Nasopharyngeal Cancer: Causes, Symptoms, Diagnosis, Treatment

Nasopharyngeal cancer (commonly known as nose cancer) is a rare type of cancer that occurs in the head and neck. It usually starts in the upper region of the throat, known as the nasopharynx

The nasopharynx is located at the roof of your mouth and placed at the base of the skull. The air flows into the nasopharynx and throat and finally into the lungs when we breathe.

Also known as NPC, nasopharyngeal cancer is native to Southeast Asia, with a prevalence rate of up to 50 cases per 100,000 people. This is much lower compared to the United States and other parts of the world, which have a reported incidence of less than 1 case per 100,000 people.

Types of nasopharyngeal cancer

Nasopharyngeal cancer can be classified into three main types:

• Keratinising squamous cell carcinoma (type 1)
• Non-keratinising squamous cell carcinoma (type 2)
• Undifferentiated carcinomas (type 3)

Causes of nasopharyngeal cancer

The exact cause of nasopharyngeal cancer is unknown but there are several factors that contribute to a higher chance of developing the disease such as:

• Epstein-Barr virus (EBV) infection: EBV infection has been linked to nasopharyngeal cancer development, however, not everyone who has had EBV infection will develop nasopharyngeal cancer.
• Dietary habits: Nasopharyngeal cancer has also been linked to certain dietary habits e.g. diets that are high in salts, cured fish and meat.
• Tobacco smoking

Signs and symptoms of nasopharyngeal cancer

It is challenging to recognise nasopharyngeal cancer at its initial stages because the symptoms are similar to other less severe medical conditions. Additionally, there are not many evident symptoms until cancer reaches an advanced stage in some cases.

Some notable symptoms of nasopharyngeal cancer include:

• A lump in the neck (most common symptom)
• Headache
• Double vision
• Nose bleeds
• Stuffy nose
• Unintentional weight loss
• Swallowing problems
• Numbness at the lower region of the face
• Hearing loss (usually happens in one ear)
• Trouble speaking or breathing
• Facial pain
• Ear infections
• Ringing in the ears (tinnitus)

Risk factors of nasopharyngeal cancer

Some of the risk factors of nasopharyngeal cancer include:

• Alcohol and tobacco: Heavy alcohol intake and tobacco use can raise your risk of developing nasopharyngeal carcinoma.
• Age: Nasopharyngeal cancer can occur at any age, but it's most commonly diagnosed in adults between the ages of 30 and 50.
• Workplace exposure: To causative agents e.g. wood dust, formaldehyde and chemical fumes.

Diagnosis of nasopharyngeal cancer

• Physical examination: The oncologist will ask detailed questions on your past medical history and closely examine your mouth, neck, throat, lymph nodes and head.
• Nasal endoscopy: A thin, flexible, and lighted tube known as an endoscope will be inserted through your nose and throat to look for any abnormalities.
• Biopsy: A sample tissue from the affected area is removed and examined under a microscope to find the presence of a tumour.
• Imaging tests:
• Positron emission tomography (PET) scan
• Magnetic resonance imaging (MRI) scan
• Computed tomography (CT) scan
• Chest x-ray

The doctor can understand the stage of your cancer after looking at the test results and will be able to devise a treatment plan accordingly.

Learn more about the different types of screening and diagnostic procedures performed to diagnose nasopharyngeal cancer.

Treatment options for nasopharyngeal cancer

There is a specific treatment method suitable for every stage of cancer. Some of these include:

• Radiation therapy: As nasopharyngeal cancer cells are sensitive to radiation, high-energy x-ray beams are used to destroy the cancer cells.
• Chemotherapy: Useful for cancers that have spread to different body parts. Anti-cancer drugs are given intravenously or orally.
• Targeted drug therapy: This is often combined with radiation therapy and chemotherapy. Nasopharyngeal cancer patients may benefit from cetuximab injections (synthetic version of an immune system protein).
• Surgery: Nasopharynx is a tricky area to operate, however in some in certain cases the tumour can be surgically removed. Surgery can also be used to remove lymph nodes that are not responding to other treatments.

Learn more about the different types of treatment technologies to treat nasopharyngeal cancer.

Prevention of nasopharyngeal cancer

• Limit the amount of preserved or fermented foods you eat or avoid them completely.
• Avoid smoking and heavy alcohol consumption.
• Comply with your workplace’s health and safety regulations and take precautions to minimise exposure to causative agents e.g. wood dust, formaldehyde and chemical fumes.

Detect to Protect!

Early identification can lead to improved patient outcomes. Doctors may offer screening for people who are considered at high risk for nasopharyngeal cancer. Screening may include:

• Blood tests: To detect the presence of Epstein-Barr virus.
• Nasopharyngoscopy: A convenient, cheap and simple procedure in which the internal areas of the nose and throat can be examined with a fibre-optic instrument.

Make an appointment at Gleneagles Hospitals

If you are experiencing any of the symptoms of nasopharyngeal cancer, get in touch with us to find out more about our Oncology Services at your nearest Gleneagles Hospital.

Gleneagles Hospital works with oncologists to assist patients through cancer treatment. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.