Nasopharyngeal carcinoma


What tests are done for nasopharyngeal carcinoma?
The examination items for nasopharyngeal carcinoma are mainly divided into three types. The first type is imaging examinations, the second type is blood tests, and the third type is endoscopic pathological biopsy. Imaging examinations mainly involve CT or MRI of the nasopharynx and the whole body. If necessary, PET-CT may also be considered to clarify the extent of the condition and determine the presence of neck or distant metastases, which is helpful for diagnosis and adjuvant therapy. The second type involves blood tests, mainly including general biochemical blood tests and virus detection, which can assess the basic functional status of the body. The third type is the endoscopic pathological biopsy, which involves performing a pathological biopsy under nasal endoscopy, primarily to confirm the diagnosis and observe the extent of the lesion in the nasopharynx.


Can nasopharyngeal carcinoma be treated with surgery?
Nasopharyngeal cancer is a malignant tumor in the nasopharynx, which is mainly found in coastal and Guangdong areas, and is more common among Mongoloid races. The treatment methods for nasopharyngeal cancer include radiotherapy, chemotherapy, and combined chemoradiotherapy. If the tumor does not disappear after combined chemoradiotherapy and is insensitive to drugs, surgery can be considered. Surgery is not the first-line treatment option for nasopharyngeal cancer; the first-choice treatments are radiotherapy and combined chemoradiotherapy, which are very effective and have a high five-year survival rate. If the cancer is insensitive to radiation and drugs, surgical treatment can be an option in such cases.


Do people with nasopharyngeal carcinoma lose weight?
Some patients with nasopharyngeal carcinoma may experience weight loss, but individual differences exist. This is somewhat related to the condition itself as well as to the individual's resistance and their baseline physical fitness. If the condition is detected early and the clinical symptoms are not particularly obvious, most patients will not show significant weight loss, and many people may not have noticeable symptoms. If the condition is severe, and diet and nutrition are not properly managed in a timely manner, patients may experience weight loss, especially in advanced stages of the illness. This can result in a cachectic-like state, which poses greater challenges for treatment. It is necessary to seek medical attention promptly, assess the physical condition, and consider the need for radiotherapy and chemotherapy.


Distinction between Nasopharyngitis and Nasopharyngeal Carcinoma
Nasopharyngitis and nasopharyngeal carcinoma have fundamental differences. Nasopharyngitis is an inflammatory disease, while nasopharyngeal carcinoma is a malignant tumor disease. Clinically, nasopharyngitis mainly presents with increased secretions in the nasopharyngeal area, sometimes with a slight amount of bloody secretions, but this is extremely rare. On the other hand, nasopharyngeal carcinoma primarily shows symptoms such as the proliferation of malignant tumor tissues in the nasopharynx, enlargement of the lymph nodes in the neck, headaches, and ear stuffiness. In terms of treatment, nasopharyngitis is primarily treated with medications, such as traditional Chinese medicines, nasal sprays, and nasal corticosteroids; whereas nasopharyngeal carcinoma is primarily treated with radiotherapy combined with chemotherapy, which is currently the common sandwich therapy. Overall, there are fundamental differences between the two.


Can nasopharyngeal cancer be cured?
A portion of nasopharyngeal carcinoma patients can meet the criteria for clinical cure. It largely depends on the specific staging and type of the cancer. Patients with higher differentiation and earlier stages, especially stages one and two, tend to have better treatment outcomes. Currently, radiation therapy is the primary treatment, and some patients may also need to undergo chemotherapy. Overall, chemotherapy is quite effective for most patients. However, whether clinical cure can be achieved primarily depends on the extent of the disease and individual differences. Some people respond better to radiotherapy and chemotherapy, which in turn increases their chances of clinical cure. The five-year survival rate is considered the most important indicator.


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.