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Nasopharyngeal carcinoma
Nasopharyngeal carcinoma clinical manifestations
Nasopharyngeal carcinoma is the most common malignant tumor in the nasopharyngeal area, and clinically, it is primarily squamous cell carcinoma. The incidence of nasopharyngeal carcinoma is particularly high in the southern regions of China, especially in Guangdong. Initially, nasopharyngeal carcinoma manifests locally as a tumorous mass in the nasopharyngeal area, often with ulceration on the surface. This can lead to the presence of blood in nasal mucus, known as bloody nasal discharge. As the disease progresses, there can be swelling of the cervical lymph nodes, primarily involving the upper deep cervical lymph nodes, with about 60% of patients experiencing this type of lymph node enlargement. As the tumor enlarges, it may block the nasal passage, leading to persistent nasal congestion. The tumor's pressure on the Eustachian tube can cause symptoms of secretory otitis media. Furthermore, damage to the skull base by the tumor can lead to severe headaches. As a malignant tumor, the cancer can cause systemic symptoms such as malnutrition and cachexia. In advanced stages, metastatic symptoms may appear, such as bone and liver metastases, affecting these vital organs.
Causes of Nasopharyngeal Carcinoma
Nasopharyngeal carcinoma is a highly prevalent malignant tumor in China, especially common in the Guangdong and Guangxi regions, as well as other coastal areas including Hunan, Fujian, and Jiangxi. These regions are among the highest incidence areas for nasopharyngeal carcinoma worldwide. The incidence rate in males is three times that of females, with the age group of 40 to 50 years being particularly at risk. The occurrence of nasopharyngeal carcinoma is associated with genetic, viral, and environmental factors, exhibiting racial and familial patterns. In areas like Guangzhou and the Pearl River Delta, it is possible for five out of nine people in the same family to have nasopharyngeal carcinoma. Infection with the Epstein-Barr virus is also one of the causes of nasopharyngeal carcinoma, in addition to environmental factors. Areas with low trace elements in rice and water, as well as low fluoride levels, are prone to higher incidences of this cancer. Patients with nasopharyngeal carcinoma typically have higher fluoride levels in their hair, and nitrites are also one of the major contributing factors to the condition.
Does nasopharyngeal carcinoma require surgery?
Nasopharyngeal carcinoma generally does not consider surgery. For most patients with nasal cancer, radiotherapy is the first choice, and depending on the different stages, it may be necessary to consider concurrent or adjuvant chemotherapy. The overall treatment plan primarily focuses on curative radiotherapy, and it also requires regular follow-ups to monitor recovery. If radiotherapy and chemotherapy fail or there is a recurrence, surgery may need to be considered in these cases, but the surgery is relatively difficult, and a detailed analysis of the patient's specific situation is required. Only a very small number of patients would be indicated for surgery.
What are the symptoms of nasopharyngeal carcinoma?
Nasopharyngeal carcinoma is a malignant, space-occupying lesion in our nasopharynx. Clinically, the initial symptoms are those of the nasopharynx, manifesting as discomfort in the nasopharyngeal area, or blood in nasal discharge when sniffling. As the nasopharyngeal carcinoma tissue enlarges, it can block the posterior nasal apertures, leading to nasal congestion, rapid breathing, and difficulty in breathing. The tumor tissue pressing on our Eustachian tube can cause secretory middle ear infections. The metastasis of nasopharyngeal carcinoma cells to our cervical lymph nodes causes swelling of these lymph nodes. Destruction of the cranial structure by nasopharyngeal carcinoma tissues presents symptoms such as headaches. There are also other symptoms, mainly due to the spread of nasopharyngeal carcinoma throughout the body or its metastasis to other parts causing corresponding symptoms.
How is nasopharyngeal carcinoma diagnosed?
Nasopharyngeal carcinoma is a malignant, occupying lesion that occurs in the nasopharyngeal area, and clinically it is mainly squamous cell carcinoma. Relatively speaking, although this tumor is malignant, its degree of malignancy is relatively low, especially when compared to liver cancer, lung cancer, and other malignant tumors. The definitive diagnosis of any tumor primarily relies on histopathological diagnosis, which means that pathological examination is the gold standard. In the case of nasopharyngeal carcinoma, we can make a pathological examination by using nasopharyngeal biopsy tissue with forceps under nasendoscopy. If cancer cells are found, then it is essentially confirmed. Of course, other examination methods, such as CT and MRI, are also helpful in diagnosing nasopharyngeal carcinoma and determining whether there are any metastases.
Can late-stage nasopharyngeal carcinoma be cured?
Nasopharyngeal cancer is a malignant tumor located in the nasopharynx. Late-stage nasopharyngeal cancer refers to stages three and four, particularly stage four, where the patient experiences destruction of adjacent tissue structures and metastasis to distant organs. In such cases, clinical treatment generally involves symptomatic management or palliative care, aimed at improving the patient's quality of life and alleviating suffering. Whether nasopharyngeal cancer, especially in its late stages, can be cured is highly uncertain; its prognosis is very poor, and no one can definitively answer if it can be cured. However, the chances of cure are extremely slim, and the main approach is to provide palliative treatments.
Where is the best place to treat nasopharyngeal carcinoma?
Nasopharyngeal carcinoma currently mainly considers radiation therapy and chemotherapy, with radiation therapy as the primary treatment. It requires staging and typing based on different ranges of lesions and pathological biopsy types. After determining the stage and type, further radiation and chemotherapy plans can be established. At present, radiation therapy is the most important. Most patients need concurrent chemotherapy or adjuvant chemotherapy and require regular follow-ups. For some patients with cervical lymph node metastasis or recurrence of nasopharyngeal carcinoma after radiation therapy, who cannot undergo radiation or chemotherapy again or for whom radiation and chemotherapy have failed, surgery may be considered. However, surgery is generally not the first choice and its effectiveness is not particularly certain.
Is nasopharyngeal carcinoma contagious?
Nasopharyngeal carcinoma currently has no definite transmissibility, and the exact cause of nasopharyngeal cancer is not particularly clear. Clinical studies have shown that there is a certain relationship between nasopharyngeal carcinoma and EB virus infection, but it may also be related to other factors, such as familial heredity or living environment. Exposure to radioactive or chemical substances may also have a certain impact. Currently, there is no evidence to suggest that there is genetic or absolute contagion. Overall, in terms of treatment, radiotherapy is mainly used, and some patients need to be combined with chemotherapy. Generally, the five-year survival rate is relatively high among early-stage patients. If the disease staging is later and the differentiation is poor, the treatment difficulty and treatment effect are relatively worse.
How is nasopharyngeal carcinoma diagnosed?
The examination of nasopharyngeal carcinoma is mainly divided into two major categories. The first category is imaging examinations, and the second category is pathological biopsy tests. Imaging examinations primarily involve performing a CT or MRI of the nasopharyngeal area to determine the scope of the cancerous changes in the nasopharynx, which is quite helpful for clinical staging and typing. It also plays a role in designing targeted therapy for subsequent radiation treatment. Pathological testing is an important means for diagnosing nasopharyngeal carcinoma. Generally, it requires a nasopharyngoscopy. If cancerous changes are suspected during the nasopharyngoscopy, a pathological biopsy can be taken simultaneously. After the biopsy, the specific differentiation degree and type of cancer can be determined. Then, in conjunction with the imaging examinations, a plan for radiotherapy and chemotherapy can be formulated.
What are the symptoms of late-stage nasopharyngeal carcinoma?
Nasopharyngeal cancer is a common malignancy in otolaryngology, primarily located in the nasopharyngeal area. In advanced stages, nasopharyngeal cancer manifests symptoms in two main aspects. One involves symptoms directly caused by the cancer or its metastasis, typically presenting as increased nasal masses, enlarged cervical lymph nodes, severe headaches, decreased hearing, and bleeding in the nasal area due to tumor cells or tissue eroding the internal carotid artery. Additionally, there is a foul smell from the nasopharyngeal area. The second aspect relates to systemic symptoms due to the growth of nasopharyngeal cancer, leading to poor overall nutritional status and cachexia, characterized by extreme emaciation. There is also the potential for distant metastasis of the tumor cells, presenting symptoms in the corresponding areas.