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Nasopharyngeal cancer

Nasopharyngeal cancer

Overview

Nasopharyngeal cancer is the type of cancer that develops in the nasopharynx. The nasopharynx is the anatomical area in your body that consists of the junction between your posterior nose and upper pharynx. It is a rare type of cancer in the US, but it is more common in Southeast Asia. It is hard to identify nasopharyngeal carcinoma in time. Its symptoms and signs might mimic other medical conditions, and the examination of the nasopharynx needs specialized instruments. In this article, we will focus on the essential information regarding nasopharyngeal cancer, its causes, risk factors, symptoms, diagnosis, and treatment.

How common is nasopharyngeal cancer?

Nasopharyngeal cancer is not common in the US. It most commonly appears in other parts of the world, such as Southeast Asia, and the Asians/Pacific Islanders, in general. Nasopharyngeal carcinoma affects an estimated one person in every 100,000 individuals in the US every year. Asians/Pacific Islanders are six times more likely to develop the disease compared to the rest of the world. It may affect people from all age groups, and 50% of the cases appear in those younger than 55 years old. The five-year survival rate expresses the possibility of survival five years after the identification of the disease. An early stage of nasopharyngeal cancer has a 72% five-year survival rate. However, only about 9% of patients receive a diagnosis in this stage. Stage II nasopharyngeal cancer has a 64% survival rate, and for Stage III, it drops to 62%.

What is the cause of nasopharyngeal cancer?

Generally, cancer begins when the DNA of some cells develop some changes or mutations, that lead to their uncontrollable growth. These cells present the ability to invade adjacent and distant tissues. The same is the case for nasopharyngeal cancer. However, scientists do not know its exact cause. Some risk factors, such as the Ebstein Barr virus, may increase the chance of developing the disease.

Risk factors of nasopharyngeal cancer

Risk factors increase an individual’s chance of developing a disease. The following are some of the most well-established risk factors for nasopharyngeal carcinoma:

  • Sex. Men have a higher chance of developing nasopharyngeal cancer than women.
  • Ethnicity. Being from China, Southeast Asia, and northern Africa increases your risk for nasopharyngeal carcinoma.
  • Age. Being between the ages of 30 and 50 increases your chance of developing nasopharyngeal cancer.
  • Diet. Eating salt-cured foods raises your chances of nasopharyngeal carcinoma.
  • Having had Epstein-Barr virus raises your risk for nasopharyngeal cancer.
  • Having a family history of nasopharyngeal cancer increases the likelihood of presenting with nasopharyngeal carcinoma in the future.
  • Being a smoker or an excessive alcohol user increases your risk for nasopharyngeal cancer.

What are the symptoms and signs of nasopharyngeal cancer?

Early-stage nasopharyngeal cancer may be asymptomatic. As the disease progresses, it may present with some of the following symptoms and signs:

  • Swollen lymph node
  • A lump in the throat or neck
  • Blood in the saliva or nasal secretions
  • Tinnitus or ringing in the ears
  • Nasal congestion
  • Recurrent ear infections or hearing loss
  • Sore throat
  • Headaches

Types of nasopharyngeal cancer

Knowing the type of nasopharyngeal carcinoma is essential for its management and treatment. To identify the type of cancer cells involved in a tumor, doctors perform a biopsy and look at the sample tissue under the microscope. The following are the three main types of nasopharyngeal cancer:

  • Keratinizing squamous cell carcinoma. This type of nasopharyngeal cancer has keratin in the cancer cells.
  • Non-keratinizing carcinoma. This type of cancer is the most common type of nasopharyngeal cancer.
  • Basaloid squamous cell carcinoma. This type of cancer is the rarest type of nasopharyngeal cancer.

What is the diagnosis of nasopharyngeal cancer?

We can divide diagnostic procedures into diagnostic ones, used to identify the disease, and staging ones, used to establish its extent. The diagnosis begins with a physical examination, during which your doctor takes your medical history and palpates your lymph nodes to check for swelling. If he or she suspects nasopharyngeal carcinoma, you may have to undergo a nasal endoscopy. This procedure, performed to gain visual access to your nasopharynx, uses a thin, flexible tube with a camera. You may require local anesthesia. During nasal endoscopy, your doctor might remove a small sample of your tissue for biopsy, to confirm the presence of cancerous cells. To determine the stage of the disease, your doctor will recommend some of the following imaging tests:

  • Computerized tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)
  • X-ray

Other additional tests could be some of the following:

  • Blood exam. A blood exam may reveal valuable information regarding the course of the disease.
  • Ebstein-Barr virus test. Ebstein-Barr virus raises a person’s chance of developing nasopharyngeal cancer.
  • Hearing test. Nasopharyngeal cancer may present with hearing loss as a symptom.
  • HPV test (human papillomavirus test)

What is the treatment of nasopharyngeal cancer?

There are three standard treatment options for nasopharyngeal cancer:

  • Surgery
  • Radiation therapy
  • Chemotherapy

To choose the correct treatment method, your doctor has to review your general characteristics, such as your age and the presence or absence of other diseases. Another significant factor regarding your treatment is the stage of your disease. In some cases, palliative care is the only choice. Depending on each particular case, you might need one or a combination of treatment methods. For example, small nasopharyngeal carcinomas may require radiation therapy as a monotherapy, whereas in different cases, you might need chemotherapy before, during, or after surgery or radiation therapy.

References
https://www.cancerresearchuk.org/about-cancer/nasopharyngeal-cancer/types
https://www.cancer.gov/types/head-and-neck/patient/adult/nasopharyngeal-treatment-pdq
https://www.mayoclinic.org/diseases-conditions/nasopharyngeal-carcinoma/diagnosis-treatment/drc-20375535
https://www.cancer.net/cancer-types/nasopharyngeal-cancer/statistics

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