Nasopharyngeal cancer refers to cancer that develops in the area behind the nose and the upper part of the throat. Cancer that arises in the nasopharynx, located behind the nose and the upper back of the throat, is called nasopharyngeal carcinoma. Since nasopharyngeal carcinoma is difficult to detect early and its symptoms can overlap with other diseases, it requires careful attention.
Treatment Process: The treatment generally involves radiation therapy, chemotherapy, or a combination of both. Given that each individual may have different conditions, treatment is initiated after a thorough evaluation.
What is the Nasopharynx? The nasopharynx is a region in the human body that affects the respiratory system. It connects the nasal cavity to the mouth. The nasopharynx includes the area behind the nose and the back of the mouth and is connected to the ears through the Eustachian tube and to the throat, leading to the respiratory and digestive tracts.
Symptoms of Nasopharyngeal Cancer: In the early stages, nasopharyngeal carcinoma may not show obvious symptoms. However, there are some notable symptoms, including:
- Presence of blood in saliva
- Swelling in the neck due to lymph node enlargement
- Bloody nasal discharge
- Nasal congestion
- Hearing loss
- Frequent ear infections
- Headaches
If symptoms like these persist despite painkillers or antibiotics, it is important to consult a doctor. Persistent symptoms over ten days should raise the possibility of cancer.
Causes of Nasopharyngeal Cancer: The exact cause of cancer is not fully known, but it has become a significant topic with advancements in technology. Cancer may result from genetic mutations that cause normal cells to grow uncontrollably. These cells can spread to different parts of the body, known as metastasis.
In nasopharyngeal carcinoma, the cancer triggers occur in the squamous cells covering the surface of the nasopharynx.
Although the exact cause of mutations in genes leading to nasopharyngeal cancer is unknown, factors such as the Epstein-Barr virus (EBV) have been identified as increasing cancer risk. The exact cause of cancer in individuals with all risk factors versus those without is not fully understood.
Risk Factors for Nasopharyngeal Cancer: Studies have identified several risk factors associated with nasopharyngeal cancer, including:
- Age: It can develop in any age group but is more common in individuals aged 30-50.
- Diet: Foods preserved in salt, such as fish and vegetables, may increase risk.
- Epstein-Barr Virus (EBV): This virus, which can cause symptoms similar to a cold or mononucleosis, is linked to some rare cancers.
- Family History: Having family members with this disease increases risk.
Complications of Nasopharyngeal Cancer: As nasopharyngeal carcinoma progresses, it may invade nearby structures. Complications can arise if cancerous cells spread to the throat, bones, or brain.
Metastasis can occur, with cancer cells spreading to different tissues and organs. The most common sites for distant metastasis include bones, liver, and lungs.
Diagnosis of Nasopharyngeal Cancer: Several tests are used to diagnose nasopharyngeal cancer:
- Physical Examination: Usually starts with an examination of the head and neck area. The doctor collects information on symptoms and family history.
- Endoscopy: A camera is used to visualize the nasopharynx through a flexible tube.
- Biopsy: A sample of suspicious tissue is taken for laboratory analysis.
Imaging techniques like CT scans, MRI, PET scans, and X-rays help determine the extent of cancer spread.
Stages of Nasopharyngeal Cancer:
- Stage 0: Cancer cells are confined to the surface of the nasopharynx. There is no spread to lymph nodes or distant tissues.
- Stage I: Cancer remains within the nasopharynx, possibly spreading to nearby soft tissues.
- Stage IIa: Cancer has spread to the upper part of the throat.
- Stage IIb: Cancer may be limited to the nasopharynx but may spread to nearby lymph nodes.
- Stage III: Cancer may spread to sinuses or bones (Stage IIIa) or lymph nodes in both parts of the throat (Stage IIIb).
- Stage IV:
- IVa: Tumor has spread to cranial nerves, the hypopharynx, eyes, or surrounding tissues.
- IVb: Spread to lymph nodes in the shoulder area.
- IVc: Spread to lymph nodes and distant tissues.
Is Nasopharyngeal Cancer Deadly? Nasopharyngeal cancer is sensitive to radiation and/or chemoradiotherapy. Early detection and treatment improve the chances of cure. Cure rates are around 90% for stages I-II. As the stage progresses, the cure rate decreases, but even stage IV may not be completely untreatable.
Treatment of Nasopharyngeal Cancer:
- Surgical Intervention: Typically considered if cancer recurs after radiation or chemoradiotherapy, but surgery may be challenging due to the location.
- Radiation Therapy: The primary treatment, involving external beam radiation therapy (EBRT) to target cancer cells. Techniques like IMRT or Arc therapy may be used.
- Chemotherapy: Used alongside radiation to enhance effectiveness and prevent metastasis. High doses may be used to shrink large tumors before radiation.
- Immunotherapy: Used for recurrent cases and should be managed by an experienced team.
Duration of Nasopharyngeal Cancer Treatment: Radiation therapy is the main treatment, usually administered in 33-35 sessions over approximately 7 weeks, excluding weekends.
Nutrition in Nasopharyngeal Cancer: Proper nutrition is crucial during cancer treatment. Inadequate nutrition can weaken the immune system and impact the effectiveness of treatment. Weight loss can complicate radiation therapy. Consultation with a dietitian is essential before starting treatment.