Nasopharyngeal cancer is actually one of the “Head & Neck cancer“, the affected areas of Head & Neck cancer are include the lips, tongue, cavity, tonsil, salivary gland, throat, sinus and nasopharynx, whereas brain and thyroid cancer don’t belong to this group. As the data shows¹, there were over 1,700 new cases of head and neck cancer in 2016², of which 800 were nasopharyngeal cancer.
Don’t confuse with allergic rhinitis
One early sign of nasopharyngeal cancer is the secretion of blood in the nasal cavity. Although dry weather or rubbing the nostril too hard can lead to nosebleeds, one should go to see a doctor if it sustains for months and shows signs of deterioration.
Tricky enough, not all early-stage nasopharyngeal cancer patients have nosebleeds. Some may only have a stuffy or painful nose which shares similar symptoms with those of upper respiratory diseases, and thus ignore the health alarm. The symptoms of nasopharyngeal cancer vary according to where the tumor grows. If it’s near the nasopharynx tube, tinnitus or hearing impairment may occur in either ear in general. If it’s beneath the brain, the nerves controlling eye movements may be affected, leading to diplopia or doubled images. If it reaches the cervical lymph, patients may even feel a painless lump in the neck by touching.
Salted fish and preserved meat are the culprits?
Nasopharyngeal cancer used to be one of Hong Kong’s 10 most common cancers and our eating habits are closely related to its drop-out. One of the causes of nasopharyngeal cancer is the consumption of cured food over a long period of time, such as salted fish and preserved sausages which contain the carcinogen ‘nitrosamine’. Since there have been no research in nasopharyngeal cancer, people in the Canton province paid no attention to the side effects of this kind of food and it’s not surprising that the disease was very common in South China. It was not until recent years that the number of cases was brought down when their eating habits improved. Besides, family history, smoking and drinking also increase the risk of developing nasopharyngeal cancer.
Over 70% of patients missed out on the golden treatment period
If patients are diagnosed with stage 1 and 2 nasopharyngeal cancer, radiotherapy would be their main choice of treatment and over 90% and 80% respectively could achieve the 5-year survival rate. But data² shows that over 70% diagnosed cases were at stage 3 and 4, where the cancer cells have locally spread to the lymph and skull base or even widely spread to other parts of the body. In this case, radiotherapy is still the main choice of treatment but some patients have to receive chemotherapy at the same time to shrink the cancer cells or control their growth. About 70% of stage-3 patients and 50% of stage-4 patients can survive given that the cancer cells haven’t widely spread out. Otherwise, the survival rate would drop further and the aim of treatment would become extending the patients’ lifespan and maintaining their living standards.
In one of the cases, a 50-year-old man was diagnosed with stage 1 nasopharyngeal cancer. Afraid of the side effects of radiotherapy, he turned to some alternative treatments which didn’t offer any help and the tumor grew rapidly within one year. He was at stage 3 when he decided to receive radiotherapy with chemotherapy. Though it was a radical cure, he had to endure more side effects.
¹Information of Hong Kong Cancer Registry: http://www3.ha.org.hk/cancereg/default.asp
²Nasopharyngeal Cancer in 2016: http://www3.ha.org.hk/cancereg/pdf/factsheet/2016/npc_2016.pdf
Dr Maverick Tsang
Specialty of Clinical oncology