Have you suddenly felt a lump in your neck? Maybe you didn't pay much attention to it because it wasn't painful. Or do you constantly feel like your nose is blocked and your ears are full? These could be symptoms of a common cold. However, if these things persist, it could be a sign of a specific type of cancer that we're going to talk about today, which develops in the head and neck. Let's talk about it in detail and simply.
What is Nasopharyngeal Cancer?
Simply put, this is a relatively rare type of cancer that occurs in our head and neck. Although its name is a bit complicated, it will be easy to understand once you know where it occurs.
This cancer develops in a part of our body called the `nasopharynx`. Now you might be wondering what `nasopharynx` is. Imagine, behind our nose, to be precise, a little above the roof of the mouth, there is a small space at the base of the skull. Where the nose and throat connect. That is what we call the `nasopharynx`. When we breathe through our nose, air passes through this part before going into the lungs.
So, this `Nasopharyngeal Cancer` is when the cells in the `nasopharynx` part start to grow abnormally and without control. The cells that grow in this way gather and form cancerous tumors. These cancer cells can later spread to the lymph nodes in our neck, liver, lungs, and even bones.
What are the main types of this cancer?
There are different types of tissues in our `nasopharynx`. These tissues are made up of different types of cells. So this cancer is classified according to the type of cells that the cancer is made of. According to the World Health Organization (WHO), there are three main types of this cancer.
| Cancer type (WHO classification) | Simple explanation |
|---|---|
| Keratinizing squamous cell carcinoma (WHO type 1) | In this, cancer cells develop in the tissues that line the nasopharynx. These cells contain a protein called keratin. Keratin is the same protein found in our hair and nails. |
| Nonkeratinizing squamous cell carcinoma (WHO type 2) | This type of cancer cells do not contain the protein keratin. |
| Undifferentiated or poorly differentiated carcinoma (WHO type 3) | When viewed under a microscope, these types of cancer cells look very different from healthy cells. These types of cancer cells can grow and spread very quickly. |
Is this cancer common?
In countries like America, this is very rare. However, this condition is seen more often in Southeast Asian countries like Sri Lanka, North Africa and the Middle East. Therefore, it is very important for us to be aware of this. Generally, this cancer can occur more often in young people between the ages of 15-24 and in adults between the ages of 65-79.
What are the symptoms of this cancer?
Often, the first sign someone with this cancer notices is a lump in the back or side of the neck. There may be one or more of these lumps. The most important thing is that they are usually painless. These lumps form when the cancer spreads to the lymph nodes in the neck, causing them to swell.
Apart from that, there are several other features that you should pay attention to.
- Ear problems: Ringing in the ears (`Tinnitus`), hearing loss, a feeling of heaviness in the ear, and frequent ear infections that do not improve despite treatment.
- Headache: Persistent headache.
- Nasal problems: Constant stuffy nose and nosebleeds.
- Mouth and facial problems: Difficulty opening the mouth, pain or tingling in the face.
- Difficulty breathing and speaking: Sometimes you may have difficulty breathing or speaking.
The important thing is that these symptoms are often similar to those of other minor illnesses (e.g., a cold, an ear infection). So don't be afraid that you have cancer just because you have one or two of these. However, if these symptoms persist for more than two weeks, or if they come and go, it's definitely best to see a doctor for advice.
What are the risk factors for developing this cancer?
Although it is not possible to say exactly what causes this cancer, doctors have identified several factors that increase the risk of developing this cancer. Let's take a look at what they are.
| Risk factor | Description |
|---|---|
| Smoking and alcohol | People who smoke heavily or use other tobacco products and those who regularly drink alcohol excessively are at higher risk. |
| Epstein-Barr virus (EBV) | This is the same virus that causes the disease `mononucleosis`. This virus is commonly found in the bodies of patients with `Nasopharyngeal Cancer`. |
| Diet | Regular consumption of salt-cured foods increases the risk. For example, people who regularly eat salt-cured meat and fish (such as dried fish and oysters) are at higher risk. |
| Environmental factors | Frequent exposure to things like wood dust and smoke can also increase the risk. |
| Family history and genetics | If someone in your immediate family has had this cancer, you are slightly more likely to develop it too. |
| Race and gender | People living in areas such as Southeast Asia, southern China, and northern Africa are at higher risk. Also, men are about three times more likely to develop this cancer than women. |
How is this cancer diagnosed?
When you go to see a doctor, he will first ask you about your symptoms and family history. He will then do a complete physical examination. He will examine your nasopharynx, head, neck, mouth, throat, nose, facial muscles, and lymph nodes. He may also test your hearing.
In addition, one or more of these tests may be done to confirm the diagnosis:
- Epstein-Barr virus test: Because this cancer is linked to the EBV virus, a blood test will be done to measure the amount of EBV in your blood.
- Biopsy: This is the main test to confirm the diagnosis. This involves taking a very small piece of tissue from the suspicious area of the nasopharynx and examining it under a microscope to see if there are any cancer cells.
- CT scan (Computed Tomography scan): This can determine the size of the tumor and whether it has spread to surrounding tissues.
- MRI scan (Magnetic Resonance Imaging scan): This can provide clearer images of the soft tissues of the head and neck.
- PET scan (Positron Emission Tomography scan): This test is important to see if the cancer has spread to other distant sites in the body.
The doctor determines the stage of the cancer based on the results of these tests.
What are the stages of cancer?
The stage of cancer is determined by the size of the tumor, its location, and how far the cancer cells have spread. This is very important for planning treatment.
- Stage 0: The cancer is limited to the layer of cells on the inside of the nasopharynx.
- Stage 1: The cancer has spread to nearby areas, such as the back of the throat or nasal cavity.
- Stage 2: The cancer has spread to one or more lymph nodes on one side of the neck.
- Stage 3: The cancer has spread to the lymph nodes on both sides of the neck.
- Stage 4: The cancer has spread to the skull, eyes, nerves leading to the brain, salivary glands, or lower part of the throat. Or it has spread to distant organs such as the lungs or liver.
What are the treatments for this?
The treatment you receive will depend on factors such as the stage of the cancer and your overall health. The following treatments are mainly used:
- Radiation therapy: The use of high-energy rays to destroy cancer cells. This is the main treatment method most commonly used for this type of cancer.
- Chemotherapy: Giving drugs to kill cancer cells. These can be given by injection or as pills.
- Chemoradiation: Giving both radiation therapy and chemotherapy together.
- Targeted therapy: Giving drugs that target specific molecules that help cancer cells grow and spread.
- Surgery: Surgery is not usually the main treatment because the nasopharynx is a difficult area to operate on. However, surgery may be done to remove lymph nodes in the neck that have not responded to other treatments.
Treatments can have side effects. For example, radiation therapy can cause dry mouth and loss of taste. You can talk to your doctor about these and ask for help managing them.
Can this cancer be cured? What is the survival rate?
The answer to this question is, yes, it can. Especially if it is detected early, that is, before the cancer has spread to other parts of the body, it can be completely cured.
When talking about survival rates, we need to remember that these are just statistics. They shouldn't be taken lightly. Your situation can vary based on many factors.
- If the cancer has not spread (local): About 82 out of 100 people whose cancer is confined to the nasopharynx will survive five years after diagnosis.
- If it has spread to nearby areas (regional): About 72 out of 100 people whose cancer has spread to nearby areas, such as lymph nodes in the neck, will still be alive after five years.
- If it has spread distantly (Metastatic): Of those whose cancer has spread to distant organs such as the lungs or liver, about 49 out of 100 are still alive after five years.
The important thing is that these statistics are just averages based on the experiences of other patients. Your situation may vary depending on many factors, such as your age, overall health, and response to treatment. So talk to your doctor to get the best information about your situation.
Take-Home Message
- Nasopharyngeal cancer is a rare cancer that develops in the back of the nose and upper part of the throat.
- Be on the lookout for symptoms such as painless lumps in the neck, persistent ear problems, nasal congestion, or nosebleeds.
- This cancer is commonly seen in Southeast Asian countries like Sri Lanka.
- Smoking, excessive alcohol consumption, and frequent consumption of salty and preserved foods (dried tomatoes, pickles) increase the risk.
- This cancer can be completely cured if detected early.
- If you have any doubts, do not delay and consult your doctor immediately for advice.
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