry are done. In those parts of the world like China where disease prevalence is high, some advanced screening tests are available. One of the advanced screening tests is Next-generation Sequencing.
Next-Generation Sequencing (NGS)
It is the advanced screening of early noninvasive nasopharyngeal cancer. This screening can detect nasopharyngeal cancer at early stages. This test detects this type of cancer so early even patient is not having any symptoms. This test enables to test of multiple genes simultaneously for mutation and disease marker. This test provides results for mutation specifically needed. At the same time, the NGS test can identify new markers. This may help the doctor to know the pattern of the patient’s response.
Take 2 health, Hong Kong is a company that has commercialized this NGS test.
Staging of nasopharyngeal carcinoma
After the diagnosis of this cancer, staging is done. There are 4 stages of this type of cancer starting from I to IV. A lower number means the cancer is confined to its original place and small. A higher number means cancer has spread to other parts of the body.
Treatment
Treatment is based on many factors like treatment goal, stage of cancer, and overall health of the patient. Treatment usually begins with radiotherapy. But sometimes it can be a combination of both Radio and chemotherapy.
- Radiotherapy
Radiation therapy is usually carried out in a procedure called external beam therapy. Sometimes internal radiotherapy is used called brachytherapy. Radiotherapy is sufficient to treat small tumors of nasopharyngeal cancer. In some situations, chemotherapy is also recommended.
Side effects of radiotherapy: Hearing loss, skin redness, and dry mouth.
Dry mouth is a very uncomfortable condition as it causes frequent infections and difficulties in eating, swallowing, and speaking. Getting help from a doctor or dentist can reduce this condition. Doctors usually recommend brushing teeth several times in the day.
- Chemotherapy
Chemotherapy includes the use of medicines that kill cancerous cells. There can be 3 types of chemotherapies in nasopharyngeal cancer.
- Combination of radio and chemotherapies
These therapies increase the effect of each other and desired results achieved early. But this combination causes many side effects.
- Chemotherapy after radiation therapy
In this situation, the doctor recommends the use of chemotherapy after radiotherapy.
- Chemotherapy before Radiotherapy
There is no evidence of chemotherapy efficacy before radiotherapy and still require more investigation
Surgery
Surgery is not the usual option for nasopharyngeal carcinoma. But surgery can be helpful to remove cancerous lymph nodes from the neck. Sometimes, surgery is also used to remove the lump in the Nasopharynx. This is done by the incision on the roof of the mouth.
