The incidence of nasopharyngeal cancer is higher in the south of China, especially in the central and western regions of Guangdong, Zhaoqing, Foshan and Guangzhou. There are significant racial differences, and the peak incidence is between 40 and 60 years old. The cause of nasopharyngeal cancer may be related to EBV infection, environment, diet and genetic factors. The early manifestations are: 1. Blood in the nose or epistaxis accounts for 23.2% of the initial symptoms, and 73.7% of patients have this manifestation at the time of diagnosis. The back of the soft palate rubs against the tumor when the nasal cavity or nasopharyngeal secretion is sucked back hard, which may cause aspiration (also called retractable aspiration) in mild cases, often occurring in the morning after waking up and humming bloody nasal discharge from the mouth.
2. Tinnitus and hearing loss Tinnitus accounts for 19.8% of the initial symptoms and is present in 62.6% of patients at the time of diagnosis. Hearing loss accounts for 14.1% of the initial symptoms and is present in 49.9% of patients at the time of diagnosis. Unilateral tinnitus or hearing loss and a sense of occlusion in the ear are among the symptoms of early nasopharyngeal carcinoma. It is caused by tumor infiltration and compression of the eustachian tube.
3.Nasal congestion 15-9% have this symptom at the beginning and 48-0% have it at the time of diagnosis. It is caused by the tumor invading the posterior part of nasal cavity.
4.Headache 26.9% have this symptom at the beginning and 68.6% have it at the time of diagnosis. Most of them are unilateral persistent pain, mostly in temporal and parietal areas. There are many causes of headache, but brain nerve damage or skull base bone destruction is one of the causes of headache.
5. Neck masses have a high incidence, accounting for 36.5% of the initial symptoms and up to 79.37% when diagnosed, because cancer cells have metastasized to the cervical lymph nodes. Upper cervical lymph nodes <4 cm in diameter and active are still considered as early stage. 6.Facial numbness and diplopia Facial numbness refers to the numbness of facial skin. Clinical examination shows that the pain and tactile sensation are reduced or disappeared, which is caused by the tumor invading the trigeminal nerve branches. 7.Nasopharyngoscopy It can directly see the nasopharyngeal cavity mass with rough surface mucosa, disappearance of pharyngeal fossa, deformation or asymmetry of nasopharyngeal cavity. CT examination can show the asymmetric soft tissue dense shadow and occupying lesion in the nasopharyngeal cavity, not only with deformation or asymmetry of the lumen, occlusion or disappearance of the pharyngeal fossa, but also with the spread of the tumor to the adjacent tissues outside the cavity causing narrowing or disappearance of the parapharyngeal space, and invasion of the carotid sheath area and the infratemporal fossa. Serologic diagnosis of EBV is important for the diagnosis and efficacy of EBV. IgA/VCA, IgA/EA and DNA enzyme tests are often performed simultaneously, if the IgA/VCA titer ≥ 1:40; two of the three tests are positive; any of the indicators continue to rise. Those who belong to one of the three conditions should be considered as high-risk group. The treatment of choice for nasopharyngeal cancer is radiation therapy. Radical radiation therapy can be used when the patient has good general condition, early local lesions, lymphatic metastases in the neck <8M, no supraclavicular lymph node metastases, no distant metastases, and no other diseases that seriously affect this treatment. Since nasopharyngeal carcinoma is sensitive to radiation, early stage patients can get a high 5-year survival rate after treatment. It is reported that the 5-year survival rate of stage I-II nasopharyngeal carcinoma is 58q7-76q1. Late stage nasopharyngeal carcinoma can be treated with palliative radiotherapy. Chemotherapy can be used in combination for patients with mid- to late-stage nasopharyngeal carcinoma to help improve the treatment effect.