Overview.
Nasopharyngeal cancer is one of the most prevalent malignant tumors in China. Epidemiological survey shows that South China is the region with high incidence of nasopharyngeal cancer, among which Guangdong is the first, so nasopharyngeal cancer is also called “Guangdong tumor”. There are obvious regional differences in the distribution of nasopharyngeal carcinoma in China, with Zhaoqing, Foshan, Guangzhou and Wuzhou in central Guangdong and eastern Guangxi as the centers of high incidence, and gradually decreasing in the surrounding areas. The incidence rate of male is about 2~3 times that of female, and the age of 40~50 is the high incidence age. Nasopharyngeal cancer accounts for 30.97% of systemic malignant tumors, 78.08% of head and neck tumors, and 92.99% of upper respiratory tract tumors.
Etiology.
Genetic factors.
Viral infection: closely related to EBV.
Environmental factors.
Dietary factors: salted fish, dried fish, pickled products
Trace elements
Clinical manifestations.
1.Blood in nasal aspiration: Since nasopharynx is located at the back of nasal cavity and upper part of oropharynx, the location is more hidden and not easy to find, early appearance of blood in nasal aspiration should be consulted as soon as possible.
2.Ear symptoms: Tumor located in nasopharynx can compress Eustachian tube orifice and lead to negative pressure in the tympanic chamber, resulting in exudative otitis media and causing tinnitus and hearing loss.
3.Nasal congestion: Tumor can block the posterior nostril and cause nasal congestion.
4.Headache: tumor invasion or compression of skull base will lead to intractable headache.
5. Swollen lymph nodes in the neck: The rate of nasopharyngeal cancer metastasis in the neck is high, and swollen lymph nodes in the neck is the first symptom of 60%. It is possible to have lymph node metastasis in the neck alone without all the above symptoms.
6.Brain nerve symptoms: Nasopharyngeal cancer invading the abducens nerve can cause limited eye abduction and then diplopia. Invasion of other brain nerves such as trigeminal nerve can cause migraine and facial numbness.
7.Dermatomyositis
8.Distant metastasis: late stage nasopharyngeal carcinoma can appear bone, lung and liver metastasis.
Examination.
1.Indirect nasopharyngoscopy.
2.Neck palpation.
3.Electronic fiberoptic nasopharyngoscopy or fiberoptic nasopharyngoscopy or nasal endoscopy.
4.EBV serological examination.
5.Imaging.
Diagnosis and treatment.
Diagnosis requires a biopsy. The doctor will first ask you to make a pathological section, and after the diagnosis is confirmed, you will be asked to do a CT or MRI examination to determine the extent of the lesion, and a series of systemic examinations to exclude the possibility of systemic metastasis, and then a reasonable treatment plan will be given on a comprehensive basis.
Radiotherapy: radiation therapy is the best treatment for nasopharyngeal carcinoma, which uses radiation to kill the tumor, and the course of treatment takes about 2 months and can be performed in an outpatient or inpatient setting. Early stage nasopharyngeal cancer can be cured by radiation therapy alone. However, with the improvement of radiation technology, such complications are greatly reduced and patients’ quality of life is improved. Never give up treatment for fear of side effects and lose a good chance of cure.
Chemotherapy: For middle and late stage nasopharyngeal cancer, the recurrence rate of radiotherapy alone is high, therefore, adjuvant radiotherapy is very necessary, and chemotherapy can be done before or after radiotherapy, or at the same time. Chemotherapy, i.e. drug therapy, has toxic effects on normal organism while killing tumor, including gastrointestinal reaction, hair loss, liver and kidney function damage, bone marrow suppression, allergic reaction, etc. However, it is still an indispensable adjuvant in comprehensive tumor treatment, in fact, under the guidance of doctors, we can kill tumor while reducing side effects. During the treatment process, your doctor will draw blood tests for you regularly to monitor the damage of chemotherapy drugs on your body in order to respond to it timely and effectively. Therefore, active cooperation with your doctor will facilitate faster recovery from the disease.
Surgery: Surgery is not preferred for nasopharyngeal cancer, but it can be considered in the following cases.
1. Local tumor is not controlled after sufficient radiotherapy and chemotherapy
2. Residual lymph nodes in the neck after adequate radiotherapy or chemotherapy
3. Local tumor recurrence and lymph node recurrence in the neck one year after adequate radiotherapy and chemotherapy, but no distant metastasis
4. Otitis media with secretion caused by radiotherapy
5. Radiation therapy-induced maxillary osteonecrosis
6. Radiation sinusitis
7. Secondary tumor caused by radiotherapy and chemotherapy
8. Radiotherapy-induced nasal adhesion atresia
Prevention.
Can nasopharyngeal cancer be prevented? Because early detection of tumor, the cure rate can be as high as 90%. Now we will give you some suggestions for reference.
1. Correct bad dietary habits: do not eat salted fish and pickled products.
If you live in an area with a high incidence of disease or have a history of nasopharyngeal cancer in your immediate family, you should have a regular physical examination of the nasopharynx every year.
2.If the aforementioned symptoms appear, you should seek medical attention in time, instead of avoiding the disease. Early consultation can not only increase the cure rate but also reduce medical costs.
3.Earth, nose and throat specialists should be consulted instead of medical and surgical doctors, as non-specialists may also miss the diagnosis.
4.After being diagnosed with nasopharyngeal cancer, one should not be afraid and should not give up the treatment, for the patient, having a strong heart is more effective than any treatment.