The area behind the nose and just above the back of the throat is called the nasopharynx. The cells lining the nasopharynx can become cancerous and give rise to nasopharyngeal cancer or NPC.
Nasopharyngeal Cancer (Nose Cancer) affects men more frequently than women and it occurs between the ages of 35 to 55 years. This type of cancer is more frequently seen among the Chinese (especially Cantonese). It is not as common in USA or Europe. In the period 2014-2018, nasopharyngeal cancer was the eighth most frequent cause of cancer deaths in Singaporean men.
A painless lump in the neck is found in nearly 75% of newly diagnosed Nasopharyngeal Cancer (Nose Cancer). A doctor should be seen if any of the following symptoms develop and persist: a painless lump in the neck, excessive nose discharge or blockage or bleeding, decreased hearing or ringing in the ears, or unusual face pain or numbness, double vision or headache. As cancer can spread to any organ or tissue in the body, in the late stages there may be symptoms from the lung, bone or liver.
If Nasopharyngeal Cancer (Nose Cancer) is suspected, a doctor will look for swelling or lumps in the neck. The doctor may examine the nasopharynx with a special angled mirror that is placed at the back of the throat or pass a flexible tube called a nasoscope (usually 5 - 6 mm in diameter) into one of the nostrils and to the back of the nose to look for lumps or ulcers. Small pieces of tissues may be removed during this examination to diagnose cancer. This is called biopsy.
If there is a neck lump, small pieces of the lump can be removed using a needle and syringe under local anaesthesia. The tissue is then examined under a microscope to look for cancer cells.
Once cancer is confirmed, further tests will be done to see if the cancer has spread from the nasopharynx to other parts of the body. The tests usually include a thorough physical examination, blood tests, chest x-rays and scans of the head and neck region. A bone scan and liver scan may also be ordered to see if the cancer is suspected to have spread to these areas.
Early Nasopharyngeal Cancer (Nose Cancer) is treated by radiotherapy. A team led by a radiation oncologist, a doctor who specialises in giving radiotherapy, plan radiation therapy. Radiation is given to an area that covers the region around the nasopharynx and the neck and down to the collarbone. Temporary side effects include redness and peeling of the skin of the neck and cheek area, dryness of the mouth, mouth ulcers and loss of appetite.
Chemotherapy is sometimes used as part of the treatment. Chemotherapy uses drugs that kills cancers when it has spread to other parts of the body such as lungs, liver, and bones. The drugs are injected into the hand veins.
Chemotherapy may also be used in combination with radiotherapy to improve the efficiency of radiotherapy. Due to the location of the cancer, surgery is not commonly used. In some patients, surgery may be used to remove lumps in the neck that have persisted or returned after treatment with radiotherapy.
Surgery may also be considered when the cancer in the nasopharynx recurs despite radiotherapy and there is no spread of cancer elsewhere in the body.
Clinical examinations, x-rays and pathology reports all help the medical team decide what the progress of an individual case of Nasopharyngeal Cancer (Nose Cancer) may be. Then, the appropriate course of treatment will be put into action. The treatment strategy will vary from person to person. With prompt and appropriate treatment, the outlook for a person with Nasopharyngeal Cancer (Nose Cancer) is reasonable. Early disease limited to nasopharyngeal can be cured with radiation in large majority.
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