Nasopharyngeal carcinoma (patient information)

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What is nasopharyngeal carcinoma?

Nasopharynx is the upper part of the throat (pharynx) that lies behind the noseare. It serves as a passageway for air from the nose to the throat. Nasopharyngeal carcinoma is common in China. But in the United States and other countries, it is fairly rare. There is not any early symptoms in nasopharyngeal carcinoma. With the development of the cancer, frequent symptoms include a lump or mass in the neck, hearing loss, ringing in the ear, or feeling of fullness in the ear, nasal blockage or stuffiness, nosebleeds and headache. Treatments include surgery, radiation, chemotherapy.

How do I know if I have nasopharyngeal carcinoma and what are the symptoms of nasopharyngeal carcinoma?

Early nasopharyngeal carcinoma does not have any symptoms. As the tumor grows larger, people may notice one or more of the following symptoms:

  • A lump or mass in the neck
  • Hearing loss, ringing in the ear, or feeling of fullness in the ear (especially on one side only)
  • Nasal blockage or stuffiness or nosebleeds
  • Headache
  • Facial pain or numbness
  • Trouble opening the mouth
  • Blurred or double vision

Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell his/her doctor so that the problems can be diagnosed and treated as early as possible.

Who is at risk for nasopharyngeal carcinoma?

Clinical data has suggested that the development of nasopharyngeal cancer is related to several factors.

  • Epstein-Barr virus (EBV) infection: The link between EBV infection and nasopharyngeal carcinoma is not yet completely understood. Studies show that almost all nasopharyngeal cancer cells contain parts of the Epstein-Barr virus, and most nasopharyngeal cancer patients have infected Epstein-Barr virus in their blood.
  • Genetic factors: Scientists found that people with certain inherited tissue types which would affect immune responses have an increased risk of developing nasopharyngeal carcinoma.
  • Family history: Family members with nasopharyngeal carcinoma are more likely to get this cancer.
  • Life-style: Cinical surveys show that smoking, diets poor in fruits and vegetables and high in salt-cured fish and meat are at the risk of developing nasopharyngeal carcinoma.
  • Race: Nasopharyngeal carcinoma is most common in Chinese, followed by other Asian. It is rare in whites.
  • Gender: Nasopharyngeal carcinoma is about as twice in men as that in women.

How to know you have nasopharyngeal carcinoma?

  • Nasopharyngoscopy and biopsy: During this test, the doctor uses a flexible, lighted, narrow tube called fiber-optic scope to insert through the mouth or nose in order to look at the lining of the nasopharynx. And it can also be used to guide biopsy and a biopsy sample is usually removed and looked at under a microscope.
  • Fine needle aspiration (FNA) biopsy: In patients with a lump or mass in the neck, an FNA biopsy can help determine if the lump is caused by nasopharyngeal carcinoma or responses to an infection.
  • Epstein-Barr virus (EBV) DNA levels: This test may help to show how effective treatment is in some patients before and after treatment.
  • Computed tomography (CT) scan and biopsy: CT scans are often used to diagnose nasopharyngeal carcinoma. It can confirm the location of the cancer and show the organs near the nasopharynx , as well as lymph nodes and distant organs where the cancer might have spread. These are helpful for determining the stage of the cancer and in determining whether surgery is a good treatment option. CT scans can also be used to guide biopsy and a biopsy sample is usually removed and looked at under a microscope.
  • Magnetic resonance imaging (MRI): An MRI uses magnetic fields but it is a different type of image than what is produced by computed tomography (CT) and produces detailed images of the body. Like computed tomography (CT), a contrast agent may be injected into a patient’s vein to create a better picture.
  • Positron emission tomography (PET) scan: When doing this test, a small amount of a radioactive medium is injected into your body and absorbed by the organs or tissues. This radioactive substance gives off energy which in turn is used to produce the images. PET can provide more helpful information than either CT or MRI scans. It is useful to see if the cancer has spread to the lymph nodes and it is also useful for your doctor to locate where the cancer has spread.
  • Chest X-ray: This plain x-ray of your chest may be done to see if the cancer has spread to your lungs.

When to seek urgent medical care?

Call your health care provider if symptoms of nasopharyngeal carcinoma develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:

  • Severe headache
  • Severe nosebleeds
  • Facial pain or numbness

Treatment options

Patients with nasopharyngeal carcinoma have many treatment options. The selection depends on the stage of the tumor. The options are surgery, radiation therapy and chemotherapy. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects may not be the same for each person, and they may change from one treatment session to the next.

  • Radiation therapy: It is usually the main form of treatment for nasopharyngeal carcinoma because most cases are very sensitive to radiation. This is a cancer treatment to kill cancer cells or keep them from growing by using high-energy x-rays or other types of radiation.
  • Chemotherapy: The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing. For nasopharyngeal carcinoma patients, chemotherapy is often used together with radiation therapy as the first treatment for more advanced stages because it can make cancer cells more vulnerable to radiation. Also, chemotherapy is helpful for cancers that have spread beyond the head and neck or even distant organs such as the lungs and livers.
  • Surgery: Surgery is seldom the main treatment for patients with nasopharyngeal cancer. Because the nasopharynx is a difficult place to operate on, and radiation therapy is usually the main form of treatment for nasopharyngeal cancer.

Diseases with similar symptoms

Other health problems may also cause similar symptoms. Go to see your doctor to verify your diseases as early as possible. Diseases with similar symptoms are listed in the following:

  • Meniere's Syndrome
  • Anaphylactic rhinitis
  • Nasopharyngeal tuberculosis
  • Nasopharyngeal lymphatic sarcoma
  • Brain cancer

Where to find medical care for nasopharyngeal carcinoma?

Directions to Hospitals Treating nasopharyngeal carcinoma

Prevention of nasopharyngeal carcinoma

Although the reasons for the development of nasopharyngeal carcinoma are not clear, epidemic data shows the following intervention may help to reduce your risk of nasopharyngeal carcinoma:

  • Early screening of Epstein-Barr virus (EBV) in high risk areas
  • Regular check for people whose family members diagnosed nasopharyngeal carcinoma
  • Changing lifestyle: Quitting smoking, eating diets rich in fruits and vegetables and poor in salt-cured fish and meat.

What to expect (Outook/Prognosis)?

The prognosis and treatment options depend on the following:

  • The stage of the cancer: The size of the tumor, the type of nasopharyngeal cancer.
  • The patient’s age and general health.


Copyleft Sources

http://www.cancer.gov/cancertopics/pdq/treatment/nasopharyngeal/patient/

http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_nasopharyngeal_cancer_17.asp?sitearea=CRI

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