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Nasopharynx Cancer

In Singapore, the most common head and neck cancer occurs at the junction of the back of the nose and the top of the throat (pharynx). It is called nasopharyngeal cancer (NPC), which is a form of nose cancer.

There are approximately 400 new cases of NPC diagnosed each year and it is the sixth most common type of cancer in Singapore.

Causes of Nasopharynx Cancer

The exact cause of nasopharyngeal or nasopharynx cancer remains unknown. However, the condition is strongly associated with three primary etiological factors: the Epstein-Barr virus (EBV) infection, ethnic and familial trends, and diet. All these are said to contribute to a heightened risk of cancer development.

Epstein-Barr Virus

The Epstein-Barr virus is a form of herpes infection that commonly causes mononucleosis and a range of flu-like symptoms like fever, sore throat and swollen glands. However, it has been observed that the virus can also contribute to the development of nose and <throat cancers, including nasopharynx cancer.

Ethnic and Familial Trends

Nasopharynx cancer commonly occurs in parts of Southern China, Southeast Asia and Northern Africa. Those with family members who have been diagnosed with nasopharyngeal cancer also have a higher risk of acquiring it, and so they are recommended to get screened earlier and more frequently.

Diet

People who have a diet rich in salt-cured meat, fish and vegetables may be susceptible to NPC, especially when exposed to steam resulting from the cooking process. Steaming salt-cured food causes chemicals to be released, which enter the nasal cavity.

Signs and Symptoms

In many cases, patients who are diagnosed with nasopharynx cancer observe lymph node enlargement on their neck. The swelling is usually not painful and may appear on both sides of the neck. Another common symptom is a change in hearing or abrupt hearing loss. Some patients also experience nosebleeds, ringing in the ear (tinnitus), nose and ear blockage, and blood-stained sputum.

Diagnosis for Nasopharynx Cancer

The ear, nose and throat or ENT specialist will obtain the patient’s medical history and carry out a physical exam and nasal endoscopy. Once the results suggest the patient might have NPC, the head and neck surgeon will conduct a biopsy. This is done by collecting a small cell sample from the nasopharynx and examining it to check for cancer cells. Once the tests are completed, the doctors can make a diagnosis and if cancer is determined, proceed with cancer staging and treatment.

Treatments

If a patient is diagnosed with nasopharynx cancer, the doctor will provide treatment plans, which usually involve radiation therapy and chemotherapy. Radiation therapy uses a small amount of radiation to target specific areas and accurately destroy cancer cells. With chemotherapy, treatment drugs are intravenously or orally to kill cancer cells and stop them from spreading. Chemotherapy can be done simultaneously with radiation therapy in a procedure called chemoradiation.

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