Nasopharyngeal cancer (NPC) is considered head and neck cancer. It originates in the nasopharynx, which is the upper part of the throat behind the nose and near the skull base.
The nasopharynx acts as a passageway for air to travel from the nose to the throat. It contains adenoids (mass of lymphatic tissue) and openings of the eustachian tubes (a tube-like structure that connects the ear to the throat). Due to the complicated position in this space, NPC is often difficult to diagnose in the early stages.
Other types of head and neck cancer
Other types of head and neck cancer include:
- Cancer of the oropharynx
- Cancer of the hypopharynx
- Cancer of the larynx
- Cancer of the lips, oral cavity, and tongue
- Cancer of the salivary glands
- Cancer of the paranasal sinus
- Cancer of the nose structures
- Thyroid cancer
- Cancer originating in soft tissues in the head and neck region
7 causes of cancer of the nasopharynx
The exact cause of nasopharyngeal cancer (NPC) is unknown. Genetic mutations and environmental triggers are known to predispose a person to the development of cancer.
Here are a few factors that may increase your risk of NPC:
- Gender: NPC is about two times more common in men than in women.
- Ethnicity: NPC is less common in the Caucasian population. In the United States, NPC is seen in Asian and Pacific Islanders (particularly Chinese Americans), followed by American Indian and Alaskan natives, African Americans, Caucasians, and Hispanics/Latinos. People from Singapore, southern China (including Hong Kong), the Philippines, Malaysia, and Vietnam, as well as Greenland and Canada, are more predisposed to this disease.
- Epstein-Barr virus (EBV): People with EBV have a high risk of NPC in the future. EBV infection is common in teens and goes by the name mononucleosis (mono).
- Diet: NPC is more frequent in people who eat diets that are very high in salt-cured fish and meat.
- Family history: People with a family history of NPC have a high likelihood of getting the disease. Whether this is because of inherited genes, diet, or other shared environmental factors is unknown.
- Addictions: Smoking and alcohol may increase your risk of NPC.
- Other possible risk factors: Exposure to aromatic compounds present in certain incense sticks and workplace exposure to aromatic carbon compounds such as benzene, phenols, and formaldehyde may also cause NPC.
5 symptoms of nasopharyngeal carcinoma
In many cases, cancer remains undetected up to late stages because it may not cause symptoms. In other cases, it may cause symptoms that include:
- A feeling of a blocked nose or choked sinuses
- A lump or swelling in the neck or jaw or cheek
- Bleeding from the nose or mouth
- Breathing difficulty
- Weight loss
How is nasopharyngeal carcinoma diagnosed?
It is important to see your physician as soon as you suspect something is amiss.
A careful physical examination followed by blood tests, an endoscopy, imaging tests (such as computed tomography scans or magnetic resonance imaging), biopsy, bone scans, and positron emission tomography scans to check for tumor metastasis that helps diagnose the tumor and classify its type may be done.
Depending on the tumor size, local invasion, and distant spread, the surgeon will assign it a stage and grade (TNM classification), which will help chalk a treatment strategy.
How is nasopharyngeal carcinoma treated?
Treatment for nasopharyngeal cancer (NPC) includes a multi-prong approach that consists of the following:
- Surgical tumor resection: This is a major surgery in which the surgeon will remove the tumor and a healthy margin of tissues from surrounding areas. They may also resect surrounding bony parts and lymph nodes to ensure no tumor cell remains in the area.
- Radiation therapy: This is often done to mop up any missed tumor cells in the head, neck, and face area. Most surgeries are followed by radiation therapy. In some cases, where the tumor is advanced and surgical resection is risky or not possible, the surgeon may give palliative radiation to reduce tumor size.
- Chemotherapy: Drugs such as cisplatin, carboplatin, and paclitaxel, among others, are administered in cycles to prevent the tumor from recurring.
The next two groups of drugs are often initiated after chemotherapy in selected cases:
- Targeted drug therapy for NPC: Recent interventions include targeted drug therapies that inhibit the epidermal growth factor receptor found on NPC cells using a drug called cetuximab. Such therapy is much more effective than chemo in some cases and has a better safety profile.
- Immunotherapy for NPC: Keytruda (pembrolizumab) and Opdivo (nivolumab) are drugs that boost the immune response against cancer cells in NPC.
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