Introduction:
Nasopharyngeal cancer or nasopharyngeal carcinoma (NPC) is a rare head and neck cancer. It begins in the upper part of the throat and behind the nose, and this area is called the nasopharynx. The nasopharynx is placed at the base of the skull and above the roof of the mouth. The nostrils open into the nasopharynx, and while breathing, air flows through the nose into the throat and nasopharynx and then into the lungs.
Who Is More Likely to Get Nasopharyngeal Cancer?
It is said that fewer than one in every 1 lakh people gets nasopharyngeal cancer. This cancer is common in:
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Southeast Asia.
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Southern China.
It is also much more common in:
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North Africa.
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Other parts of Asia.
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Chinese groups in the U.S.
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Alaska and Canada.
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African-Americans.
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Hispanics.
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White people in the U.S.
This cancer occurs more common in:
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Males.
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A family history of nasopharyngeal cancer.
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People having genes linked to cancer development.
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A person coming in contact with the Epstein-Barr virus.
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People eating a diet rich in salt-cured meats and fish.
Also, there are chances of higher risk in people who:
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Smoke.
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Work around a chemical called formaldehyde.
What Causes Nasopharyngeal Cancer?
The exact cause is not known; however, this cancer has been strongly linked to the Epstein-Barr virus (EBV). Epstein-Barr virus infection is common, but not everyone who has Epstein-Barr virus infection will get nasopharyngeal cancer. Most people who have had an Epstein-Barr virus infection never had nasopharyngeal cancer, and still, researchers are trying to find how the Epstein-Barr virus leads to nasopharyngeal cancer. It is also said that DNA (deoxyribonucleic acid) from the virus affects the DNA in the cells of the nasopharynx. Abnormal growth and division of cells occur due to the change in the DNA, causing cancer.
The risk for nasopharyngeal cancer increases with a diet rich in salt-cured fish and meat. In addition, tobacco and alcohol may also increase the risk. It is said that chemicals in these things are further causing damage to the DNA in the cells.
What Are the Symptoms of Nasopharyngeal Cancer?
The most typical symptom of nasopharyngeal cancer is a lump in the neck. The following are the other symptoms of nasopharyngeal cancer.
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Ear infections that recur.
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Blurry vision.
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Face pain.
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Headache.
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Numbness.
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Hearing loss.
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Difficulty in opening mouth.
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Ringing in the ears.
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Nosebleeds.
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Stuffy nose.
All the above-mentioned symptoms are more likely to occur with other diseases that are far less serious than nasopharyngeal cancer. When the above symptoms are experienced, consult the doctor because only an experienced medical person can rule out nasopharyngeal cancer.
How Is Numbness of Hands and Legs Diagnosed?
The doctor will ask about the symptoms, family history, and medical history and perform a detailed physical examination that includes examining the ears, nose, and throat. When the doctor diagnoses something unusual, he refers to the doctor who specializes in these areas, known as an otolaryngologist.
The doctor will also feel the neck as most patients with nasopharyngeal cancer will have a lump in the neck, and this is a sign of cancer spreading to the lymph nodes. The doctor will place a flexible, lighted tube through the nose or mouth to help the doctor to view the nasopharynx better. This is called a nasopharyngoscopy, and it helps the doctor to check the area for bleeding, abnormal growths, or other problems.
When the examination is abnormal, the doctor may recommend a biopsy, where a small amount of tissue is removed and placed for examination under a microscope. The biopsy is taken during the nasopharyngoscopy and when a lump is present in the neck. The biopsy is done by placing a fragile, hollow needle into the lump.
Nasopharyngeal cancer and the extent of spread can be spotted with imaging tests. Imaging tests include:
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Chest x-ray.
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Ultrasound of the neck.
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MRI (magnetic resonance imaging).
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Complete blood count (CBC).
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EBV (Epstein-Barr virus) testing.
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Other blood tests.
When you are diagnosed with nasopharyngeal cancer, staging of the cancer is done to determine if the cancer has spread. Nasopharyngeal cancer has four stages, from Stage 0 (early stage) to Stage IV (advanced stage).
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Stage 0 - Carcinoma in situ.
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Stage 1 - It is the early stage of nasopharyngeal cancer. It has not spread to distant parts of the body or lymph nodes.
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Stage 2 - Spread of nasopharyngeal cancer to nearby tissues and lymph nodes and not spread to distant parts of the body.
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Stages 3 and 4 - These are advanced stages, where nasopharyngeal cancer has spread to the surrounding nearby tissues, lymph nodes, and distant parts of the body.
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When nasopharyngeal cancer occurs again, it is called recurrent cancer.
How Is Nasopharyngeal Cancer Treated?
When you are diagnosed with nasopharyngeal cancer, then a regular follow-up with the medical team is needed before, during, and after the treatment. The treatment will depend on the patient's overall health, location, and stage of the tumor. The treatment may include the following;
1. Radiation Therapy: It is used to kill cancer cells and stop them from multiplying. It is a standard treatment for early-stage nasopharyngeal cancer. Intensity-modulated radiation therapy (IMRT) is a type of radiation therapy that delivers high-dose radiation directly to the tumor, and it minimizes damage to nearby healthy tissues. It causes some side effects when compared to conventional radiation treatment to the nasopharynx. They are,
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Inflammation of the throat and mouth.
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Death of healthy tissue.
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Blindness.
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Dry mouth.
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Brain stem injury.
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Tooth decay.
2. Chemotherapy: Chemotherapy uses some drugs to kill the cancer cells, but it usually does not help treat nasopharyngeal cancer. It helps to live longer when combined with biological drugs or radiotherapy.
3. Surgery: Surgery is not often performed because the tumor may sometimes be located near nerves and blood vessels and may cause permanent damage to the eye and surrounding structures. So, everyone with nasopharyngeal cancer cannot have surgery, and the doctor will consider the location and stage of the tumor when discussing the treatment options.
4. Biologic Drugs: These drugs help the body's immune system fight disease, and they are monoclonal antibodies such as Pembrolizumab (Keytruda), Cetuximab (Erbitux), and Nivolumab (Opdivo). Biologic drugs are used more often in recurrent or advanced cancer cases, and they work differently than chemotherapy drugs.
5. Palliative Therapy: This therapy helps to control the symptoms related to cancer and cancer treatment. It makes the patient as comfortable as possible.
Conclusion:
In most cases, nasopharyngeal cancer cannot be prevented. Still, by avoiding salt-cured fish and meats, quitting smoking, and not drinking a lot of alcohol, one may lower the risk of nasopharyngeal cancer.
