Nasopharyngeal Cancer (Nose Cancer)

Nasopharyngeal Cancer (Nose Cancer)

The nasopharynx refers to the area where the back of the nose meets the upper part of the throat. Nasopharyngeal cancer typically originates from the curved part behind the nose or the post nasal space. Because the tumor is located near critical structures such as the brain, spinal cord, and throat, advanced-stage nasopharyngeal cancer can manifest numerous symptoms.

This type of cancer is prevalent among the Chinese population, particularly in regions like Hong Kong and Southern China. In Singapore, the incidence rate is approximately 25 cases per 100,000 people.

Recent data from the National Cancer Registry indicates that nasopharyngeal cancer ranks as the second most common cancer among Singaporen men, following lung cancer. Compared to global statistics, Singaporen Chinese males exhibit the second-highest incidence rate, while local Chinese women have the highest incidence worldwide.

The incidence of this cancer tends to increase with age, especially between 50 and 60 years old. However, as the population grows, there has been an observable rise in cases in recent years.

While an epidemiological study in Hong Kong years ago linked the consumption of salted fish at a young age to nasal cancer, recent studies have suggested a viral origin of the disease, particularly involving the Epstein-Barr virus. Other environmental factors, such as the consumption of preserved food and fermented fish products, as well as exposure to toxic fumes and tobacco, may also contribute to its development.

Symptoms

Early symptoms may include:

- Nosebleeds
- Hearing issues like ringing and tingling
- Nasal congestion

As the disease progresses, symptoms may include:

- Hearing loss
- Facial numbness
- Coughing up blood
- Difficulty swallowing
- Breathing difficulties due to nasal blockage
- Double vision

Diagnosis

Diagnosis typically begins with a comprehensive examination by an ear, nose, and throat (ENT) specialist, who may perform a biopsy if abnormalities are detected. A biopsy involves taking a small tissue sample to confirm the presence of cancer cells. Further tests, such as CT scans or MRIs of the head and neck, may be conducted to determine the extent of the disease.

Treatment

For early-stage (Stage I or II) nasopharyngeal cancer confined to the back of the nose, radiotherapy is the primary treatment option. At advanced stages (Stages III and IV), which involve lymph node involvement, a combination of radiotherapy and chemotherapy is often recommended. The side effects of treatment may include dry mouth, loss of taste, difficulty swallowing, and skin changes, but these are usually temporary and can be managed with proper care.

Newer treatment techniques, such as CT scan-based treatment planning, aim to reduce long-term side effects.