Nasopharyngeal cancer (NPC) is a type of cancer that begins in the nasopharynx, which is a part of the throat located behind the nose. It can have many different signs and symptoms, including persistent nasal congestion, frequent nosebleeds, ear pain, persistent headaches, and jaw pain. It is usually caused by infection with the Epstein-Barr virus, and it is more common in people in southeastern Asia. Treatment usually involves radiation therapy, chemotherapy, and/or surgery, depending on the stage and extent of the cancer.
The most common signs and symptoms of nasopharyngeal cancer include:
- Earache or ear pain
- Sore throat
- Difficulty breathing or noisy breathing
- Persistent stuffy nose
- Difficulty hearing
- Tinnitus (ringing in the ear)
- Unilateral hearing loss
- Sinus infection
- Swelling of nerves in the face or neck
- Lump or mass in neck
- Coughing up of blood
- Swollen lymph nodes in neck
- Weight loss
- Chronic headache
The exact cause of nasopharyngeal cancer is unknown, however, there are some established risk factors that increase a person’s chances of developing the disease. These include:
- Age – Nasopharyngeal cancer is most common in people between the ages of 40 and 60.
- Gender – Men are more likely to get nasopharyngeal cancer than women.
- Race/ethnicity – People of Chinese and Southeast Asian descent are at an increased risk of developing nasopharyngeal cancer.
- Exposure to certain viruses – Certain types of viruses, such as Epstein-Barr virus (EBV), human papillomavirus (HPV), and human herpesvirus 8 (HHV-8), have been associated with an increased risk of nasopharyngeal cancer.
- Genetics – Certain genetic mutations may increase a person’s risk of developing nasopharyngeal cancer.
- Diet – People who eat diets high in salt-cured fish and meat, as well as those who consume large amounts of alcohol, may be more likely to develop nasopharyngeal cancer.
- Environmental factors – Exposure to certain chemicals, such as formaldehyde, is thought to increase the risk of developing the condition.
- Occupational hazards – People who are regularly exposed to airborne chemical toxins and radiation, such as metal workers and welders, may be at an increased risk of developing nasopharyngeal cancer.
The risk factors for nasopharyngeal cancer include:
- Age: The risk for nasopharyngeal cancer increases after the age of 40.
- Gender: Men are more likely to develop nasopharyngeal cancer than women.
- Family history: If you have a family history of nasopharyngeal cancer, then you may be at an increased risk.
- Exposure to chemicals and metals: People who are frequently exposed to certain types of chemicals and metals, such as nickel and asbestos, may be at an increased risk.
- Certain viruses: Certain viruses, such as Epstein-Barr virus, can increase the risk of developing nasopharyngeal cancer.
- Ethnicity: People of certain ethnicities, such as Chinese and Southeast Asian people, are at an increased risk.
- Tobacco use: Long-term or frequent use of tobacco can increase the risk of developing nasopharyngeal cancer.
Nasopharyngeal cancer is typically diagnosed by imaging tests such as X-rays, CT scans, and MRI scans. In some cases, a biopsy of tissue may be taken in order to run laboratory tests to confirm the diagnosis. The doctor may also conduct a physical exam, palpating the lymph nodes in the neck and looking in the throat, ear, and nose for any abnormal growths. Blood tests may also be conducted to check for high levels of specific markers associated with nasopharyngeal cancer.
Nasopharyngeal cancer is a type of cancer that originates in the nasopharynx, the upper part of the throat behind the nose. It is divided into several subtypes, based on the type of cell the cancer originated from. They are as follows:
- Non-keratinizing squamous cell carcinoma: This type of nasopharyngeal cancer is the most common, accounting for approximately 90% of nasopharyngeal cancers. Non-keratinizing squamous cell carcinoma usually appears as lumps or ulcers in the nasopharynx, and can spread to other parts of the body.
- Keratinizing squamous cell carcinoma: This type of nasopharyngeal carcinoma is less common, accounting for only 5-10% of all nasopharyngeal cancers. Keratinizing squamous cell tumors typically have a more aggressive growth pattern, and can spread to nearby lymph nodes and other organs.
- Lymphoepithelial carcinoma: this type of nasopharyngeal carcinoma is rare, accounting for only 2-3% of nasopharyngeal cancer cases. It usually appears as a lump in the nasopharynx, which can ulcerate and spread to other parts of the body.
- Undifferentiated carcinoma: Undifferentiated carcinoma is an uncommon type of nasopharyngeal cancer that does not conform to one of the other 3 categories. It usually appears as a mass in the nasopharynx, and can spread to other parts of the body.
- Adenocarcinoma: Adenocarcinoma is an uncommon type of nasopharyngeal cancer accounting for 1-2% of all nasopharyngeal cancer cases. It tends to be more aggressive and difficult to treat than other forms of nasopharyngeal cancer.
The treatment options for Nasopharyngeal cancer depend on the individual’s specific diagnosis, such as the stage and type of cancer. Generally, the treatment options may include:
- Radiation therapy: This is the most common type of treatment for nasopharyngeal cancer and can be delivered either externally or internally via brachytherapy. External radiation therapy uses a beam of energy, such as X-rays, to target and eliminate cancer cells. Brachytherapy involves placing a radioactive source inside the body, near the area of the tumor.
- Chemotherapy: Chemotherapy utilizes drugs to destroy cancer cells. Chemotherapy may be offered as a standalone treatment, or in combination with radiation therapy to increase its effectiveness.
- Surgery: Surgery can be used to remove the tumor and may be recommended in certain cases, such as if the tumor is small or located in a specific area.
- Targeted therapy: Targeted therapy is a type of treatment which specifically targets certain proteins or genetic mutations which can help to make the cancer cells more vulnerable and reduce their growth.
- Immunotherapy: Immunotherapy helps the body’s immune system recognize and attack cancer cells.
- Limit exposure to tobacco smoke, both active and passive.
- Limit exposure to on-the-job occupational exposure to chemicals and other known carcinogens.
- Follow a healthy diet rich in fresh fruits and vegetables and limit intake of salted, cured, and smoked foods.
- Avoid frequent and long-term exposure to wood dust or coal dust.
- Get recommended immunizations against the Epstein-Barr virus.
- Discuss with your doctor the potential benefits of low dose aspirin use.
- Get screened regularly for cancer and follow up with your doctor if you experience any unexplained symptoms.
- Consider speaking to your doctor about risks and benefits of HPV vaccination.
There are some gender-specific differences in the presentation and management of nasopharyngeal cancer. Studies have shown that nasopharyngeal cancer is more common in males than in females, with an approximately 2 to 3-fold greater incidence among men. Furthermore, women tend to present with more localized tumors than men and have better prognoses. On the other hand, men may present with more advanced stages of the disease due to delayed diagnosis. The differences between men and women in the presentation of nasopharyngeal cancer have been linked to the increased risk of exposure to environmental carcinogens such as cigarette smoke, which are more prevalent among men.
In terms of management, both genders may receive treatment including surgery, chemotherapy, and radiation, with the exact treatment plan typically based on the stage and extent of the tumor. However, studies have found that men are more likely to receive radical surgery with radiotherapy or chemotherapy than women, while women tend to receive more conservative treatments such as radiotherapy and chemotherapy alone. Additionally, women tend to have higher survival rates post-treatment.
Nutrition plays an important role in the management of nasopharyngeal cancer. Proper nutrition can help to improve the effectiveness of cancer treatments, prevent malnutrition, improve the patient’s quality of life and reduce the side effects of cancer treatment. It is recommended that patients with nasopharyngeal cancer receive adequate nutrition with balanced and nutritious meals to ensure that they have enough energy and strength to fight their disease. Eating a variety of healthy foods such as fruits and vegetables, whole grains and lean proteins may help to maintain a healthy weight, build and maintain muscle and reduce the risk of side effects like fatigue, nausea and poor appetite. Additionally, proper hydration is essential in order to maintain electrolyte balance and to reduce the risk of dehydration. This can be achieved by drinking plenty of fluids as well as eating foods that contain high amounts of water such as fruits and vegetables. It is also important for patients to take a multivitamin, particularly one that contains folic acid, as this can help to reduce the risk of chemotherapy side effects.
Physical activity has been linked to a lower risk for nasopharyngeal cancer. Exercise is thought to reduce inflammation and improve overall immune system functioning. It is believed that regular physical activity may help reduce the risk of developing this type of cancer by reducing inflammation and improving overall immune system functioning. Additionally, physical activity has been linked to a decreased risk of other types of cancer, including colorectal and breast cancer. Therefore, regular physical activity is recommended as a way to help reduce the risk of developing nasopharyngeal cancer.